Manjula Nandakumar
Effect of Hypoglycemia and Rebound Hyperglycemia on Proteomic Cardiovascular Risk Biomarkers
Nandakumar, Manjula; Sathyapalan, Thozhukat; Atkin, Stephen L.; Butler, Alexandra E.
Authors
Professor Thozhukat Sathyapalan T.Sathyapalan@hull.ac.uk
Professor of Diabetes, Endocrinology and Metabolism
Stephen L. Atkin
Alexandra E. Butler
Abstract
Introduction: Hypoglycemia has been associated with cardiovascular events, and glucose variability has been suggested to be associated with increased cardiovascular risk. Therefore, in this study, we examined the effect on proteomic cardiovascular risk protein markers of (i) mild iatrogenic hypoglycemia and (ii) severe iatrogenic hypoglycemia followed by rebound hyperglycemia. Methods: Two iatrogenic hypoglycemia studies were compared; firstly, mild hypoglycemia in 18 subjects (10 type 2 diabetes (T2D), 8 controls; blood glucose to 2.8 mmoL/L (50 mg/dL) for 1 h), and secondly, severe hypoglycemia in 46 subjects (23 T2D, 23 controls; blood glucose to <2.2 mmoL/L (<40 mg/dL) transiently followed by intravenous glucose reversal giving rebound hyperglycemia). A SOMAscan assay was used to measure 54 of the 92 cardiovascular protein biomarkers that reflect biomarkers involved in inflammation, cellular metabolic processes, cell adhesion, and immune response and complement activation. Results: Baseline to euglycemia showed no change in any of the proteins measured in the T2D cohort. With severe hypoglycemia, the study controls showed an increase in Angiopoietin 1 (ANGPT1) (p < 0.01) and Dickkopf-1 (DKK1) (p < 0.01), but no changes were seen with mild hypoglycemia. In both the mild and severe hypoglycemia studies, at the point of hypoglycemia, T2D subjects showed suppression of Brother of CDO (BOC) (p < 0.01). At 1 h post-hypoglycemia, the changes in ANGPT1, DKK1, and BOC had resolved, with no additional protein biomarker changes despite rebound hyperglycemia from 1.8 ± 0.1 to 12.2 ± 2.0 mmol/L. Conclusions: Proteomic biomarkers of cardiovascular disease showed changes at hypoglycemia that resolved within 1 h following the hypoglycemic event and with no changes following hyperglycemia rebound, suggesting that any cardiovascular risk increase is due to the hypoglycemia and not due to glucose fluctuation per se.
Citation
Nandakumar, M., Sathyapalan, T., Atkin, S. L., & Butler, A. E. (2024). Effect of Hypoglycemia and Rebound Hyperglycemia on Proteomic Cardiovascular Risk Biomarkers. Biomedicines, 12(6), Article 1137. https://doi.org/10.3390/biomedicines12061137
Journal Article Type | Article |
---|---|
Acceptance Date | May 14, 2024 |
Online Publication Date | May 21, 2024 |
Publication Date | Jun 1, 2024 |
Deposit Date | Aug 22, 2024 |
Publicly Available Date | Aug 23, 2024 |
Journal | Biomedicines |
Print ISSN | 2227-9059 |
Electronic ISSN | 2227-9059 |
Publisher | MDPI |
Peer Reviewed | Peer Reviewed |
Volume | 12 |
Issue | 6 |
Article Number | 1137 |
DOI | https://doi.org/10.3390/biomedicines12061137 |
Keywords | Type 2 diabetes; Hypoglycemia; Glucose variability; Cardiovascular markers |
Public URL | https://hull-repository.worktribe.com/output/4736402 |
Files
Published article
(235 Kb)
PDF
Publisher Licence URL
http://creativecommons.org/licenses/by/4.0
Copyright Statement
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
You might also like
Molecular Aspects of Cardiovascular Risk Factors
(2024)
Journal Article
A Cross-Sectional Study of Glomerular Hyperfiltration in Polycystic Ovary Syndrome
(2024)
Journal Article
Downloadable Citations
About Repository@Hull
Administrator e-mail: repository@hull.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search