Insulin resistance with its associated metabolic derangements is associated with cardiovascular disease. It is unknown if lesser degrees of this metabolic derangement are associated with early vascular functional or structural changes. Our aim is to examine the relationship between glycemic indices and early vascular dysfunction in healthy subjects.

For this study 109 male and 117 female, lifelong non-smoking, normotensive subjects (40±11 years, BMI 25.6±3.9 kg.m²) were recruited from general population. Subjects with abnormal glycemic responses after an oral glucose tolerance test (OGTT) were excluded. High resolution B-mode ultrasound images (HD7XE, Philips, U.K) of the common carotid artery were used to measure carotid intima-media thickness (CIMT) and calculate carotid compliance/distensibility. Central aortic blood pressure and pulse wave velocity (PWV) were measured using applanation tonometry (Sphygmacor & Vicorder, Skidmore Medical, U.K). Early/late mitral valve filling velocity (MV E/A) was used to assess cardiac diastolic function (Vivid 7 Dimension, GE, USA).

Mean fasting and plasma glucose and post OGTT glucose were 5.02±0.46 mmol.L⁻¹ and 4.96±1.09 mmol.L⁻¹. Mean CIMT, carotid compliance & distensibility, PWV and MV E/A were 0.52±0.07 mm, 15.86±13.15 m².kPa.10⁻⁷ & 49.09±34.95 kPa.10⁻³, 7.03±1.23 m.s⁻¹ and 43.46±18.65 respectively.

Spearman’s analysis revealed significant correlations between fasting blood glucose and carotid compliance & distensibility (−0.2205, p<0.0238; −0.2615, p<0.007), MV E/A ratio (−0.3722 p<0.0001) and PWV (0.1666, p<0.0127). No significant correlation with CIMT was observed (0.0614, p<0.4983).

These results indicate that the vascular disease continuum exists in association with metabolic derangement even in the “normal” ranges.