Postprandial lipemia induces endothelial dysfunction and higher insulin resistance in healthy subjects

Abstract OBJECTIVES: The objective of the study was to evaluate the effect of metformin alone or in combination with coenzyme Q10 (CoQ10) on inflammatory changes and endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A total numbers of 54 patients with T2DM compared to 30 healthy subjects were divided into three groups: Group A (n = 30): healthy subjects without any medications; Group B (n = 24): T2DM patients treated with metformin 1 g/day; and Group C (n = 30): T2DM patients treated with metformin 1 g/day plus CoQ10, 300 mg/day. The duration of the study was 8 weeks. Fasting blood glucose, glycated hemoglobin, lipid profile, blood pressure variables, fasting insulin, insulin resistance, homeostatic model assessment of insulin resistance, vascular cell adhesion molecule 1 (VCAM-1), and E-selectin were measured before and after therapy. RESULTS: Metformin and/or CoQ10 therapy illustrated an insignificant effect on the fody mass index. This combination produced a significant improvement of metabolic changes in patients with T2DM (P < 0.01). sVCAM-1 serum level was decreased significantly after the initiation of metformin and/or CoQ10 therapy compared to the baseline P < 0.05. E-selectin was declined significantly following metformin monotherapy and after metformin plus CoQ10 therapy (P = 0.0001). CONCLUSION: CoQ10 add-on metformin therapy improves endothelial dysfunction and inflammatory changes in patients with T2DM alongside with amelioration of metabolic profile.

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Effects of glucagon-like peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00237.2004 ◽

2004 ◽

Vol 287 (6) ◽

pp. E1209-E1215 ◽

Cited By ~ 432

Author(s):

Thomas Nyström ◽

Mark K. Gutniak ◽

Qimin Zhang ◽

Fan Zhang ◽

Jens Juul Holst ◽

...

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Healthy Subjects ◽

Stable Coronary Artery Disease ◽

Artery Disease ◽

Type 2 Diabetic ◽

Diabetes Patients

GLP-1 stimulates insulin secretion, suppresses glucagon secretion, delays gastric emptying, and inhibits small bowel motility, all actions contributing to the anti-diabetogenic peptide effect. Endothelial dysfunction is strongly associated with insulin resistance and type 2 diabetes mellitus and may cause the angiopathy typifying this debilitating disease. Therefore, interventions affecting both endothelial dysfunction and insulin resistance may prove useful in improving survival in type 2 diabetes patients. We investigated GLP-1's effect on endothelial function and insulin sensitivity (SI) in two groups: 1) 12 type 2 diabetes patients with stable coronary artery disease and 2) 10 healthy subjects with normal endothelial function and SI. Subjects underwent infusion of recombinant GLP-1 or saline in a random crossover study. Endothelial function was measured by postischemic FMD of brachial artery, using ultrasonography. SI [in (10−4 dl·kg−1·min−1)/(μU/ml)] was measured by hyperinsulinemic isoglycemic clamp technique. In type 2 diabetic subjects, GLP-1 infusion significantly increased relative changes in brachial artery diameter from baseline FMD(%) (3.1 ± 0.6 vs. 6.6 ± 1.0%, P < 0.05), with no significant effects on SI (4.5 ± 0.8 vs. 5.2 ± 0.9, P = NS). In healthy subjects, GLP-1 infusion affected neither FMD(%) (11.9 ± 0.9 vs. 10.3 ± 1.0%, P = NS) nor SI (14.8 ± 1.8 vs. 11.6 ± 2.0, P = NS). We conclude that GLP-1 improves endothelial dysfunction but not insulin resistance in type 2 diabetic patients with coronary heart disease. This beneficial vascular effect of GLP-1 adds yet another salutary property of the peptide useful in diabetes treatment.

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Endothelial Dysfunction and Subclincal Atherosclerosis in Insulin Resistance Syndrome

Hypertension ◽

10.1161/hyp.36.suppl_1.690-a ◽

2000 ◽

Vol 36 (suppl_1) ◽

pp. 690-690

Author(s):

Akira Satoh ◽

Hidehiro Matsuoka ◽

Shuji Iida ◽

Kei Fukami ◽

Seiya Okuda ◽

...

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Mean Arterial Pressure ◽

Endothelial Dysfunction ◽

Healthy Subjects ◽

Structural Changes ◽

Subclinical Atherosclerosis ◽

Insulin Resistance Syndrome ◽

Large Artery ◽

Apparently Healthy

68 Insulin resistance syndrome, which constitutes obesity, hypertension, impaired glucose tolerance, and low high density lipoprotein is closely associated with cardiovascular events. Impairment of endothelial function precedes and exacerbates atherosclerosis. Accordingly, the aim of this study was to investigate a possible link among endothelial dysfunction, subclinical atherosclerosis, and insulin resistance syndrome. First, to examine the association between functional changes of large artery and insulin resistance syndrome, flow-mediated vasodilation (FMD) of the brachial artery was examined by high resolution ultrasonography, as a non-invasive measure of endothelial function in subjects without cardiovascular diseases (n=75). Coronary risk factors, including factors constituting insulin resistance syndrome were evaluated as well. Univariate and multivariate analyses revealed that FMD was inversely correlated with body mass index (BMI; r=-.26, p<0.03), mean arterial pressure (r=-.27, p<0.03), HbA1C (r=-.39, p<0.01), triglyceride (r=-.37, p<0.01), and the number of risk factors (r=-.47, p<0.001). Second, to examine the association between structural changes of large artery and insulin resistance syndrome in apparently healthy subjects (n=545), duplex scanning of the carotid arteries was performed to measure the intima-media thickness (IMT), an index of subclinical atherosclerosis. Age-adjusted-IMT was positively correlated with BMI (r=.14, p<0.002), mean arterial pressure (r=.27, p<0.001), HbA1C (r=.40, p<0.001), triglyceride (r=.12, p<0.005), HOMA, an index of insulin resistance, (r=.17, p<0.007), and the number of risk factors (r=.37, p<0.001). Finally, FMD was inversely correlated with IMT (r=-.28, p<0.03). Thus, the factors constituting insulin resistant syndrome were closely associated with both functional and structural changes of arteries in apparently healthy subjects. Our results suggest that insulin resistance may play a key role in the early process of atherosclerosis.

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