Apolipoprotein E Genotype and Sex Influence Glucose Tolerance in Older Adults: A Cross-Sectional Study

Background: Glucose intolerance and apolipoprotein ε4 allele (E4+) are risk factors for Alzheimer's disease (AD). Insulin sensitizers show promise for treating AD, but are less effective in E4+ individuals. Little is known about how the APOE genotype influences glucose metabolism. Methods: Cross-sectional analysis of 319 older adults who underwent oral glucose tolerance tests; a subset had insulin, amyloid beta (Aβ42), and Mini Mental Status Examination. Glucose and insulin patterns with respect to cognitive diagnosis, E4 status, and sex were examined with analysis of covariance and Pearson correlation. Results: People with cognitive impairment had higher fasting insulin levels. E4 status did not affect fasting glucose values, whereas men had higher fasting glucose levels than women. E4+ men had the lowest and E4+ women had the highest glucose levels, compared to E4- groups; insulin did not differ by sex or E4 group. E4 status and sex moderated correlations between metabolic measures and AD risk factors including age and Aβ. Conclusions: Insulin resistance was associated with cognitive impairment, and sex, E4 status, and glucose values are interrelated in older adults at risk of AD. Understanding glucose metabolism for different APOE and sex groups may help elucidate differences in therapeutic responses.

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Assessment of cardiovascular risk factors in persons with impaired glucose tolerance

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh180212048n ◽

2019 ◽

Vol 147 (7-8) ◽

pp. 416-421

Author(s):

Tatjana Novakovic ◽

Zlatica Mirkovic ◽

Nenad Milosevic ◽

Zorica Zivkovic ◽

Dijana Miric ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Cardiovascular Risk Factors ◽

Glucose Tolerance Test ◽

Fasting Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Glucose Levels

Introduction/Objective. The aim of the study was to determine the profile of cardiovascular risk factors in patients with impaired glucose tolerance (IGT) in comparison to patients with impaired fasting glucose (IFG). Methods. The study consisted of 222 adult participants with established fasting blood glucose values within the 5.6?6.9 mmol/L range. IGT was defined as blood glucose of 7.8?11.1 mmol/L in the second hour after the administration of 75 g during oral glucose tolerance test. IFG is the metabolic state between normal and impaired glucose tolerance, where fasting glucose levels are 5.6?6.9 mmol/L, and normal oral glucose tolerance test values. IGT was confirmed in 142 of these individuals (107 females and 35 males; aged 54 ? 13 years). The remaining 80 participants (56 females and 24 males, p = 0.329; aged 53 ? 13 years, p = 0.76) were considered the IFG group. The following parameters were analyzed in both groups: body mass index, waist circumference, blood pressure, fasting glucose, fasting insulin levels, HOMA-IR (homeostasis model assessment ? insulin resistance), C-reactive protein, fibrinogen concentrations and lipid profile. Results. Participants in the IGT group were more obese than those in the IFG group (body mass index 30.8 ? 5.5 kg/m2 vs. 26.7 ? 3.8 kg/m2, p < 0.001), and with greater waist circumference (111 ? 12 cm vs. 101 ? 6 cm; p < 0.001). Glucose levels (6.02 ? 0.75 mmol/L vs. 5.80 ? 0.62 mmol/L; p < 0.001), and blood insulin levels (21.61 ? 3.46 vs. 6.00 ? 2.8 mIU/L; p < 0.001), as well as HOMA-IR (5.78 ? 2.68 mIU/L vs. 1.54 ? 1.46 mIU/L; p < 0.001) were also higher in the IGT group. Median levels of HbA1c in IGT subjects were higher compared with those in the IFG group, but the difference was not statistically significant (6.21 ? 0.75% vs. 5.92 ? 0.43%; p = 0.105). Median hs-CRP levels in the IGT subjects (6.7 ? 4.88 mg/L) were higher than in the IFG subjects (5.83 ? 6.47 mg/L), but without statistical significance (p = 0.76). Conclusion. Our study indicates the presence of a large number of cardiovascular risk factors in both groups. Still, obesity, hyperinsulinemia, hypercholesterolemia, hypertriglyceridemia, higher diastolic blood pressure, as well as sedentary lifestyle, were statistically significantly more prevalent in patients with IGT.

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Identification of factors differentially associated with isolated impaired fasting glucose and isolated post-load impaired glucose tolerance: the Hong Kong Cardiovascular Risk Factor Study

Acta Endocrinologica ◽

10.1530/eje.1.02250 ◽

2006 ◽

Vol 155 (4) ◽

pp. 623-632 ◽

Cited By ~ 11

Author(s):

G Neil Thomas ◽

C Mary Schooling ◽

Sarah M McGhee ◽

Sai-Yin Ho ◽

Bernard M Y Cheung ◽

...

Keyword(s):

Hong Kong ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Glucose Intolerance ◽

Impaired Fasting Glucose ◽

Early Life ◽

Fasting Glucose ◽

Oral Glucose ◽

Hip Circumference ◽

Glucose Levels

Background: The use of fasting and post-prandial glucose levels in the classification of hyperglycaemic states often identifies distinct subjects, but the factors determining these intermediate-isolated glucose intolerant states are yet to be clearly elucidated in Chinese subjects. Methods: Representative subjects (n = 2769) were randomly recruited from the Hong Kong Chinese population and glycaemic status was determined using both fasting and 2h 75 g oral glucose tolerance test glucose levels. The relationship between the groups with isolated glucose intolerance and vascular risk factors was investigated using ANOVA and logistic regression analyses. Results: Using either criterion, diabetes was identified in 265 (9.6%) subjects and glucose intolerance in 568 (20.5%) subjects. Of those 568, isolated impaired glucose tolerance (IGT) using the post-load criterion was identified in 49.5% and isolated impaired fasting glucose (IFG) in 30.5%. Ageing and hyperinsulinaemia were common determinants of IGT and IFG; with small hip circumference a marker of poorer early life development and being born in China rather than Hong Kong, a possible low birth weight marker was also associated with IFG. Hypertension, hypertriglyceridaemia and poor education were also associated with IGT. When we looked for factors differentially associated with these glucose intolerant states, female sex, greater hip circumference, high triglyceride levels, low fasting insulin levels, and not being born in China were independently associated with isolated IGT compared with isolated IFG. Conclusion: Despite common antecedents to the glucose intolerant states, isolated IFG appeared to be particularly associated with early life development, and isolated IGT was more strongly associated with obesity-related determinants such as hypertriglyceridaemia.

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Impaired Fasting Glucose in Nondiabetic Range: Is It a Marker of Cardiovascular Risk Factor Clustering?

Disease Markers ◽

10.1155/2015/804739 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Giovanna Valentino ◽

Verónica Kramer ◽

Lorena Orellana ◽

María José Bustamante ◽

Cinthia Casasbellas ◽

...

Keyword(s):

Risk Factors ◽

Impaired Fasting Glucose ◽

Aerobic Capacity ◽

Fasting Glucose ◽

Hdl Cholesterol ◽

Cross Sectional Study ◽

Cross Sectional ◽

Glucose Levels ◽

Framingham Risk ◽

And Gender

Background. Impaired fasting glucose (IFG) through the nondiabetic range (100–125 mg/dL) is not considered in the cardiovascular (CV) risk profile. Aim. To compare the clustering of CV risk factors (RFs) in nondiabetic subjects with normal fasting glucose (NFG) and IFG. Material and Methods. Cross-sectional study in 3739 nondiabetic subjects. Demographics, medical history, and CV risk factors were collected and lipid profile, fasting glucose levels (FBG), C-reactive protein (hsCRP), blood pressure (BP), anthropometric measurements, and aerobic capacity were determined. Results. 559 (15%) subjects had IFG: they had a higher mean age, BMI, waist circumference, non-HDL cholesterol, BP, and hsCRP (p<0.0001) and lower HDL (p<0.001) and aerobic capacity (p<0.001). They also had a higher prevalence of hypertension (34% versus 25%; p<0.001), dyslipidemia (79% versus 74%; p<0.001), and obesity (29% versus 16%; p<0.001) and a higher Framingham risk score (8% versus 6%; p<0.001). The probability of presenting 3 or more CV RFs adjusted by age and gender was significantly higher in the top quintile of fasting glucose (≥98 mg/dL; OR = 2.02; 1.62–2.51). Conclusions. IFG in the nondiabetic range is associated with increased cardiovascular RF clustering.

