Uncomplicated human type 2 diabetes is associated with meal-induced blood pressure lowering and cardiac output increase

作者：Smits Mark M^*; Muskiet Marcel H A; Tushuizen Maarten E; Kwaa Kelly A A; Karemaker John M; van Raalte Daniel H; Diamant Michaela

来源：Diabetes Research and Clinical Practice, 2014, 106(3): 617-626.

DOI：10.1016/j.diabres.2014.09.044

• Type 2 diabetes
• Metabolic syndrome
• Postprandial hemodynamics
• Autonomic nervous system

Aims: Since many type 2 diabetes patients experience postprandial hypotension, the aim of this study was to unravel meal-related changes in systemic hemodynamics and autonomic nervous system (ANS)-balance. %26lt;br%26gt;Methods: Forty-two age-matched males (15 type 2 diabetes; 12 metabolic syndrome; 15 controls) without overt autonomic neuropathy received a standardized high-fat mixed meal after an overnight fast. Hemodynamic variables were measured by finger plethysmography. Fourier analysis was used to calculate the low-/high-frequency (LF/HF)-ratio, a marker of autonomic nervous system-balance, and baroreceptor reflex sensitivity (BRS). %26lt;br%26gt;Results: Following the meal, diastolic blood pressure (DBP) decreased in type 2 diabetes patients only, paralleled by a significant decrement in systemic vascular resistance (SVR) and an increase in cardiac index. All groups showed an increase in postprandial heart rate. Controls, but not metabolic syndrome or type 2 diabetes patients, showed a meal-related increase in LF/HF-ratio. When combining all study subjects, homeostatic model assessment- insulin resistance (HOMA-IR) was inversely correlated with changes in DBP, SVR, LF/HF-ratio and BRS. %26lt;br%26gt;Conclusions: Based on these data, we hypothesize that in patients with uncomplicated type 2 diabetes, insulin resistance hampers adequate meal-induced sympathetic activation, leading to a decrease in SVR and resulting in a postprandial drop in DBP.

• 出版日期2014-12