Weight change and sulfonylurea therapy are related to 3 year change in microvascular function in people with type 2 diabetes

Casanova, Francesco; Gooding, Kim M.; Shore, Angela C.; Adingupu, D.D.; Mawson, D; Ball, Claire; Anning, Christine; Aizawa, Kunihiko; Gates, Philip E

doi:10.1007/s00125-020-05125-4

Cited by 3 publications

(5 citation statements)

References 27 publications

(32 reference statements)

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“…The observed weight reduction (−3.9%) is unlikely to change microvascular function since previous studies have shown that a reduction in body weight of 5% or more of is associated with clear benefits in endothelial‐dependent microvascular function 44 …”

Section: Discussionmentioning

confidence: 89%

“…Thus, the studies by us and others suggest that antidiabetic drugs may have divergent effects on glucose control and microvascular function, and their relation to future cardiovascular events 37. The observed weight reduction (−3.9%) is unlikely to change microvascular function since previous studies have shown that a reduction in body weight of 5% or more of is associated with clear benefits in endothelial-dependent microvascular function 44. Our secondary analyses in patients who tolerated the higher dose of exenatide for the reminder for the study suggest improved skin microvascular reactivity, which was not seen in patients continuing on the lower dose, while HbA1c did not change.…”

mentioning

confidence: 86%

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Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

et al. 2020

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Objective We studied the effect of the GLP‐1RA exenatide on skin microvascular function in patients with T2DM and CAD. Methods Thirty‐five patients with T2DM, CAD, and HbA1C 42–86 mmol/mol were randomized to treatment with exenatide or conventional non‐GLP‐1‐based therapy for 12 weeks. Skin microvascular function was examined in the forearm by LDF and iontophoretic application of acetyl choline and SNP, and by PORH at baseline and after 12 weeks. Blood samples for fasting plasma glucose, HbA1C, and lipid profile were collected. Results At 12 weeks, patients on exenatide showed reductions in HbA1C (from 63.5 ± 13 to 60.7 ± 14 mmol/mol, p = .065), body weight (from 92.6 ± 16 to 89 ± 16 kg, p < .001), and systolic blood pressure (from 141 ± 13 to 134 ± 16 mm Hg, p < .05) as compared to the conventionally treated group. There were no significant changes in skin microvascular function between or within the two groups at follow‐up. Conclusions Three months' daily treatment with the GLP‐1RA exenatide in T2DM patients with CAD showed no significant effects on skin microvascular function or blood glucose control, while this study confirms a reduction in body weight and blood pressure by exenatide, as compared to conventional antidiabetic drug treatment.

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Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 86%

Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

et al. 2020

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“…Reactive hyperaemia index (RHI) was calculated as the ratio of postocclusion to preocclusion signal amplitudes as a marker of endothelial-dependent vasodilation. Urinary albumin to creatinine ratio (UACR), a marker of endothelial dysfunction, was obtained by a random spot urine sample obtained during the study visit with a detection limit for albumin of 3.0 mg/l [18].…”

Section: Methodsmentioning

confidence: 99%

“…BMI (calculated from height and weight) and waist circumference were obtained using a standard protocol. Total and HDL cholesterol, and HbA1c were measured from participants' fasting blood samples by the Exeter Pathology Services (Royal Devon and Exeter NHS Foundation Trust, Exeter, UK) [18]. SBP and DBP, PP, MAP and heart rate were measured from the brachial BP assessment as described above.…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

Carotid–femoral pulse wave velocity acquisition methods and their associations with cardiovascular risk factors and subclinical biomarkers of vascular health

