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- Title
Insulin resistance may contribute to vascular dysfunction in patients with chronic obstructive pulmonary disease.
- Authors
Urban, Matthias Helmut; Ay, Leyla; Funk, Georg-Christian; Burghuber, Otto Chris; Eickhoff, Philipp; Wolzt, Michael; Valipour, Arschang
- Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) are at an increased cardiovascular risk; however, the underlying mechanisms for this relationship are ill defined. Altered glucose metabolism may increase cardiovascular risk via impaired endothelial function. Methods: We conducted a longitudinal pilot study to assess the interrelationship between systemic vascular function, glucose metabolism, and lung function in patients with COPD. Eighteen non-smoking patients with stable moderate-to-severe COPD [67 % male; median (first to third quartiles) Forced Expiratory Volume in 1 second (FEV1) % predicted: 38 % (28-55 %); body mass index: 26 kg/m (24-28 kg/m)] free from cardiovascular risk factors were evaluated. Systemic vascular function was assessed by means of flow-mediated dilation technique of the brachial artery. Laboratory measurements included fasting blood glucose levels, circulating concentrations of insulin, C-reactive protein, and fibrinogen. Homeostatic model assessment of insulin resistance (HOMA-IR) was determined. Measurements were performed at baseline and were repeated after 12 months. Results: Flow-mediated dilation significantly decreased from 13.5 % (11-15 %) at baseline to 9.8 % (6-12 %; p = 0.002) at the follow-up visit, whereas both fasting blood glucose concentrations and HOMA-IR increased from 94 mg/dl (86-103 mg/dl) to 102 mg/dl (94-111 mg/dl; p = 0.027) and from 1.2 (0.8-2.1) to 1.7 (1.2-3.0; p = 0.023), respectively. There was a significant relationship between changes in endothelial function and changes in fasting serum glucose ( r = − 0.483, p = 0.009), HOMA-IR ( r = − 0.441, p = 0.019), and FEV1 ( r = 0.336, p = 0.05). Conclusion: Altered glucose metabolism may be associated with progression of endothelial dysfunction in patients with COPD.
- Subjects
OBSTRUCTIVE lung diseases; CARDIOVASCULAR diseases risk factors; GLUCOSE metabolism; ENDOTHELIAL cells; INSULIN resistance
- Publication
Wiener Klinische Wochenschrift, 2014, Vol 126, Issue 3/4, p106
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-013-0478-0