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Cited by 99

The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.

Effects of Acute and Antecedent Hypoglycemia on Endothelial Function and Markers of Atherothrombotic Balance in Healthy Humans

Joy, Nino G., Tate, Donna B., Younk, Lisa M., Davis, Stephen N.·2015·Diabetes
DOI 10.2337/db14-1729
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Abstract

The aim of this study was to determine the effects of single and repeated episodes of clamped hypoglycemia on fibrinolytic balance, proinflammatory biomarkers, proatherothrombotic mechanisms, and endothelial function. Twenty healthy individuals (12 male and 8 female) were studied during separate 2-day randomized protocols. Day 1 consisted of either two 2-h hyperinsulinemic (812 ± 50 pmol/L)-euglycemic (5 ± 0.1 mmol/L) or hyperinsulinemic (812 ± 50 pmol/L)-hypoglycemic (2.9 ± 0.1 mmol/L) clamps. Day 2 consisted of a single 2-h hyperinsulinemic-hypoglycemic clamp. Two-dimensional Doppler ultrasound was used to determine brachial arterial endothelial function. Plasminogen activator inhibitor 1, vascular cell adhesion molecule-1, intracellular adhesion molecule-1, E-selectin, P-selectin, TAT (thrombin/antithrombin complex), tumor necrosis factor-α, and interleukin-6 responses were increased (P < 0.05) during single or repeated hypoglycemia compared with euglycemia. Endogenous and exogenous nitric oxide (NO)-mediated vasodilation were both impaired by repeated hypoglycemia. Neuroendocrine and autonomic nervous system (ANS) responses were also blunted by repeated hypoglycemia (P < 0.05). In summary, acute moderate hypoglycemia impairs fibrinolytic balance; increases proinflammatory responses, platelet activation, and coagulation biomarkers; and reduces NO-mediated endothelial function in healthy individuals. Repeated episodes of hypoglycemia further impair vascular function by additionally reducing exogenously NO-mediated endothelial function and increasing coagulation biomarkers. We conclude that despite reduced neuroendocrine and ANS responses, antecedent hypoglycemia results in greater endothelial dysfunction and an increased proatherothrombotic state compared with a single acute episode of hypoglycemia.

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Show all 12 references

Research works printed but not linked: 26

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Cited by

Metadata

Authors
Joy, N. G., Tate, D. B., Younk, L. M., & Davis, S. N.
Affiliations
Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
Venue
Diabetes
Publisher
American Diabetes Association
Published
2015-02-18
Volume
64
Issue
7
Pages
2571-2580
ISSN
  • 0012-1797
  • 1939-327X
DOI
10.2337/db14-1729
Cited by
99
References
12
Language
en
Licence
www.diabetesjournals.org/site/license (vor, 317 d)
Funders
  • Vanderbilt Diabetes Research and Training ((DRTC) NIH/NIDDK)
  • National Institutes of Health (P50 HL081009 NIH/NHLBI, PO1 HL056693 NIH/NHLBI, RO1 DK069803 NIH/NIDDK)

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