Aizawa¹,

Mawson²,

Mawson³

et al. 2021

Journal of Hypertension

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Background:Different methods to measure carotid–femoral pulse wave velocity (CFPWV) may affect the measurements obtained and influence the association between CFPWV, cardiovascular risk factors and biomarkers of subclinical vascular health. The estimation of distance between the carotid and femoral artery measurement sites (the arterial path length) is particularly problematic.Method:We determined if CFPWV and equation-based estimates of CFPWV were influenced by arterial path length and if this affected the association of CFPWV with cardiovascular risk factors and subclinical vascular biomarkers. The CFPWV derived from the measurement of surface distance (CFPWV-D), arterial path length formula (CFPWV-F), and estimated CFPWV (ePWV) were obtained from 489 older adults (67.2 ± 8.8 years). Macrovascular [carotid artery: lumen diameter (LD), inter-adventitial diameter (IAD), intima–media thickness (IMT) and total plaque area (TPA)] and microvascular [reactive hyperaemia index and urinary albumin-creatinine ratio (UACR)] biomarkers were also measured.Results:CFPWV-D was significantly greater than CFPWV-F [9.6 (8.0–11.2) vs. 8.9 (7.6–10.5) m/s, P < 0.001], because of estimated path length being longer in CFPWV-D than CFPWV-F (495.4 ± 44.8 vs. 465.3 ± 20.6 mm, P < 0.001). ePWV was significantly greater than both CFPWV-F and CFPWV-D [11.0 (10.0–12.2) m/s, P < 0.001]. The three CFPWV methods were similarly associated with LD, IAD, IMT, TPA and UACR but not with cardiovascular risk factors.Conclusion:Different methods to measure CFPWV affect the derived measurement values and the association with cardiovascular risk factors but not the association with subclinical biomarkers of vascular health. These hitherto unreported observations are important considerations in experimental design, data interpretation and of particular importance, comparison between studies where CFPWV is measured.

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“…Urinary albumin to creatinine ratio was obtained by a random spot urine sample obtained during the study visit with a detection limit for albumin of 3.0 mg/L. 21 Albuminuria (macro-albuminuria) was defined as the urinary albumin to creatinine ratio >25 mg/ mmol for men and 35 mg/mmol for women.…”

Section: Renal Functionmentioning

confidence: 99%

Reservoir Pressure Integral Is Independently Associated With the Reduction in Renal Function in Older Adults

et al. 2022

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Background: Arterial hemodynamic parameters derived from reservoir-excess pressure analysis exhibit prognostic utility. Reservoir-excess pressure analysis may provide useful information about an influence of altered hemodynamics on target organ such as the kidneys. We determined whether the parameters derived from the reservoir-excess pressure analysis were associated with the reduction in estimated glomerular filtration rate in 542 older adults (69.4±7.9 years, 194 females) at baseline and after 3 years. Methods: Reservoir-excess pressure parameters, including reservoir pressure integral, excess pressure integral, systolic, and diastolic rate constants, were obtained by radial artery tonometry. Results: After 3 years, and in a group of 94 individuals (72.4±7.6 years, 26 females), there was an estimated glomerular filtration rate reduction of >5% per year (median reduction of 20.5% over 3 years). A multivariable logistic regression analysis revealed that higher baseline reservoir pressure integral was independently associated with a smaller reduction in estimated glomerular filtration rate after accounting for conventional cardiovascular risk factors and study centers (odds ratio: 0.660 [95% CIs, 0.494–0.883]; P =0.005). The association remained unchanged after further adjustments for potential confounders and baseline renal function (odds ratio: 0.528 [95% CIs, 0.351–0.794]; P =0.002). No other reservoir-excess pressure parameters exhibited associations with the reduction in renal function. Conclusions: This study demonstrates that baseline reservoir pressure integral was associated with the decline in renal function in older adults at 3-year follow-up, independently of conventional cardiovascular risk factors. This suggests that reservoir pressure integral may play a role in the functional decline of the kidneys.

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Weight change and sulfonylurea therapy are related to 3 year change in microvascular function in people with type 2 diabetes

Cited by 3 publications

References 27 publications

Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

Carotid–femoral pulse wave velocity acquisition methods and their associations with cardiovascular risk factors and subclinical biomarkers of vascular health

Reservoir Pressure Integral Is Independently Associated With the Reduction in Renal Function in Older Adults

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