Abstract
Background
Arterial stiffness, specifically augmentation index (AIx), is an independent predictor
of cardiovascular risk. Previous studies suggest that insulin infusion decreases AIx
and that this response is attenuated in insulin resistance. Whether physiological
postprandial insulinemia similarly affects AIx measurements, and whether insulin resistance
modifies this response, has not been studied.
Methods
Seven relatively insulin-resistant and seven insulin-sensitive postmenopausal women
received low-carbohydrate and high-carbohydrate high-fat meals on separate days. Glucose
and insulin levels were measured for 360-min following meal consumption. AIx was measured
by radial artery applanation tonometry at regular intervals postprandially.
Results
Postprandial increases in glucose and insulin were greater following the high-carbohydrate
high-fat meal in both insulin-sensitive and insulin-resistant subjects. AIx decreased
in both groups following both meals. In insulin-sensitive subjects, the postprandial
reduction (incremental area above the curve) in AIx was greater following the high-carbohydrate
vs. low-carbohydrate high-fat meal (−6821±1089 vs. −3797±1171%·min, respectively, P=0.009). In contrast, in insulin-resistant subjects, postprandial AIx responses were
similar following the meals, suggesting that insulin resistance is associated with
impaired postprandial arterial relaxation.
Conclusions
This study demonstrates that the carbohydrate content of a meal, and, hence, the magnitude
of the postprandial glucose and insulin responses it elicits, are important determinants
of postprandial AIx measurements. The further observation that insulin resistance
modified this effect raises the possibility that this phenomenon is a contributor
to increased cardiovascular risk in insulin resistance. The results indicate that
future studies of AIx need to control for the effects of these potentially confounding
variables and that measurement of AIx should be standardized with respect to meals.
Keywords
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Article info
Publication history
Published online: May 04, 2006
Accepted:
December 11,
2005
Received in revised form:
October 12,
2005
Received:
July 16,
2005
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
