Effect of Daily Glucose Fluctuation on Coronary Plaque Vulnerability in Patients Pre-Treated With Lipid-Lowering Therapy

Kuroda, Minpei; Shinke, Toshiro; Sakaguchi, Kazuhiko; Otake, Hiromasa; Takaya, Tomofumi; Hirota, Yushi; Sugiyama, Daisuke; Nakagawa, Masayuki; Hasegawa, Hirotoshi; Inoue, Tatsuo; Osue, Tsuyoshi; Taniguchi, Yu; Iwasaki, Masanori; Nishio, Ryo; Kinutani, Hiroto; Konishi, Akihide; Hiranuma, Noritoshi; Takahashi, Hidetoshi; Terashita, Daisuke; Hirata, Ken Ichi

doi:10.1016/j.jcin.2014.11.025

Cited by 66 publications

(60 citation statements)

References 23 publications

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“…Recent studies have demonstrated robust associations of low serum 1,5-AG concentrations with long-term microvascular and macrovascular complications in persons with diabetes 5, 6 , and with major cardiovascular events in persons without diabetes 7 . These observations are supported by complementary evidence linking daily glucose fluctuations to cardiovascular complications 8 . Gaining insights into the genetic underpinnings of a glycemic marker with unique properties, such as 1,5-AG, may improve our understanding not only of the biology of the marker itself, but also of diabetes, hyperglycemia and glucose metabolism.…”

Section: Introductionmentioning

confidence: 60%

Genome-wide association study of 1,5-anhydroglucitol identifies novel genetic loci linked to glucose metabolism

Maruthur

Loomis

et al. 2017

Sci Rep

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1,5-anhydroglucitol (1,5-AG) is a biomarker of hyperglycemic excursions associated with diabetic complications. Because of its structural similarity to glucose, genetic studies of 1,5-AG can deliver complementary insights into glucose metabolism. We conducted genome-wide association studies of serum 1,5-AG concentrations in 7,550 European ancestry (EA) and 2,030 African American participants (AA) free of diagnosed diabetes from the ARIC Study. Seven loci in/near EFNA1/SLC50A1, MCM6/LCT, SI, MGAM, MGAM2, SLC5A10, and SLC5A1 showed genome-wide significant associations (P < 5 × 10−8) among EA participants, five of which were novel. Six of the seven loci were successfully replicated in 8,790 independent EA individuals, and MCM6/LCT and SLC5A10 were also associated among AA. Most of 1,5-AG-associated index SNPs were not associated with the clinical glycemic markers fasting glucose or the HbA1c, and vice versa. Only the index variant in SLC5A1 showed a significant association with fasting glucose in the expected opposing direction. Products of genes in all 1,5-AG-associated loci have known roles in carbohydrate digestion and enteral or renal glucose transport, suggesting that genetic variants associated with 1,5-AG influence its concentration via effects on glucose metabolism and handling.

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Section: Introductionmentioning

confidence: 60%

Genome-wide association study of 1,5-anhydroglucitol identifies novel genetic loci linked to glucose metabolism

Maruthur

Loomis

et al. 2017

Sci Rep

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“…Then, using a motorized pullback device, the IVUS transducer was withdrawn at a rate of 0.5 mm/s until the coronary ostium was observed [12]. Lesions with angiographically mild to moderate stenosis, defined as a vessel diameter between 30 and 70% of the normal diameter, with a 30–70% plaque burden in the minimum lumen area of <4 mm 2 , as defined by IVUS, were analyzed as described previously [6] (Fig. 2a).…”

Section: Methodsmentioning

confidence: 99%

“…Previously, we have reported that daily glucose fluctuations could affect the coronary plaque vulnerability in coronary artery disease (CAD) patients undergoing lipid-lowering therapy [6, 7], but the mechanisms underlying this effect remain unclear. Certain clinical studies indicate a strong relation between glucose fluctuation and systemic inflammation, especially through the activation of toll-like receptors (TLR) [8–10].…”

Section: Introductionmentioning

confidence: 99%

Impact of CD14++CD16+ monocytes on plaque vulnerability in diabetic and non-diabetic patients with asymptomatic coronary artery disease: a cross-sectional study

