Decrease in the plasma von Willebrand factor concentration following glucose ingestion: the role of insulin sensitivity.
Elevated plasma von Willebrand factor (vWF) concentration is thought to be associated with increased prevalence of cardiovascular events in the insulin resistance syndrome. We examined the effects of oral glucose challenge and accompanying metabolic and hemodynamic changes on vWF levels with respect to insulin sensitivity. Forty normotensive and hypertensive subjects (mean age +/- SD, 40 +/- 5 years) underwent a standard oral glucose tolerance test (OGTT). Plasma vWF antigen, glucose, insulin, catecholamines, and hemodynamics were measured at rest, and at 30, 60, 90, and 120 minutes after glucose intake. Insulin sensitivity was determined by the insulin sensitivity index (ISI(0,120)). Resting plasma vWF concentration was associated with screening systolic blood pressure (BP) (r =.43, P =.005). There were time effects for all variables of interest. While vWF antigen (P =.044), epinephrine (P =.003), and diastolic BP (P =.001) decreased after glucose challenge, norepinephrine (P =.009), systolic BP (P =.022), and heart rate (P <.001) increased. Decline in vWF (area under the curve) was associated with decrease in epinephrine (r =.46, P =.004) and with screening systolic BP (r =.45, P =.004). However, neither resting plasma vWF levels nor vWF decrease following glucose ingestion were significantly associated with the ISI(0,120.) The plasma vWF concentration decreases following glucose ingestion. While mechanisms underlying this phenomenon may relate to sympathetic nervous system function, they seem not related to insulin sensitivity. Endothelial dysfunction such as caused by hypertension rather than metabolic dysregulation per se may underlie the elevated plasma vWF concentration found with insulin resistance.
von Känel
R
R
Department of Psychiatry, University of California, San Diego, CA 92093-0804, USA.
Nelesen
R A
RA
Le
D T
DT
Ziegler
M G
MG
Dimsdale
J E
JE
D000328:Adult; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D004837:Epinephrine / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D044465:White People; D014841:von Willebrand Factor / Q000032:analysis*
D001786:Blood Glucose; D007328:Insulin; D014841:von Willebrand Factor; D009638:Norepinephrine; D004837:Epinephrine