The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study

Yuri D. Foreman; Martijn C.G.J. Brouwers; Tos T.J.M. Berendschot; Martien C.J.M. van Dongen; Simone J.P.M. Eussen; Marleen M.J. van Greevenbroek; Ronald M.A. Henry; Alfons J.H.M. Houben; Carla J.H. van der Kallen; Abraham A. Kroon; Koen D. Reesink; Miranda T. Schram; Nicolaas C. Schaper; Coen D.A. Stehouwer

doi:10.1186/s12933-019-0950-x

The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study

Yuri D. Foreman (Corresponding author), Martijn C.G.J. Brouwers, Tos T.J.M. Berendschot, Martien C.J.M. van Dongen, Simone J.P.M. Eussen, Marleen M.J. van Greevenbroek, Ronald M.A. Henry, Alfons J.H.M. Houben, Carla J.H. van der Kallen, Abraham A. Kroon, Koen D. Reesink, Miranda T. Schram, Nicolaas C. Schaper, Coen D.A. Stehouwer

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Abstract

Background: Daily glucose variability may contribute to vascular complication development irrespective of mean glucose values. The incremental glucose peak (IGP) during an oral glucose tolerance test (OGTT) can be used as a proxy of glucose variability. We investigated the association of IGP with arterial stiffness, arterial remodeling, and microvascular function, independent of HbA_1c and other confounders. Methods: IGP was calculated as the peak minus baseline plasma glucose value during a seven-point OGTT in 2758 participants (age: 60 ± 8 years; 48% women) of The Maastricht Study, an observational population-based cohort. We assessed the cross-sectional associations between IGP and arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV], carotid distensibility coefficient [carDC]), arterial remodeling (carotid intima-media thickness [cIMT]; mean [CWS_mean] and pulsatile [CWS_puls] circumferential wall stress), and microvascular function (retinal arteriolar average dilatation; heat-induced skin hyperemia) via multiple linear regression with adjustment for age, sex, HbA_1c, cardiovascular risk factors, lifestyle factors, and medication use. Results: Higher IGP was independently associated with higher cf-PWV (regression coefficient [B]: 0.054 m/s [0.020; 0.089]) and with higher CWS_mean (B: 0.227 kPa [0.008; 0.446]). IGP was not independently associated with carDC (B: - 0.026 10^-3/kPa [- 0.112; 0.060]), cIMT (B: - 2.745 μm [- 5.736; 0.245]), CWS_puls (B: 0.108 kPa [- 0.054; 0.270]), retinal arteriolar average dilatation (B: - 0.022% [- 0.087; 0.043]), or heat-induced skin hyperemia (B: - 1.380% [- 22.273; 19.513]). Conclusions: IGP was independently associated with aortic stiffness and maladaptive carotid remodeling, but not with carotid stiffness, cIMT, and microvascular function measures. Future studies should investigate whether glucose variability is associated with cardiovascular disease.

Original language	English
Article number	152
Number of pages	12
Journal	Cardiovascular Diabetology
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12933-019-0950-x
Publication status	Published - 14 Nov 2019

Funding

The Maastricht Study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), School for Cardiovascular Diseases (CARIM, Maastricht, the Netherlands), Care and Public Health Research Institute (CAPHRI, Maastricht, the Netherlands), School for Nutrition and Translational Research in Metabolism (NUTRIM, Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands), Health Foundation Limburg (Maastricht, the Netherlands), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands), Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands), and Medtronic (Tolochenaz, Switzerland).

Keywords

Arterial remodeling
Arterial stiffness
Glucose metabolism status
Glucose variability
Oral glucose tolerance test

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Foreman, Y. D., Brouwers, M. C. G. J., Berendschot, T. T. J. M., van Dongen, M. C. J. M., Eussen, S. J. P. M., van Greevenbroek, M. M. J., Henry, R. M. A., Houben, A. J. H. M., van der Kallen, C. J. H., Kroon, A. A., Reesink, K. D., Schram, M. T., Schaper, N. C., & Stehouwer, C. D. A. (2019). The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study. Cardiovascular Diabetology, 18(1), Article 152. https://doi.org/10.1186/s12933-019-0950-x

