Open AccessGlycemic Associations With Endothelial Function and Biomarkers Among 5 Ethnic Groups: The Multi‐Ethnic Study of Atherosclerosis and the Mediators of Atherosclerosis in S outh A sians Living in A merica Studies
Author(s) -
Kanaya Alka M.,
Dobrosielski Devon A.,
Ganz Peter,
Creasman Jennifer,
Gupta Ritu,
Nelacanti Vidya,
VogelClaussen Jens,
Herrington David
Publication year - 2013
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.112.004283
Subject(s) - medicine , diabetes mellitus , impaired fasting glucose , overweight , body mass index , biomarker , ethnic group , endothelial dysfunction , obesity , brachial artery , insulin , endocrinology , glycemic , fasting glucose , type 2 diabetes , impaired glucose tolerance , insulin resistance , blood pressure , biochemistry , chemistry , sociology , anthropology
Background The association of prediabetic states with endothelial dysfunction measured by flow‐mediated dilation ( FMD ) or endothelial biomarker levels remains controversial. We examined data from 5 ethnic groups to determine the association between glucose categories and FMD or endothelial biomarkers. We determined whether these associations vary by ethnic group or body mass index. Methods and Results We used data from 3516 participants from 5 race/ethnic groups with brachial FMD , endothelial biomarkers, and glucose category (normal, impaired fasting glucose [ IFG ], and diabetes) measures. There were significant ethnic differences in FMD , biomarker levels, and the prevalence of IFG and diabetes. However, all 5 ethnic groups showed similar patterns of higher FMD for the IFG group compared with the normal glucose and diabetes groups, which was most significant among whites and A sian I ndians. Associations between glucose categories and endothelial biomarkers were more uniform, with the IFG and diabetes groups having higher biomarker levels than the normal glucose group. These associations did not change with further adjustment for fasting insulin levels. Whites with normal BMI had higher FMD values with higher glucose levels, but those with BMI in the overweight or obese categories had the inverse association ( P for interaction=0.01).Conclusions The discordance of IFG being associated with higher FMD but more abnormal endothelial biomarker levels is a novel finding. This higher FMD for the IFG group was most notable in whites of normal BMI . The higher FMD among those with impaired fasting glucose may reflect differences in insulin signaling pathways between the endothelium and skeletal muscle.