Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/20853
Title: Comparison of endothelial function and sympathetic nervous system activity along the glucose continuum in individuals with differing metabolic risk profiles and low dietary sodium intake.
Authors: Baqar, Sara;Straznicky, Nora E;Lambert, Gavin;Kong, Yee Wen;Dixon, John B;Jerums, George;Ekinci, Elif Ilhan;Lambert, Elisabeth
Affiliation: Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
Department of Human Neurotransmitters Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
Faculty of Health, Arts and Design, Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia
Vascular and Hypertension, Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2019
EDate: 2019
Citation: BMJ Open Diabetes Research & Care 2019; 7(1): e000606
Abstract: Low sodium intake may trigger sympathetic nervous system (SNS) activation and endothelial dysfunction. Studies have not explored these associations along the glucose continuum. Accordingly, we compared endothelial function and SNS activity in individuals with low sodium intake and differing categories of metabolic risk along the glucose continuum. We hypothesized that low sodium intake is associated with (1) impairment of endothelial function and (2) higher SNS activity in individuals with higher metabolic risk. In this prospective observational study, participants (n=54) with low sodium intake (single 24 hours urine sodium excretion <150 mmol/24 hours) were categorized based on oral glucose tolerance testing as: normal glucose tolerance (NGT, n=10), impaired glucose tolerance (IGT, n=15), treatment naive type 2 diabetes (T2D-) (n=12) or treated type 2 diabetes (T2D+) (n=17). We assessed endothelial function using pulse amplitude tonometry (PAT) derived reactive hyperemic index and PAT ratio; arterial stiffness via augmentation index; muscle sympathetic nerve activity (MSNA) using microneurography; cardiac baroreflex; heart rate; blood pressure; glycosylated hemoglobin A1c (HbA1c) and lipid profile. Mean (SD) sodium excretion was 110.6 (26) mmol/24 hours. Compared with NGT, IGT and T2D-, the T2D+ group had lower MSNA (p=0.005), PAT ratio (p=0.04) and baroreflex sensitivity (p=0.0002) and an augmented heart rate (p=0.02). The T2D+ group had appropriate mean (SD) glycemic (HbA1c 7.2 (1.72)%), total cholesterol (4.2 (1.0) mmol/L), low-density lipoprotein (2.2 (1.0) mmol/L) and blood pressure (systolic 136 (13), diastolic 78 (12)) (mm Hg) control. Individuals with T2D+ have impaired endothelial and baroreflex function, despite low sodium intake, appropriately managed cardiometabolic risk factors and lower SNS activity, compared with others along the glucose continuum. Whether low sodium intake is associated with modulation of the sympathovascular profile in T2D requires further investigation.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20853
DOI: 10.1136/bmjdrc-2018-000606
ORCID: 0000-0002-4921-1349
0000-0003-2372-395X
0000-0002-2232-9048
PubMed URL: 31114697
ISSN: 2052-4897
Type: Journal Article
Subjects: cardiovascular disease
endothelial dysfunction
impaired glucose tolerance
microneurography
pulse amplitude tonometry
sympathetic nervous system
twenty four hour urinary sodium excretion
type 2 diabetes
Appears in Collections:Journal articles

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