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title = "The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study",

abstract = "Background: Daily glucose variability may contribute to vascular complication development irrespective of mean glucose values. The incremental glucose peak (IGP) during an oral glucose tolerance test (OGTT) can be used as a proxy of glucose variability. We investigated the association of IGP with arterial stiffness, arterial remodeling, and microvascular function, independent of HbA1c and other confounders. Methods: IGP was calculated as the peak minus baseline plasma glucose value during a seven-point OGTT in 2758 participants (age: 60 ± 8 years; 48% women) of The Maastricht Study, an observational population-based cohort. We assessed the cross-sectional associations between IGP and arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV], carotid distensibility coefficient [carDC]), arterial remodeling (carotid intima-media thickness [cIMT]; mean [CWSmean] and pulsatile [CWSpuls] circumferential wall stress), and microvascular function (retinal arteriolar average dilatation; heat-induced skin hyperemia) via multiple linear regression with adjustment for age, sex, HbA1c, cardiovascular risk factors, lifestyle factors, and medication use. Results: Higher IGP was independently associated with higher cf-PWV (regression coefficient [B]: 0.054 m/s [0.020; 0.089]) and with higher CWSmean (B: 0.227 kPa [0.008; 0.446]). IGP was not independently associated with carDC (B: - 0.026 10-3/kPa [- 0.112; 0.060]), cIMT (B: - 2.745 μm [- 5.736; 0.245]), CWSpuls (B: 0.108 kPa [- 0.054; 0.270]), retinal arteriolar average dilatation (B: - 0.022% [- 0.087; 0.043]), or heat-induced skin hyperemia (B: - 1.380% [- 22.273; 19.513]). Conclusions: IGP was independently associated with aortic stiffness and maladaptive carotid remodeling, but not with carotid stiffness, cIMT, and microvascular function measures. Future studies should investigate whether glucose variability is associated with cardiovascular disease.",

keywords = "Arterial remodeling, Arterial stiffness, Glucose metabolism status, Glucose variability, Oral glucose tolerance test",

author = "Foreman, {Yuri D.} and Brouwers, {Martijn C.G.J.} and Berendschot, {Tos T.J.M.} and {van Dongen}, {Martien C.J.M.} and Eussen, {Simone J.P.M.} and {van Greevenbroek}, {Marleen M.J.} and Henry, {Ronald M.A.} and Houben, {Alfons J.H.M.} and {van der Kallen}, {Carla J.H.} and Kroon, {Abraham A.} and Reesink, {Koen D.} and Schram, {Miranda T.} and Schaper, {Nicolaas C.} and Stehouwer, {Coen D.A.}",

year = "2019",

month = nov,

day = "14",

doi = "10.1186/s12933-019-0950-x",

language = "English",

volume = "18",

journal = "Cardiovascular Diabetology",

issn = "1475-2840",

publisher = "BioMed Central",

number = "1",

}

Foreman, YD, Brouwers, MCGJ, Berendschot, TTJM, van Dongen, MCJM, Eussen, SJPM, van Greevenbroek, MMJ, Henry, RMA, Houben, AJHM, van der Kallen, CJH, Kroon, AA, Reesink, KD, Schram, MT, Schaper, NC & Stehouwer, CDA 2019, 'The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study', Cardiovascular Diabetology, vol. 18, no. 1, 152. https://doi.org/10.1186/s12933-019-0950-x

The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study. / Foreman, Yuri D. (Corresponding author); Brouwers, Martijn C.G.J.; Berendschot, Tos T.J.M. et al.
In: Cardiovascular Diabetology, Vol. 18, No. 1, 152, 14.11.2019.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling

T2 - the Maastricht study

AU - Foreman, Yuri D.

AU - Brouwers, Martijn C.G.J.

AU - Berendschot, Tos T.J.M.

AU - van Dongen, Martien C.J.M.

AU - Eussen, Simone J.P.M.

AU - van Greevenbroek, Marleen M.J.

AU - Henry, Ronald M.A.

AU - Houben, Alfons J.H.M.

AU - van der Kallen, Carla J.H.

AU - Kroon, Abraham A.

AU - Reesink, Koen D.

AU - Schram, Miranda T.

AU - Schaper, Nicolaas C.

AU - Stehouwer, Coen D.A.

