Glucose fluctuation and the resultant endothelial injury are correlated with pancreatic β cell dysfunction in patients with coronary artery disease

Aims We evaluated whether glucose fluctuation (GF) causes vascular endothelial injury and affects glucometabolic factors during lengthy oral glucose tolerance test (OGTT). Methods We enrolled consecutive 116 patients with coronary artery disease (CAD) who were performed coronary angiography and 4-h OGTT. Blood samples were collected before and 4 h after glucose load to measure endothelial injury factor [von Willebrand factor (vWF) and vWF/a disintegrin-like and metalloproteinase with thrombospondin type-1 motifs 13 (ADAMTS-13) ratio]. GF was defined as maximum – minimum blood glucose levels during 4-h OGTT. We estimated the relationship between GF and glucometabolic factors. Results vWV and vWF/ADAMTS-13 ratio were significantly correlated with GF during 4-h OGTT. GF was significantly correlated with homeostasis model to assess insulin resistance (HOMA-IR) (R = 0.262), Matsuda index (R = −0.405), insulinogenic index (R = −0.336), HbA1c (R = 0.281) and disposition index (R = −0.672). When dividing patients into impaired and preserved category groups according to the average value of GF (122 mg/dL), adjusted to age, sex, HOMA-β, insulinogenic index, HOMA-IR, Matsuda index and HbA1c, disposition index was an independent risk factor for impaired GF [odds ratio (95% confidence interval): 2.87 (1.70–4.83), P Conclusion Pancreatic β cell dysfunction is associated with GF and causes endothelial injury in CAD patients.