Glucose fluctuation and the resultant endothelial injury are correlated with pancreatic ß cell dysfunction in patients with coronary artery disease.

ABSTRACT

AIMS: We evaluated whether glucose fluctuation (GF) causes vascular endothelial injury and affects glucometabolic factors during lengthy oral glucose tolerance test (OGTT). METHODS: We enrolled consecutive 116 patients with coronary artery disease (CAD) who were performed coronary angiography and 4-h OGTT. Blood samples were collected before and 4h after glucose load to measure endothelial injury factor [von Willebrand factor (vWF) and vWF/a disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS-13) ratio]. GF was defined as maximum - minimum blood glucose levels during 4-h OGTT. We estimated the relationship between GF and glucometabolic factors. RESULTS: vWV and vWF/ADAMTS-13 ratio were significantly correlated with GF during 4-h OGTT. GF was significantly correlated with homeostasis model to assess insulin resistance (HOMA-IR) (R=0.262), Matsuda index (R=-0.405), insulinogenic index (R=-0.336), HbA1c (R=0.281) and disposition index (R=-0.672). When dividing patients into impaired and preserved category groups according to the average value of GF (122mg/dL), adjusted to age, sex, HOMA-ß, insulinogenic index, HOMA-IR, Matsuda index and HbA1c, disposition index was an independent risk factor for impaired GF [odds ratio (95% confidence interval) 2.87 (1.70-4.83), P<0.001]. CONCLUSION: Pancreatic ß cell dysfunction is associated with GF and causes endothelial injury in CAD patients.