title: Glycemic associations with endothelial function and biomarkers among 5 ethnic groups: the Multi-Ethnic Study of Atherosclerosis and the Mediators of Atherosclerosis in South Asians Living in America studies.
abstract: BACKGROUND
  The association of prediabetic states with endothelial dysfunction measured by flow-mediated dilation (FMD) or endothelial biomarker levels remains controversial. We examined data from 5 ethnic groups to determine the association between glucose categories and FMD or endothelial biomarkers. We determined whether these associations vary by ethnic group or body mass index.
  
  
  RESULTS
  We used data from 3516 participants from 5 race/ethnic groups with brachial FMD, endothelial biomarkers, and glucose category (normal, impaired fasting glucose [IFG], and diabetes) measures. There were significant ethnic differences in FMD, biomarker levels, and the prevalence of IFG and diabetes. However, all 5 ethnic groups showed similar patterns of higher FMD for the IFG group compared with the normal glucose and diabetes groups, which was most significant among whites and Asian Indians. Associations between glucose categories and endothelial biomarkers were more uniform, with the IFG and diabetes groups having higher biomarker levels than the normal glucose group. These associations did not change with further adjustment for fasting insulin levels. Whites with normal BMI had higher FMD values with higher glucose levels, but those with BMI in the overweight or obese categories had the inverse association (P for interaction=0.01).
  
  
  CONCLUSIONS
  The discordance of IFG being associated with higher FMD but more abnormal endothelial biomarker levels is a novel finding. This higher FMD for the IFG group was most notable in whites of normal BMI. The higher FMD among those with impaired fasting glucose may reflect differences in insulin signaling pathways between the endothelium and skeletal muscle.
authors.affiliation: University of California, San Francisco, CA 94143-0320, USA. alka.kanaya@ucsf.edu
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
authors.forename: Devon A
authors.initials: DA
authors.lastname: Dobrosielski
authors.forename: Peter
authors.initials: P
authors.lastname: Ganz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Creasman
authors.forename: Ritu
authors.initials: R
authors.lastname: Gupta
authors.forename: Vidya
authors.initials: V
authors.lastname: Nelacanti
authors.forename: Jens
authors.initials: J
authors.lastname: Vogel-Claussen
authors.forename: David
authors.initials: D
authors.lastname: Herrington
mesh_terms: D001741:Black or African American; D000368:Aged; D001213:Asian; D044466:Asian People; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007194:India / Q000208:ethnology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000208:ethnology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011236:Prediabetic State / Q000097:blood / Q000000981:diagnostic imaging / Q000208:ethnology / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014664:Vasodilation; D044465:White People; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019040:E-Selectin; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; C546936:SELE protein, human; C051321:SERPINE1 protein, human; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1