The Role of Hyperglycemia and Insulin Resistance in the Development and Progression of Pulmonary Arterial Hypertension

Grinnan, Daniel; Farr, Grant; Fox, Adam; Sweeney, Lori B.

doi:10.1155/2016/2481659

Cited by 41 publications

(41 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Despite many publications demonstrating the adverse effect of hyperglycaemia on pulmonary endothelial or SMC function, there are a few clinical reports/articles discussing PH in diabetes (Table ; Grinnan et al . ). Movahed et al .…”

Section: Vascular Function In Hyperglycaemiamentioning

confidence: 97%

Pulmonary vascular dysfunction in metabolic syndrome

Willson

Watanabe

Tsuji‐Hosokawa

2018

The Journal of Physiology

View full text Add to dashboard Cite

Metabolic syndrome is a critically important precursor to the onset of many diseases, such as cardiovascular disease, and cardiovascular disease is the leading cause of death worldwide. The primary risk factors of metabolic syndrome include hyperglycaemia, abdominal obesity, dyslipidaemia, and high blood pressure. It has been well documented that metabolic syndrome alters vascular endothelial and smooth muscle cell functions in the heart, brain, kidney and peripheral vessels. However, there is less information available regarding how metabolic syndrome can affect pulmonary vascular function and ultimately increase an individual's risk of developing various pulmonary vascular diseases, such as pulmonary hypertension. Here, we review in detail how metabolic syndrome affects pulmonary vascular function.

show abstract

Section: Vascular Function In Hyperglycaemiamentioning

confidence: 97%

Pulmonary vascular dysfunction in metabolic syndrome

Willson

Watanabe

Tsuji‐Hosokawa

2018

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…In addition, Abernethy et al showed that DM is an independent predictor for the prognosis of PH patients [ 25 ]. Furthermore, Grinnan et al described that DM is an independent predictor for PH development, even when the other components of metabolic syndrome are controlled (odds ratio = 1.53; P < 0.001) [ 26 ]. However, most of the patients in these studies were in group 1 (pulmonary arterial hypertension) and patients in group 3 were rarely included, whereas all our study subjects had chronic respiratory disease patients.…”

Section: Discussionmentioning

confidence: 99%

Associations between diabetes mellitus and pulmonary hypertension in chronic respiratory disease patients

et al. 2018

View full text Add to dashboard Cite

BackgroundPulmonary hypertension (PH) is a common complication of chronic respiratory disease. Recent studies have reported diabetes mellitus (DM) to be a poor prognostic factor in patients with chronic respiratory disease, including chronic obstructive pulmonary disease or interstitial pneumoniae. However, the association between DM and PH in chronic respiratory disease remains unclear. In this study, we aimed to investigate whether DM is a predictor of PH in patients with chronic respiratory disease.MethodsWe prospectively analyzed 386 patients in our hospital with chronic respiratory disease. An echocardiographic pressure gradient between the right atrium and the right ventricle of ≥ 40 mmHg was defined as PH. We compared the clinical characteristics and impact of DM between chronic respiratory disease patients with and those without PH.ResultsOf the 386 patients, 42 (10.9%) were diagnosed as having PH. The PH group had higher modified medical research council (mMRC) grade and complication rate of DM, but not hypertension and hyperlipidemia, when compared to the non-PH group. Multivariable logistic regression analysis revealed that mMRC scale (odds ratio 1.702, 95% confidence interval, 1.297 to 2.232, P < 0.001) and presence of DM (odd ratio 2.935, 95% confidence interval, 1.505 to 5.725, P = 0.002) were associated with PH in chronic respiratory disease patients.ConclusionDM is potentially associated with PH and is an independent factor for prediction of PH in patients with chronic respiratory disease.

show abstract

“…Although the hypotheses mentioned above have not yet been confirmed, it is clear that the prediabetic condition will further damage the pulmonary vascular system and contribute to disease progression. High glucose concentrations induce mitogen-activated protein kinase/phosphatidylinositol 3-kinase(PI3K)-dependent upregulation of PDGF receptor-beta and potentiate migration and proliferation of smooth muscle cells (SMC) [ 20 , 21 ]. The inflammatory milieu associated with IR, as demonstrated by high levels of pro-inflammatory biomarkers such as C-reactive protein, interleukin-6, and myeloperoxidase, is thought to underlie the associated endothelial dysfunction and vascular disease [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic Status in Patients with Operable vs. Inoperable Left-to-Right Shunts

et al. 2018

View full text Add to dashboard Cite

BackgroundPrevious studies have shown the prognostic value of insulin resistance, hyperuricemia, and dyslipidemia in clinical outcome of pulmonary arterial hypertension. Whether these metabolic derangements are different between operable and inoperable left-to-right shunts is unknown.Material/MethodsOur study included 116 patients with left-to-right shunts (76 with atrial septal defect and 40 with ventricular septal defect) with or without pulmonary arterial hypertension. Operability of defect closure were assessed by cardiac catheterization and patients were subdivided into an operable group or an inoperable group. The metabolic status, including prediabetes, hyperuricemia, dyslipidemia, hypertension and obesity, were compared between groups.ResultsPatients receiving defect correction had a lower HbA1c (B: 5.52±0.49 vs. 5.71±0.41, p=0.042) and uric acid (C: 358±105 vs. 406±126, p=0.029) but a higher HDLC (D: 1.21±0.33 vs. 1.08±0.22, p=0.017) and BMI (A: 20.4±3.9 vs. 18.8±3.1, p=0.023). Patients in the inoperable group had a higher prevalence of prediabetes (58% vs. 41%, p=0.076), hyperuricemia (37.2% vs. 21.9, p=0.106), dyslipidemia (74% vs. 56%, p=0.049) but a lower prevalence of hypertension (13.9% vs. 30.1%, p=0.049) and obesity (4.6% vs. 12.3%, p=0.301). According to logistic regression, only HbA1c (1.76 (0.53, 2.99), HR (95% CI), p=0.005) remained significant for pulmonary vascular resistance.ConclusionsAlthough prediabetes, hyperuricemia, and dyslipidemia were all more prevalent in patients with inoperable left-to-right shunts, only prediabetes was found to be significantly associated with higher pulmonary vascular resistance.

show abstract

The Role of Hyperglycemia and Insulin Resistance in the Development and Progression of Pulmonary Arterial Hypertension

Cited by 41 publications

References 44 publications

Pulmonary vascular dysfunction in metabolic syndrome

Pulmonary vascular dysfunction in metabolic syndrome

Associations between diabetes mellitus and pulmonary hypertension in chronic respiratory disease patients

Metabolic Status in Patients with Operable vs. Inoperable Left-to-Right Shunts

Contact Info

Product

Resources

About