Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes.
OBJECTIVE
Augmentation index (AIx) and pulse wave velocity (PWV), both measures of arterial stiffness, constitute risk factors for cardiovascular disease. Notably, hyperglycaemia during an acute cardiovascular event is associated with poor prognosis. The objective of this study was to investigate whether acute hyperglycaemia increases arterial stiffness in patients with type 1 diabetes and in healthy subjects.


METHODS
Twenty-two male patients with type 1 diabetes and thirteen healthy men, who were age-matched non-smokers and without any diabetic complications, underwent a 120 min hyperglycaemic clamp (15 mmol/l). AIx was calculated to assess arterial stiffness. Before and during the clamp, carotid-radial (brachial) and carotid-femoral (aortic) PWV was measured.


RESULTS
At baseline there was a difference in the AIx between patients with type 1 diabetes and healthy volunteers (-5 +/- 2.7 vs -20 +/- 2.8%, p < 0.05). Acute hyperglycaemia rapidly increased AIx in patients with type 1 diabetes (-5 +/- 2.7 vs 8 +/- 2.5%, p < 0.001) and healthy volunteers (-20 +/- 2.8 vs 6 +/- 8.8%, p < 0.001). Brachial PWV increased during acute hyperglycaemia in patients with type 1 diabetes (7.1 +/- 1.2 vs 8.0 +/- 1.0 m/s, p < 0.001), but not in healthy men (7.4 +/- 1.7 vs 7.3 +/- 1.4 m/s, NS).


CONCLUSIONS
Acute hyperglycaemia increases the stiffness of intermediate-sized arteries and resistance arteries in young patients with type 1 diabetes and consequently emphasises the importance of strict daily glycaemic control. No change was observed in aortic PWV during the clamp, indicating that acute hyperglycaemia does not affect the large vessels.
Gordin
D
D
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Rönnback
M
M
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Forsblom
C
C
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Heikkilä
O
O
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Saraheimo
M
M
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Groop
P-H
PH
Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, POB 63, FIN-00014, Helsinki, Finland. per-henrik.groop@helsinki.fi.|Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. per-henrik.groop@helsinki.fi.
D000328:Adult; D001158:Arteries / Q000473:pathology* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D015309:Glucose Clamp Technique; D006339:Heart Rate; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology*; D008297:Male; D011674:Pulse; D012016:Reference Values
D001786:Blood Glucose