Acute hyperglycemia induces an oxidative stress in healthy subjects
Open accessAbstract
Recent prospective studies indicate that long-term glycemic control of diabetes is an important predictor not only of microvascular disease but also of macrovascular complications, including coronary heart disease (1). Possible links between glucose and cardiovascular events in the diabetic patient include modifications of important vascular functions of the endothelium with a switch from a quiescent, relaxant, antithrombotic, antioxidant, and antiadhesive state to an activated state displaying a more atherogenetic risk profile (2). Generation of reactive oxygen species could be a common downstream mechanism by means of which multiple byproducts of glucose are exerting their adverse effects on blood vessels (3). Indeed, in April 2001, Pennathur et al. (4) reported in the JCI that hyperglycemia favors oxidative reactions in the microenvironment of the artery wall in vivo. We studied the effect of acute elevations of plasma glucose levels on plasma nitrotyrosine, a marker of oxidative stress, in 20 healthy subjects (11 men, 9 women). Their age was 34 ± 4 years (mean ± SD), and the body mass index was 24 ± 1 kg/m2. None used any medication. After giving informed written consent to participate in the study, each subject underwent a hyperglycemic glucose clamp test in which plasma glucose concentrations were acutely raised at about 15 mmol/l for 120 minutes (Figure (Figure1).1). Mean blood pressure and nitrotyrosine (5) rose significantly during the clamp; there was a positive correlation (r = 0.49) between nitrotyrosine and mean blood pressure increases during hyperglycemia. In control studies (n = 6), in which plasma glucose was maintained at normal concentrations (5 mmol/l for 120 minutes), we could detect no variation in nitrotyrosine plasma levels from baseline (baseline: 0.15 ± 0.05 μmol/l; 120-minute values: 0.13 ± 0.05 μmol/l, P = not significant). Figure 1 Twenty healthy subjects were submitted to a hyperglycemic glucose clamp study in which plasma glucose levels were acutely raised to 15 mmol/l (0.33 g/kg as intravenous bolus injection followed by a variable 30% glucose infusion). Mean blood pressure ... We show here that acute hyperglycemia in normal subjects causes an oxidative stress as evidenced by the raised circulating nitrotyrosine levels during the hyperglycemic clamp. However, we cannot exclude the possibility that some nitrotyrosine can be generated via a peroxynitrite-independent mechanism, or that a reduced nitrotyrosine clearance during hyperglycemia could also contribute to its raised plasma concentrations. Since nitrotyrosine is considered a good marker of peroxynitrite formation (6), and since peroxynitrite may account for a considerable portion of the toxic effects previously attributed to nitric oxide or the superoxide anion (7), it is possible that some of the toxic effects of hyperglycemia on the vascular tree may be modulated by peroxynitrite. Acute hyperglycemia in normal subjects may in fact induce vasoconstriction, activate thrombosis, increase the circulating levels of soluble adhesion molecules, and prolong the QT interval (8, 9). The recent demonstration (10) that apoptosis of myocytes, endothelial cells, and fibroblasts in heart biopsies taken from diabetic patients is selectively associated with intracellular levels of nitrotyrosine supports a role for high-energy oxidants (such as peroxynitrite) as mediators of the vascular damage brought about by hyperglycemia.
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Postprandial hyperglycemia and hypertriglyceridemia cause endothelial dysfunction and inflammation via oxidative stress.
“Evidence suggests that postprandial hypertriglyceridemia and hyperglycemia induce endothelial dysfunction and inflammation through oxidative stress.”
In healthy people, a sudden rise in blood glucose raises nitrotyrosine and impairs endothelial function at the same time.
“Evidence that an acute increase in glycemia simultaneously induces an increase in nitrotyrosine (NT) and endothelial dysfunction in healthy subjects 14”
Rising nitrotyrosine levels during hyperglycemia or fat loading support the idea that glucose and free fatty acids trigger oxidative stress through shared pathways.
“The increase in NT, a useful marker of both peroxynitrite and NO activity, during hyperglycemia or fat load supports this hypothesis.[13][14][15]”
Weight loss is accompanied by decreased circulating CRP, TNF-a, IL-6, and sICAM-1.
“Weight loss is accompanied by decreased concentrations of circulating mediators of inflammation, such as CRP, TNF-a, IL-6 and sICAM-1 (155,268 -270) , although it is difficult to dissect whether this effect is due to the weight loss per se or to the nature of the diet used to induce weight loss.”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [268]
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- Authors
- Marfella, R., Quagliaro, L., Nappo, F., Ceriello, A., & Giugliano, D.
- Corresponding author
- Giugliano, Dario
- Venue
- Journal of Clinical Investigation
- Published
- 2001-08-15
- Volume
- 108
- Issue
- 4
- Pages
- 635-636
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC209408
- OpenAlex
- W2052924362
- Cited by
- 242
- References
- 14
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 1 · 2021: 5 · 2020: 7 · 2019: 9 · 2018: 4 · 2017: 6 · 2016: 6 · 2015: 7 · 2014: 10 · 2013: 8 · 2012: 12
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Clinical Investigation (publishedVersion, cc-by)
- Journal of Clinical Investigation (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (University of Udine) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Keywords
- acute hyperglycemia, oxidative stress, nitrotyrosine, glucose clamp, reactive oxygen species, endothelial dysfunction, blood pressure, healthy volunteers, cardiovascular risk, diabetes complications, vascular function, nitrosative stress, nitric oxide, nitric oxide synthase, nitric oxide radical
- MeSH terms
- Adult, Diabetic Angiopathies, Female, Hemodynamics, Humans, Hydrogen-Ion Concentration, Hyperglycemia, Male, Nitrates, Tyrosine, Vasoconstriction, Glucose Clamp Technique, Biomarkers, Confounding Factors, Epidemiologic, Oxidative Stress
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