Elevated 1-h post-challenge plasma glucose levels in subjects with normal glucose tolerance or impaired glucose tolerance are associated with whole blood viscosity
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It has been suggested that glucose levels ≥155 mg/dl at 1-h during an oral glucose tolerance test (OGTT) may predict development of type 2 diabetes and cardiovascular events among adults with normal glucose tolerance (NGT 1 h-high). Studies showed a link between increased blood viscosity and type 2 diabetes. However, whether blood viscosity is associated with dysglycemic conditions such as NGT 1 h-high, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) is unsettled.
1723 non-diabetic adults underwent biochemical evaluation and OGTT. A validated formula based on hematocrit and total plasma proteins was employed to estimate whole blood viscosity. Subjects were categorized into NGT with 1 h glucose <155 mg/dL (NGT-1 h-low), NGT-1 h-high, IFG and/or IGT.
Hematocrit and blood viscosity values appeared significantly higher in individuals with NGT 1 h-high, IFG and/or IGT as compared to NGT 1 h-low subjects. Blood viscosity was significantly correlated with age, waist circumference, blood pressure, HbA1c, fasting, 1- and 2-h post-challenge insulin levels, total cholesterol and low-density lipoprotein, triglycerides, fibrinogen, white blood cell, and inversely correlated with high-density lipoprotein and insulin sensitivity. Of the four glycemic parameters, 1-h post-challenge glucose showed the strongest correlation with blood viscosity (β = 0.158, P < 0.0001) in a multivariate regression analysis model including several atherosclerosis risk factors.
Our results demonstrate a positive relationship between blood viscosity and 1-h post-challenge plasma glucose. They also suggest that a subgroup of NGT individuals with 1-h post-challenge plasma >155 mg/dl have increased blood viscosity comparable to that observed in subjects with IFG and/or IGT.
Keywords1 h post-load hyperglycemia Blood viscosity Hematocrit Impaired glucose tolerance
This work was supported, in part, by the Foundation for Diabetes Research of the Italian Diabetes Society, through the award of “Fondazione Diabete Ricerca FO.DI.RI.—MSD” scholarships in 2014 and 2015 to Gaia Chiara Mannino.
M.A.M, T.V.F: researched data, reviewed and edited the manuscript; F.A, A.S: contributed to research data; G.C.M, M.P: reviewed the manuscript; F.P: contributed to the discussion and reviewed the manuscript; G.S. designed the study, analysed the data and wrote the manuscript.
Compliances with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards and all participants gave their informed consent in writing prior to inclusion in the study.
Human and animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Comitato Etico Azienda Ospedaliera “Mater Domini”, Italy) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all patients for being included in the study.
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