CLINICAL STUDY: ENDOTHELIAL FUNCTION
Oral glucose loading acutely attenuates endothelium-dependent vasodilation in healthy adults without diabetes: an effect prevented by vitamins C and E
Lawrence M. Title, MD*,
Peter M. Cummings, BA, MSc ,
Karen Giddens* and
Bassam A. Nassar, MB, PhD, BCh
* Division of Cardiology, Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada
Department of Pathology and Laboratory Medicine at the Queen Elizabeth II Health Sciences Center, Halifax, Nova Scotia, Canada
Manuscript received February 2, 2000;
revised manuscript received May 25, 2000,
accepted July 13, 2000.
Reprint requests and correspondence to: Dr. Lawrence Title, Queen Elizabeth II Health Sciences Center, Division of Cardiology, 6896-1796 Summer St., Halifax, Nova Scotia, Canada B3H 3A7
ltitle{at}is.dal.ca
OBJECTIVES
The goal of this study was to determine whether postprandial hyperglycemia, induced by oral glucose loading, attenuates endothelial function in healthy subjects without diabetes and whether coadministration of vitamins C and E could prevent these postprandial changes.
BACKGROUND
Epidemiologic evidence suggests that postprandial hyperglycemia, below diabetic levels, is a risk factor for cardiovascular disease. Postprandial hyperglycemia may promote atherosclerosis through endothelial dysfunction and oxidative stress.
METHODS
We evaluated the acute effects of oral glucose loading (75 g), alone and with vitamins C (2 g) and E (800 IU), on endothelium-dependent flow-mediated dilation (FMD) of the brachial artery, in a randomized, double-blind, placebo-controlled, crossover study of 10 healthy volunteers. Changes in the levels of markers of oxidative stress (plasma malondialdehyde and erythrocyte glutathione, glutathione peroxidase and superoxide dismutase) were also assessed.
RESULTS
Increases in plasma glucose and insulin after glucose loading were unaffected by vitamin coadministration. With glucose loading alone, FMD fell from 6.5 ± 2.2 at baseline to 5.4 ± 1.7, 3.7 ± 2.1*, 4.1 ± 3.5* and 5.7 ± 1.9% at 1, 2, 3 and 4 h (*p < 0.05 vs. 0 h). In contrast, FMD did not change significantly after glucose plus vitamins (6.4 ± 1.3, 7.6 ± 1.8, 7.9 ± 2.7, 6.9 ± 2.3, 6.9 ± 1.9% at 0, 1, 2, 3 and 4 h). By two-way repeated measures analysis of variance we found a significant interaction between vitamin treatment and time (p = 0.0003), indicating that vitamins prevented the glucose-induced attenuation of FMD. Oxidative stress markers did not significantly change with glucose loading alone or with vitamins.
CONCLUSIONS
Oral glucose loading causes an acute, transient decrease of FMD in healthy subjects without diabetes, which is prevented by vitamins C and E.
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Abbreviations and Acronyms
| | ANOVA | = analysis of variance | | FMD | = flow-mediated dilation | | IGT | = impaired glucose tolerance | | IRCM | = Institut de recherches cliniques de Montréal | | NO | = nitric oxide | | SOD | = superoxide dismutase |
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