Forearm vascular control during acute hyperglycemia in healthy humans.
The vascular endothelium is a site of pathological changes in patients with diabetes mellitus that may be related to severe chronic hyperglycemia. However, it is unclear whether transient hyperglycemia alters vascular function in an otherwise healthy human forearm. To test the hypothesis that acute, moderate hyperglycemia impairs endothelium-dependent forearm vasodilation, we measured vasodilator responses in 25 healthy volunteers (11 F, 14 M) assigned to one of three protocols. In protocol 1, glucose was varied to mimic a postprandial pattern (i.e., peak glucose approximately 11.1 mmol/l) commonly observed in individuals with impaired glucose tolerance. Protocol 2 involved 6 h of mild hyperglycemia (approximately 7 mmol/l). Protocol 3 involved 6 h of euglycemia. Glucose concentration was maintained with a variable systemic glucose infusion. Insulin concentrations were maintained at approximately 65 pmol/l by means of a somatostatin and "basal" insulin infusion. Glucagon and growth hormone were replaced at basal concentrations. Forearm blood flow (FBF) was calculated from Doppler ultrasound measurements at the brachial artery. In each protocol, FBF dose responses to intrabrachial acetylcholine (ACh) and sodium nitroprusside (NTP) were assessed at baseline and at 60, 180, and 360 min of glucose infusion. Peak endothelium-dependent vasodilator responses to ACh were not diminished by hyperglycemia in any trial. For example, peak responses to ACh during protocol 2 were 307 +/- 47 ml/min at euglycemic baseline and 325 +/- 52, 353 +/- 65, and 370 +/- 70 ml/min during three subsequent hyperglycemic trials (P = 0.46). Peak endothelium-independent responses to NTP infusion were also unaffected. We conclude that acute, moderate hyperglycemia does not cause short-term impairment of endothelial function in the healthy human forearm.
Department of Endocrinology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Ann S
AS
Reed
Nisha
N
Charkoudian
Adrian
A
Vella
Pankaj
P
Shah
Robert A
RA
Rizza
Michael J
MJ
Joyner
D000222:Adaptation, Physiological / Q000502:physiology; D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D002096:C-Peptide; D002908:Chronic Disease; D005260:Female; D005542:Forearm / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015309:Glucose Clamp Technique / Q000379:methods; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000378:metabolism / Q000503:physiopathology; D007328:Insulin / Q000097:blood*; D008297:Male; D008657:Metabolic Clearance Rate; D012039:Regional Blood Flow / Q000502:physiology; D014463:Ultrasonography
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin