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1 Department of Endocrinology, Mayo Clinic, Rochester, MN, USA; General Clinical Research Center, Mayo Clinic, Rochester, MN, USA
2 Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA; General Clinical Research Center, Mayo Clinic, Rochester, MN, USA
* To whom correspondence should be addressed. E-mail: joyner.michael{at}mayo.edu.
The vascular endothelium is a site of pathological changes in patients with diabetes mellitus that may be related to severe chronic hyperglycemia. However, it is unclear whether transient hyperglycemia alters vascular function in an otherwise healthy human forearm. To test the hypothesis that acute moderate hyperglycemia impairs endothelium-dependent forearm vasodilation, we measured vasodilator responses in 25 healthy volunteers (11 F, 14 M) assigned to one of three protocols. In Protocol 1, glucose was varied to mimic a postprandial pattern (i.e., peak glucose ~11.1 mmol/L) commonly observed in individuals with impaired glucose tolerance. Protocol 2 involved six hours of mild hyperglycemia (~7 mmol/L). Protocol 3 involved six hours of euglycemia. Glucose concentration was maintained with a variable systemic glucose infusion. Insulin concentrations were maintained at ~65 pmol/L by means of a somatostatin and "basal" insulin infusion. Glucagon and growth hormone were replaced at basal concentrations. Forearm blood flow (FBF) was calculated from Doppler ultrasound measurements at the brachial artery. In each protocol, FBF dose-responses to intrabrachial acetylcholine (ACh) and sodium nitroprusside (NTP) were assessed at baseline, and at 60, 180 and 360 minutes of glucose infusion. Peak endothelium-dependent vasodilator responses to acetylcholine were not diminished by hyperglycemia in any trial. For example, peak responses to Ach during Protocol 2 were 307 ± 47 ml/min at euglycemic baseline and 325 ± 52, 353 ± 65 and 370 ± 70 during three subsequent hyperglycemic trials (p=0.46). Peak endothelium-independent responses to NTP infusion were also unaffected. We conclude that acute moderate hyperglycemia does not cause short-term impairment of endothelial function in the healthy human forearm.
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