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A CROSS-SECTIONAL STUDY OF THE ASSOCIATION BETWEEN THE 1-HOUR ORAL GLUCOSE TOLERANCE TEST AND THE METABOLIC SYNDROME IN A HIGH-RISK SAMPLE WITH IMPAIRED FASTING GLUCOSE

Endocrine Practice ◽

10.4158/ep-2019-0387 ◽

2020 ◽

Vol 26 (5) ◽

pp. 529-534

Author(s):

Juan Carlos Lizarzaburu-Robles ◽

Lizardo Torres-Aparcana ◽

Raúl Mansilla ◽

José Valera ◽

Gabriela Vargas ◽

...

Keyword(s):

Metabolic Syndrome ◽

Glucose Tolerance ◽

Oral Glucose Tolerance Test ◽

Impaired Fasting Glucose ◽

Glucose Tolerance Test ◽

Fasting Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Glucose Levels

Objective: The aim of this study was to evaluate the association between the 1-hour oral glucose tolerance test (OGTT) (≥155 mg/dL) and metabolic syndrome (MS) in a sample with previous impaired fasting glucose (IFG). Methods: Three hundred and twenty four Peruvian subjects with a history of IFG ≥100 mg/dL were selected for a cross-sectional study. They underwent a 75 g OGTT and were assigned to different groups according to the result. We evaluated the association between 1-hour OGTT and MS. Results: The mean age was 56.5 ± 12.6 years and 191 (61.5%) were female. During the OGTT, we found 28 (8.6%) subjects with diabetes, 74 (22.8%) with IGT, and 222 (68.5%) with a normal glucose tolerance test with a 2-hour glucose <140 mg/dL (NGT). In the NGT group, 124 (38.3%) had 1-hour glucose levels <155 mg/dL, while 98 (30.2%) had 1-hour glucose levels ≥155 mg/dL. Evaluating the association between the 1-hour value in the OGTT and MS, we found that subjects with a 1-hour glucose ≥155 mg/dL were more than twice as likely to have MS as those with a 1-hour glucose <155 mg/dL (odds ratio = 2.64, 95% confidence interval: 1.52 to 4.57). In addition, body mass index, fasting glycemia, triglycerides, and waist circumferences were significantly higher in subjects with 1-hour glucose levels ≥155 mg/dL compared to those with 1-hour glucose levels <155 mg/dL ( P<.05). Conclusion: Among subjects with IFG, performing an OGTT was helpful to identify subjects with 1-hour glucose levels ≥155 mg/dL and NGT who were significantly more likely to have MS and a worse cardiometabolic risk profile. Abbreviations: AST = aspartate aminotransferase; BMI = body mass index; CI = confidence interval; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; LDL = low-density lipoprotein; MS = metabolic syndrome; NGT = normal glucose tolerance; OGTT = oral glucose tolerance test; OR = odds ratio; T2DM = type 2 diabetes; TG = triglycerides

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Abstract P337: Association of Glucose Intolerance and Insulin Resistance with Incident Cardiovascular Disease in a Japanese Urban Cohort: The Suita Study

Circulation ◽

10.1161/circ.131.suppl_1.p337 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Yoshihiro Kokubo ◽

Makoto Watanabe ◽

Aya Higashiyama ◽

Yoko M Nakao ◽

Takashi Kobayashi ◽

...

Keyword(s):

Insulin Resistance ◽

Cardiovascular Disease ◽

Glucose Tolerance ◽

Cerebral Infarction ◽

Glucose Intolerance ◽

Fasting Glucose ◽

Tolerance Test ◽

Normal Glucose Tolerance ◽

Oral Glucose ◽

Glucose Levels

Introduction: Glucose intolerance and insulin resistance are known risk factors for cardiovascular disease (CVD). However, few prospective studies were reported the association between combinations of these two factors and incident CVD. We assessed the hypothesis that insulin resistance increased the association between glucose intolerance and CVD in Japanese general population. Methods: We studied 4,638 Japanese individuals (mean age 56.1 years, without CVD) who completed a baseline medical examination and a 75g oral glucose tolerance test in the Suita Study. Glucose categories were defined as follows: diabetes mellitus (DM; fasting plasma glucose levels [FPG] ≥126 mg/dL, 2 hours post-loaded glucose levels [2h-PG] ≥ 200 mg/dL, and/or DM medication); impaired glucose tolerance (IGT; FPG <126 mg/dL and 2h-PG =140-199 mg/dL); impaired fasting glucose (IFG; FPG =100-125 mg/dL and 2h-PG <140 mg/dL); and normal glucose tolerance [NGT]. Insulin resistance was the following formula: HOMA-IR = [FPG] x [fasting insulin] / 405. Insulin resistance was defined as HOMA-IR ≥2.5. Multivariable-adjusted Cox proportional hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated after adjusting for age, sex, body mass index, blood pressure category, hyperlipidemia, smoking, and drinking at the baseline. Results: During the 11.7-year follow-up, we documented 127 cerebral infarctions, 63 hemorrhagic stroke, 12 unclassified strokes, and 143 coronary heart disease events. The adjusted HRs (95% CIs) of subjects with FPG =100-125 mg/dL and ≥126 mg/dL were 1.38 (1.01-1.89) and 2.00 (1.12-3.58) for stroke and 1.47 (0.99-2.19) and 2.73 (1.43-5.22) for cerebral infarction, respectively, compared with the fasting NGT group. On the basis of the subjects with 2h-PG <140 mg/dL group, the adjusted HRs (95% CIs) of subjects with 2h-PG ≥200 mg/dL were 1.71 (1.07-2.72) for stroke and 2.06 (1.20-3.54) for cerebral infarction. Compared to the NGT group, the adjusted HRs (95% CIs) of the subjects with IFG, IGT, and DM were 1.59 (1.10-2.30), 1.34 (0.89-2.00), and 1.86 (1.16-3.00) for stroke and 1.82 (1.13-2.90), 1.55 (0.93-2.56), and 2.43 (1.39-4.26) for cerebral infarction, respectively. Compared to the subjects with HOMA-IR <1.5, the adjusted HRs (95% CIs) of CVD and stroke with HOMA-IR ≥2.5 were 1.45 (1.07-1.96) and 1.61 (1.07-2.42), respectively. Compared to the NGT group without insulin resistance, the IFG and DM groups with insulin resistance were observed the increased risks of stroke (HRs [95% CIs]; 2.05 [1.17-3.57] and 2.11 [1.17-3.83]) and cerebral infarction (HRs [95% CIs]; 2.45 [1.20-5.00] and 3.56 [1.84-6.88]), respectively. Conclusions: Fasting glucose intolerance and insulin resistance are predictive factors for the incidence of stroke and cerebral infarction. Insulin resistance increased the risks of incident stroke and cerebral infarction in general inhabitants with IFG and DM.

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High prevalence of steroid-induced glucose intolerance with normal fasting glycaemia during low-dose glucocorticoid therapy: an oral glucose tolerance test screening study

Rheumatology ◽

10.1093/rheumatology/keaa724 ◽

2020 ◽

Author(s):

Karolina M Nowak ◽

Monika Rdzanek-Pikus ◽

Katarzyna Romanowska-Próchnicka ◽

Anna Nowakowska-Płaza ◽

Lucyna Papierska

Keyword(s):

Risk Factors ◽

Glucose Tolerance ◽

Fasting Glucose ◽

Tolerance Test ◽

Normal Glucose Tolerance ◽

Oral Glucose ◽

Fat Percentage ◽

Normal Glucose ◽

Normal Fasting Glucose ◽

History Of

Abstract Objectives To evaluate the prevalence and risk factors of new-onset glucose metabolism impairment using an oral glucose tolerance test (OGTT) in patients with normal fasting glycaemia on long-term glucocorticoid (GC) treatment. Methods An OGTT was performed in 150 patients without a previous history of pre-diabetes or diabetes who were diagnosed with inflammatory rheumatic diseases and treated with GCs >3 months. All participants underwent clinical and biochemical evaluation for risk factors of diabetes: age, sex, current and cumulative dose of steroids, treatment duration, waist circumference, BMI, Homeostatic Model Assessment for Insulin Resistance, fasting insulin concentration, family history of diabetes, CRP, 28-joint DAS with CRP, type of connective tissue disease and trunk fat percentage measured by DXA. Logistic regression analysis was conducted to evaluate the association between the presence of impaired glucose tolerance (IGT) in the OGTT and analysed risk factors. Results A total of 102 patients (68%) had fully normal glucose tolerance. Diabetes, isolated impaired fasting glucose, isolated IGT and combined impaired fasting glucose + IGT was diagnosed in 3.3, 4.67, 19.33 and 4.67% of patients, respectively; 20% of participants had IGT or diabetes despite normal fasting glucose concentration. The median cumulative dose and current dose (5 mg) of GCs and treatment duration were similar compared with the normal glucose tolerance group. In a multivariate logistic regression model, only older age (particularly ≥50 years of age) and trunk fat percentage remained significant factors predicting IGT or diabetes in the OGTT. Conclusion New-onset GC-induced glucose intolerance, even in patients on long-term low-dose treatment, is prevalent despite normal fasting glucose concentration and patients should be screened with an OGTT despite the absence of classic risk factors of diabetes.

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SAT-004 Prevalence of Abnormalities of Glucose Metabolism in Teenage Indian Girls with PCOS

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.172 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Vipan Talwar

Keyword(s):

Diabetes Mellitus ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Adolescent Girls ◽

Fasting Glucose ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Abnormal Glucose Metabolism

Abstract Background:Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders affecting young women and has been associated with an increased risk of impaired glucose tolerance and type 2 diabetes mellitus. However, there are very few studies on glucose abnormalities in Indian adolescent girls with PCOS. This study was conducted to determine the prevalence of abnormal glucose metabolism in this patient population. Method: Study group comprised of 106 young females aged 13–18 years. None of them were on metformin at the time of initial visit. Clinical examination along with Anthropometric evaluation was done and along with routine hormonal assessment they underwent a standard 75-g oral glucose tolerance test (OGTT). American Diabetes Association (ADA) criteria were used for diagnosis of diabetes (2 hr value>200mg/dl), Impaired glucose tolerance (2 hour value > 140 -199 mg/dl) and Impaired fasting glucose (blood glucose level of 100–125 mg/dl) Results:Out of 106 girls with PCOS diagnosis;1 girl met criteria for diagnosis of type 2 diabetes mellitus (0.9%).15 had impaired glucose tolerance (14.1%). In addition, 2 girls with impaired glucose tolerance were also noted to have impaired fasting glucose (1.9%).Abnormalities of glucose metabolism had significant correlation with BMI(p-0.02),Waist circumference (p-0.01) and testosterone levels (p-0.02). Conclusions:In our series of adolescent PCOS subjects, we report the prevalence of abnormal glucose metabolism to be 14.1% which is quite significant. Based on our results, we recommend that all adolescent girls with a diagnosis of PCOS should undergo formal oral glucose tolerance testing. Further studies are necessary in this field, so as to make guidelines regarding the timing and frequency of this testing, as well as its utility in the clinical management of these girls.

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Relation between plasma insulin and blood glucose in a cross-sectional population study of the oral glucose tolerance test

Acta Endocrinologica ◽

10.1530/acta.0.1020549 ◽

1983 ◽

Vol 102 (4) ◽

pp. 549-556 ◽

Cited By ~ 9

Author(s):

K. Berntorp ◽

E. Trell ◽

J. Thorell ◽

B. Hood

Keyword(s):

Body Weight ◽

Blood Glucose ◽

Glucose Tolerance ◽

Plasma Insulin ◽

Tolerance Test ◽

Oral Glucose ◽

Oral Glucose Tolerance ◽

Cross Sectional ◽

Glucose Levels ◽

Glucose Tolerance Tests

Abstract. In a material of 3596 oral glucose tolerance tests (OGTT) performed in a population investigation of middle-aged males in Malmö, fasting and 120 min values of blood glucose and plasma insulin immunoreactivity (IRI) were studied while taking factors like body weight, smoking, alcohol, gastric resection and selfreported diabetes heredity into account. The fasting as well as the 120 min levels of both glucose and IRI were markedly influenced by body weight and smoking habits but not by the hereditary background. At 120 min, but not in the fasting state, there was a linear correlation between the IRI and glucose levels. The increase of IRI on glucose was significantly steeper in most of the hereditary subjects in comparison with their non-hereditary controls.

