Systemic hemodynamics in relation to glucose tolerance: the Health 2000 Survey

• Published in: Metabolism, clinical and experimental Vol. 60; no. 4; pp. 557 - 563
• Main Authors: Koivistoinen, Teemu, Jula, Antti, Aatola, Heikki, Kööbi, Tiit, Moilanen, Leena, Lehtimäki, Terho, Kähönen, Mika
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2011; Elsevier
• Subjects: Aged; Biological and medical sciences; Blood Glucose - metabolism; Body Mass Index; Cardiography, Impedance; Cholesterol, HDL - blood; Cluster Analysis; Cohort Studies; Diabetes Mellitus, Type 2 - physiopathology; Endocrinology & Metabolism; fasting; Feeding. Feeding behavior; Female; Finland - epidemiology; Fundamental and applied biological sciences. Psychology; glucose; Glucose Intolerance - physiopathology; glucose tolerance; Glucose Tolerance Test; glucose tolerance tests; Health Surveys; heart rate; Hemodynamics - physiology; Humans; linear models; Male; Middle Aged; middle-aged adults; noninsulin-dependent diabetes mellitus; Regression Analysis; risk; Smoking - physiopathology; surveys; Triglycerides - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Finland; Survey; Surveillance; Health; Tolerance; Disseminated; Glucose; Hemodynamics; Endocrinology
• ISSN: 0026-0495; 1532-8600; 1532-8600
• DOI: 10.1016/j.metabol.2010.05.010

The influence of impaired glucose metabolism—that is, impaired fasting glucose, impaired glucose tolerance (IGT), and type 2 diabetes mellitus diabetes (DM2)—on systemic hemodynamics is largely unknown. Therefore, we investigated the associations of glucose metabolism disturbances with stroke index (SI), cardiac index, systemic vascular resistance index (SVRI), arterial pulse wave velocity (PWV), and heart rate among Finnish adults (N = 389; mean age, 58.3 ± 7.9 years) participating in the Health 2000 Survey. Systemic hemodynamic parameters were measured using the whole-body impedance cardiography device, and an oral glucose tolerance test (OGTT) was performed to evaluate glucose tolerance status. We found a decreasing trend for SI and increasing trends for SVRI and PWV according to the worsening of glucose tolerance ( P for trend < .003 for all). In pairwise comparisons, SI was lower in the impaired fasting glucose group ( P = .041) and the IGT group ( P < .001) as compared with the normal glucose tolerance (NGT) group. Systemic vascular resistance index was higher in the IGT group ( P = .045) and the DM2 group ( P = .043) than in the NGT group. Subjects with IGT or DM2 had higher arterial PWV (10.7 ± 0.2 m/s, P < .001 and 11.7 ± 0.5 m/s, P = .001, respectively) than subjects with NGT (9.5 ± 0.1 m/s). Moreover, 2-hour glucose in OGTT was an independent determinant of SVRI and PWV ( P < .001 and P = .005, respectively) in multivariable linear regression models. In conclusion, the present study demonstrates that glucose intolerance, even without DM2, associates with several adverse changes in systemic hemodynamics and that 2-hour glucose in OGTT is an independent determinant of SVRI and PWV. These findings support the systematic evaluation of glucose tolerance status in the estimation of cardiovascular risk among the middle-aged population.