title: Diurnal glycemic fluctuation is associated with severity of coronary artery disease in prediabetic patients: Possible role of nitrotyrosine and glyceraldehyde-derived advanced glycation end products.
abstract: Glucose fluctuation (GF) is a risk factor for coronary artery disease (CAD). However, it remains unknown whether specific indices of GF are risk factors for CAD. Therefore, we evaluated the relationship between GF, as determined by a continuous glucose monitoring system (CGMS) or the glucose level at 2h after a 75-g oral glucose tolerance test (75g OGTT 120), and the severity of CAD in prediabetic patients. We also evaluated whether nitrotyrosine (NT) and glyceraldehyde-derived advanced glycation end-products (Glycer-AGE) were induced by GF.
  
  
  
  Twenty-eight prediabetic patients underwent coronary angiography (CAG), and the Gensini score and the SYNTAX score were evaluated as the severity of CAD, while the mean amplitude of glycemic excursions (MAGE) by CGMS and 75g OGTT 120 were evaluated. Serum NT and Glycer-AGE were measured.
  
  
  
  The MAGE was closely associated with the Gensini score (r=0.742, p<0.001) and the SYNTAX score (r=0.776, p<0.001), respectively. The 75g OGTT 120 was not associated with the Gensini score (r=0.36, p=0.06), but it was significantly associated with the SYNTAX score (r=0.413, p=0.036). Multiple linear regression analysis showed that the MAGE was the only independent determinant for the severity of CAD. The levels of NT and Glycer-AGE were significantly higher in the high MAGE group than in the low MAGE group.
  
  
  
  Diurnal GF is associated with the severity of CAD, even in prediabetic patients. GF, NT, and Glycer-AGE may play a pathological role in the progression of CAD.
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan. Electronic address: kawai@kanazawa-med.ac.jp.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kawai
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Kitayama
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Hironubu
authors.initials: H
authors.lastname: Akao
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Motoyama
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Wakasa
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Saito
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Aoki
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Kousuke
authors.initials: K
authors.lastname: Fujibayashi
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Taketsugu
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Forensic Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakanishi
authors.affiliation: Department of Forensic Medicine, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Saito
authors.affiliation: Department of Advanced Medicine, Medical Research Institute, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Cardiology, Kanazawa Medical University, Ishikawa, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Kajinami
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood*; D018450:Disease Progression; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State; D012720:Severity of Illness Index; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D001786:Blood Glucose; D017127:Glycation End Products, Advanced; C002744:3-nitrotyrosine; D014443:Tyrosine
keywords: Coronary artery disease; Glucose fluctuation; Glyceraldehyde-derived advanced glycation end-products; Nitrotyrosine