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Glucose Metabolism Disorders and Risk Factors of Type 2 Diabetes in 45-74-Years-old Population in Rīga, Latvia

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/v10046-009-0049-y ◽

2009 ◽

Vol 63 (4-5) ◽

pp. 141-146

Author(s):

Noël Barengo ◽

Dana Misiņa ◽

Lauma Zariņa ◽

Jānis Kloviņš ◽

Dita Ozola ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Risk Factor ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Oral Glucose ◽

Glucose Metabolism Disorders ◽

Men And Women ◽

Risk Factor Profile

Glucose Metabolism Disorders and Risk Factors of Type 2 Diabetes in 45-74-Years-old Population in Rīga, Latvia The aims of this study were to investigate the current prevalence of abnormal glucose tolerance (AGT), compare the risk factor profile between persons with and without AGT among 45-74 years-old Latvian men and women, and to validate the Finnish diabetes risk score (FINDRISC) questionnaire in detecting AGT in the middle-aged Latvian population. A cross-sectional survey among the 45-74-years old population randomly selected from the registers of general practitioners in Rīga, Latvia was carried out between April 2008 and March 2009. The survey consisted of a questionnaire, measurements such as height, weight, waist circumference, and blood pressure as well as blood oral glucose tolerance test (OGTT), cholesterol and its fractions. Prevalence of obesity, central obesity and physical inactivity were high in the Latvian population. Women with AGT had a worse risk factor profile for T2D and cardiovascular diseases compared to those with normal glucose tolerance. No differences were found in the risk factor profile between men with and without AGT. A high proportion of men and women with more than 11 FINDRISC points had undetected AGT. The FINDRISC questionnaire can be used in clinical practice to detect persons with AGT in the Latvian population.

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Endothelial function and baroreflex sensitivity according to the oral glucose tolerance test in patients with coronary artery disease and normal fasting glucose levels

Clinical Science ◽

10.1042/cs20050095 ◽

2005 ◽

Vol 109 (4) ◽

pp. 397-403 ◽

Cited By ~ 5

Author(s):

Andrzej Wykretowicz ◽

Przemysław Guzik ◽

Grzegorz Bartkowiak ◽

Tomasz Krauze ◽

Ryszard Kąsinowski ◽

...

Keyword(s):

Coronary Artery ◽

Endothelial Dysfunction ◽

Glucose Metabolism ◽

Glucose Tolerance ◽

Endothelial Function ◽

Fasting Glucose ◽

Tolerance Test ◽

Oral Glucose ◽

Gensini Score ◽

Normal Fasting Glucose

Endothelial dysfunction and reduced BRS (baroreflex sensitivity) may be present in patients with CAD (coronary artery disease). The normal fasting glucose level does not exclude abnormal glucose metabolism in patients with CAD. The aim of present study was to evaluate endothelial function and BRS according to glucose metabolism in patients with normal fasting plasma glucose and stable CAD subjected to PTCA (percutaneous transluminal coronary angioplasty). Forty-six consecutive patients who underwent elective PTCA were studied (37 men; mean age 56 years). Endothelial function was assessed non-invasively using the arterial vasodilator response to salbutamol (albuterol). BRS was measured using a cross-correlation method. The extent of coronary narrowing was estimated by calculation of the Gensini score. All patients underwent a 75 g OGTT (oral glucose tolerance test). IGT (impaired glucose tolerance) or diabetes was present in approx. 60% of patients. The vasodilator response to salbutamol, as a measure of endothelial dysfunction, was significantly impaired in patients with IGT or diabetes compared with those with normal glucose tolerance (−0.5±1.6% compared with −7.9±2.2; P=0.01). Glucose metabolism and age were significant predictors of endothelial dysfunction (R2=35.2%, P=0.02). BRS did not differ significantly between patients with normal glucose tolerance and those with IGT or diabetes (6.9±1.2 compared with 6.1±0.6 ms/mmHg respectively; P=0.669). BRS was negatively correlated with age (r=−0.34, P=0.021) and the Gensini score (r=−0.34, P=0.022). The significant predictors of BRS were Gensini score, age and past myocardial infarction (R2=37.02%, P=0.002). Patients with established CAD, normal fasting glucose and IGT or diabetes demonstrated impaired endothelial function which did not correlate with the extent of coronary artery involvement. Conversely, BRS in the study population was not affected by glucose metabolism, but showed an interaction with the extent of coronary narrowing.

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