Acta Diabetologica (2018) 55:387–389
Brachial ow‑mediated dilation predicts glycemia worsening
in normoglycemic young subjects
· Marina Cardellini
· Giacomo Piciucchi
· Susanna Longo
· Valeria Guglielmi
· Giovanni Di Cola
· Chiara Pecchioli
· Massimo Federici
Received: 28 December 2017 / Accepted: 25 January 2018 / Published online: 26 February 2018
© Springer-Verlag Italia S.r.l., part of Springer Nature 2018
Endothelial dysfunction (ED) is a common feature of type
2 diabetes (T2D) and cardiovascular disorders. ED is early
detectable in subjects with either strong diabetes familiarity
or cardiovascular risk factors who may develop overt diabe-
tes later [1–4]. Brachial ﬂow-mediated dilatation (b-FMD)
is a marker of in vivo endothelial dysfunction, and it is a
simple no invasive method for identifying patients at risk
of CV disease. Nevertheless, to our knowledge, a clear link
between impaired endothelium-dependent vasodilation
in vivo and hyperglycemia spillover has never been reported.
To this purpose, we report here the relationship between
fasting glycaemia values analyzed 10 years later and baseline
endothelial dysfunction assessment in a group of normogly-
cemic subjects with and without familiarity for T2D [1–3].
An informed written consent was obtained from all par-
ticipants. The study was approved by the local ethics com-
mittee, and the reported investigations were carried out in
accordance with the principles of the Declaration of Helsinki
as revised in 2000. All subjects were previously enrolled for
diﬀerent studies [1–3] in which b-FMD was among available
baseline data; they carried out a new blood withdrawal
(10 years later the b-FMD registration) to evaluate fasting
glucose. Among the 125 individuals recruited in previous
reports [1–3], 121 subjects underwent a new fasting glucose
dosage; three men and one woman rejected to participate.
New cases of diabetes were identiﬁed in accordance with the
new American Diabetes Association (ADA) 2015 criteria, as
follows: (1) self-reported use of hypoglycemic medications,
(2) fasting (≥ 8 h) serum glucose level ≥ 126 mg/dl, or (3)
self-report of physician diagnosis. Similarly, in accordance
with the ADA 2015 criteria new case of impaired fasting
glucose (IFG) were stated if fasting glucose levels were
≥ 100 mg/dl. B-FMD technique was described previously,
and a single operator (S.R.) performed the measurements
and collected the data.
Statistical analysis was performed with the SPSS 15.0
software (SPSS Inc, Chicago, IL). Data were expressed
as mean ± SD or as percent frequency, and comparisons
between groups were made by independent t-test or chi-
square test, as appropriate.
Normal distribution was previously assessed with Kol-
The 10 years glucose variation was calculated as follow:
[(glycaemia 10 years later − baseline glycaemia)/baseline
glycaemia] × 100.
Multiple linear regression analysis, using the 10 years
glucose changing as dependent variable, has been controlled
for some covariates linked to glucose impairment as follows:
age, sex, BMI, diabetes oﬀspring state, baseline glucose lev-
els or HOMA-IR, and b-FMD.
For all these analyzes, a p value < 0.05 was considered
as statistically signiﬁcant.
Managed by Antonio Secchi.
* Stefano Rizza
* Massimo Federici
Department of Systems Medicine, University of Rome Tor
Vergata, Rome, Italy
Center for Atherosclerosis, Policlinico Tor Vergata, Rome,