[Vascular dysfunction in young patients with impaired glucose tolerance: insights from pulse wave velocity and...

Endothelial dysfunction is regarded as an early marker of atherosclerosis and decreased arterial disstensibility has similar significance. The aim of this study was to evaluate endothelial function and arterial distensibility in patients with impaired glucose tolerance which may constitute markers of atherosclerosis.

Study group consisted of patients without chest pain, ischemic ECG changes, arterial hypertension or any risk factors for IHD, who were divided into two groups: Impaired glucose tolerance group (ITG)--48 patients with fasting glucose levels of 5.7 +/- 0.2 mmol/l and glucose levels of 9.2 +/- 0.6 mmol/l 2 hours after starting a 75 g oral glucose load and group 2-43 healthy age and sex matched controls with fasting glucose levels of 4.9 +/- 0.5 mmol/l and normal glucose tolerance. Endothelium dependent (EDV) and independent vasodilation (EIV) was assessed with 8 MHz high resolution ultrasound (Acuson Sequoia) according to Celermajer's method. PWV was measured with Complior Colson automatic device with measurement points above femoral and carotid artery.

Flow associated with vasodilation was significantly impaired in ITG group (6.1 +/- 3.1% vs 13.4 +/- 3.9%-controls, p < 0.001). EIV was not significantly different between both groups. PWV was significantly higher in patients with impaired glucose tolerance than in controls (9.9 +/- 0.5 m/s vs 7.8 +/- 0.9 m/s) p < 0.001.

Increased values of PWV indicate an increased arterial stiffness in patients with ITG, coexisting with endothelial dysfunction. These results reveal vascular dysfunction and potentially increased risk for development of atherosclerosis in ITG patients.