PY - 2019/11/14

Y1 - 2019/11/14

N2 - Background: Daily glucose variability may contribute to vascular complication development irrespective of mean glucose values. The incremental glucose peak (IGP) during an oral glucose tolerance test (OGTT) can be used as a proxy of glucose variability. We investigated the association of IGP with arterial stiffness, arterial remodeling, and microvascular function, independent of HbA1c and other confounders. Methods: IGP was calculated as the peak minus baseline plasma glucose value during a seven-point OGTT in 2758 participants (age: 60 ± 8 years; 48% women) of The Maastricht Study, an observational population-based cohort. We assessed the cross-sectional associations between IGP and arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV], carotid distensibility coefficient [carDC]), arterial remodeling (carotid intima-media thickness [cIMT]; mean [CWSmean] and pulsatile [CWSpuls] circumferential wall stress), and microvascular function (retinal arteriolar average dilatation; heat-induced skin hyperemia) via multiple linear regression with adjustment for age, sex, HbA1c, cardiovascular risk factors, lifestyle factors, and medication use. Results: Higher IGP was independently associated with higher cf-PWV (regression coefficient [B]: 0.054 m/s [0.020; 0.089]) and with higher CWSmean (B: 0.227 kPa [0.008; 0.446]). IGP was not independently associated with carDC (B: - 0.026 10-3/kPa [- 0.112; 0.060]), cIMT (B: - 2.745 μm [- 5.736; 0.245]), CWSpuls (B: 0.108 kPa [- 0.054; 0.270]), retinal arteriolar average dilatation (B: - 0.022% [- 0.087; 0.043]), or heat-induced skin hyperemia (B: - 1.380% [- 22.273; 19.513]). Conclusions: IGP was independently associated with aortic stiffness and maladaptive carotid remodeling, but not with carotid stiffness, cIMT, and microvascular function measures. Future studies should investigate whether glucose variability is associated with cardiovascular disease.

AB - Background: Daily glucose variability may contribute to vascular complication development irrespective of mean glucose values. The incremental glucose peak (IGP) during an oral glucose tolerance test (OGTT) can be used as a proxy of glucose variability. We investigated the association of IGP with arterial stiffness, arterial remodeling, and microvascular function, independent of HbA1c and other confounders. Methods: IGP was calculated as the peak minus baseline plasma glucose value during a seven-point OGTT in 2758 participants (age: 60 ± 8 years; 48% women) of The Maastricht Study, an observational population-based cohort. We assessed the cross-sectional associations between IGP and arterial stiffness (carotid-femoral pulse wave velocity [cf-PWV], carotid distensibility coefficient [carDC]), arterial remodeling (carotid intima-media thickness [cIMT]; mean [CWSmean] and pulsatile [CWSpuls] circumferential wall stress), and microvascular function (retinal arteriolar average dilatation; heat-induced skin hyperemia) via multiple linear regression with adjustment for age, sex, HbA1c, cardiovascular risk factors, lifestyle factors, and medication use. Results: Higher IGP was independently associated with higher cf-PWV (regression coefficient [B]: 0.054 m/s [0.020; 0.089]) and with higher CWSmean (B: 0.227 kPa [0.008; 0.446]). IGP was not independently associated with carDC (B: - 0.026 10-3/kPa [- 0.112; 0.060]), cIMT (B: - 2.745 μm [- 5.736; 0.245]), CWSpuls (B: 0.108 kPa [- 0.054; 0.270]), retinal arteriolar average dilatation (B: - 0.022% [- 0.087; 0.043]), or heat-induced skin hyperemia (B: - 1.380% [- 22.273; 19.513]). Conclusions: IGP was independently associated with aortic stiffness and maladaptive carotid remodeling, but not with carotid stiffness, cIMT, and microvascular function measures. Future studies should investigate whether glucose variability is associated with cardiovascular disease.

KW - Arterial remodeling

KW - Arterial stiffness

KW - Glucose metabolism status

KW - Glucose variability

KW - Oral glucose tolerance test

UR - http://www.scopus.com/inward/record.url?scp=85075114512&partnerID=8YFLogxK

U2 - 10.1186/s12933-019-0950-x

DO - 10.1186/s12933-019-0950-x

M3 - Article

C2 - 31727061

SN - 1475-2840

VL - 18

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

IS - 1

M1 - 152

ER -

The oral glucose tolerance test-derived incremental glucose peak is associated with greater arterial stiffness and maladaptive arterial remodeling: the Maastricht study

Abstract

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Keywords

UN SDGs

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