Yoshida

Yamamoto

Shinke

et al. 2017

Cardiovasc Diabetol

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BackgroundPreviously, we have reported that daily glucose fluctuations could affect coronary plaque vulnerability, but the underlying mechanisms remained unclear. This study sought to investigate the impact of CD14++CD16+ monocytes on plaque vulnerability, as assessed by virtual histology intravascular ultrasound (VH-IVUS), as well as their relationship to fluctuating glucose levels in patients with asymptomatic coronary artery disease (CAD).MethodsFifty-one patients with asymptomatic CAD, who were undergoing lipid-lowering therapy and underwent VH-IVUS evaluation for angiographically mild to moderate lesions, were enrolled in the study. Standard VH-IVUS parameters, including the percentage volume of the necrotic core (%NC) within the plaque and the presence of a virtual histology thin-cap fibroatheroma (VH-TCFA), were then evaluated. Additionally, monocyte subsets were assessed by flow cytometry, and daily glucose fluctuations were analyzed by measuring the mean amplitude of glycemic excursion (MAGE).ResultsAmong 82 plaques from 22 diabetes mellitus (DM) patients and 29 non-DM patients, 15 VH-TCFAs were identified. CD14++CD16+ monocyte counts significantly correlated with both %NC and the presence of VH-TCFA (%NC: r = 0.339, p = 0.002; VH-TCFA: p = 0.003). Multivariate logistic regression analysis revealed that CD14++CD16+ monocyte counts were independently associated with VH-TCFA (odds ratio = 1.029, p = 0.004). Furthermore, CD14++CD16+ monocyte counts were significantly correlated with the MAGE score in the non-DM patients (r = 0.544, p = 0.005).ConclusionsCD14++CD16+ monocyte levels are associated with coronary plaque vulnerability and can serve as a biomarker for VH-TCFA in patients with CAD undergoing lipid-lowering therapy. In patients without DM, glucose fluctuations may alter the balance of monocyte subsets. Trial registration UMIN Registry number: UMIN000021228Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-017-0577-8) contains supplementary material, which is available to authorized users.

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“…However, the detailed dynamic state of blood glucose is affected by various physical conditions and therapeutic processes in the acute phase of stroke, and, accordingly, its association with stroke outcome has not been clarified. Although glycemic variability is known to be associated with the onset of acute coronary syndrome, and hypoglycemia is known to be a predictor of poor outcomes in intensive care unit patients, the relationships between these blood glucose parameters and outcomes are unknown in acute stroke patients 7, 8, 9. The GIST‐UK (Glucose‐Insulin Stroke Trial‐UK) showed no difference in clinical outcomes between acute stroke patients treated with intravenous insulin, potassium, and glucose and those treated with saline 10.…”

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confidence: 99%

Outcome Prediction in Acute Stroke Patients by Continuous Glucose Monitoring

Wada

Yoshimura

Inoue

et al. 2018

JAHA

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BackgroundThe purpose of this study was to examine the relationships between glucose parameters obtained by continuous glucose monitoring and clinical outcomes in acute stroke patients.Methods and ResultsConsecutive patients with acute ischemic stroke or intracerebral hemorrhage within 24 hours after onset were included. A continuous glucose monitoring device (iPro2) was attached for the initial 72 hours after emergent admission. Eight glucose parameters were obtained from continuous glucose monitoring: maximum, minimum, mean, and SD of blood glucose levels, as well as area under the curve more than 8 mmol/L of blood glucose, distribution time more than 8 mmol/L of blood glucose, coefficient of variation (%CV), and presence of time less than 4 mmol/L over 72 hours. The primary outcome measure was death or dependency at 3 months (modified Rankin Scale score ≥3). One hundred patients with acute ischemic stroke (n=58) or intracerebral hemorrhage (n=42) were included. Blood glucose levels varied between 5.2±1.4 and 11.4±3.2 mmol/L over 72 hours, with area under the curve more than 8 mmol/L of blood glucose of 0.7±1.4 min×mmol/L, distribution time more than 8 mmol/L of blood glucose of 31.7±32.7%, coefficient of variation of 15.5±5.4%, and presence of hypoglycemia in 20% of overall patients. Mean glucose level (adjusted odds ratio, 1.60, 95% confidence interval, 1.12–2.28/1 mmol/L), area under the curve more than 8 mmol/L of blood glucose (2.13, 1.12–4.02/1 min×mmol/L), and distribution time more than 8 mmol/L of blood glucose (1.25, 1.05–1.50/10%) were related to death or dependency for overall patients, as well as for acute ischemic stroke patients (2.05, 1.15–3.65; 2.38, 1.04–5.44; 1.85, 1.10–3.10, respectively).ConclusionsHigh mean glucose levels, distribution time more than 8 mmol/L of blood glucose, and areas under the curve more than 8 mmol/L of blood glucose during the initial 72 hours of acute stroke were associated with death or dependency at 3 months.

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Effect of Daily Glucose Fluctuation on Coronary Plaque Vulnerability in Patients Pre-Treated With Lipid-Lowering Therapy

Cited by 66 publications

References 23 publications

Genome-wide association study of 1,5-anhydroglucitol identifies novel genetic loci linked to glucose metabolism

Genome-wide association study of 1,5-anhydroglucitol identifies novel genetic loci linked to glucose metabolism

Impact of CD14++CD16+ monocytes on plaque vulnerability in diabetic and non-diabetic patients with asymptomatic coronary artery disease: a cross-sectional study

Outcome Prediction in Acute Stroke Patients by Continuous Glucose Monitoring

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