48h Glycaemic Variability from Subcutaneous Continuous Glucose Monitoring and Interleukine-6 Concentrations in Subjects with Metabolic Syndrome
Abstract Number: 225-P
Authors: SILVIO BUSCEMI, SALVATORE VERGA, SANTINA COTTONE, ANDREA RE, MARIA ROSARIA TRANCHINA, ANNA VADALÀ, ALESSANDRO MATTINA, GIOVANNI CERASOLA, Palermo, Italy
Institutions: Palermo, Italy
Results: Diabetic subjects exhibit an increased cardiovascular risk even before the appearance of diabetes. Furthermore, metabolic syndrome (MS) is a condition associated with both high cardiovascular and diabetes risk. It cannot therefore be excluded that both fasting and postprandial plasma glucose concentrations, as well as glycated haemoglobin, might not entirely describe the glycaemic control and its influence on cardiovascular risk. The glycaemic variability is a measure of the frequency and duration of glycaemic excursions and it might potentially have cardiovascular effects. The aim of this study was to investigate the glycaemic variability, measured by subcutaneous continuous glucose monitoring (SCGM), and the blood concentrations of some adipokines (IL6, TNF-α, adiponectin), 8-iso-prostaglandin (8-iso-PG) F2α and insulin in subjects with MS. Three groups of obese subjects with (MS+: 9m/13f, BMI 32.6 ± 1.4 mean ± sem) or without MS (MS-: 5m/7f, BMI 30.0 ± 2.1) and with MS and type 2 diabetes (MS/T2D: 5m/ 8f, BMI 31.4 ± 2.2) were investigated. The glycaemic variability was measured in all subjects in terms of CV% of the glycaemic values obtained every 3 minutes during the course of a 48h SCGM (Glucoday; Menarini Diagnostics, Italy); the citochine and hormone concentrations were obtained in a subgroup of 27 subjects (SM-: 7; SM+: 12; SM+/T2D: 8). The average SCGM CV% increased from MS- (21.8%) to the MS+ (23.3%) and to the MS+/T2D group (28.4%), it was not correlated with the SCGM mean glycaemia (r= 0.16; p ns). In some instances the SCGM CV% was higher in MS+ subjects than in some MS+/T2D subjects. IL-6 concentrations increased across the three groups (MS-: 72 ± 28; MS+: 83 ± 15; MS+/T2D: 109 ± 14 pg/ml); a similar trend was observed for 8-iso-PGF2α concentrations. Adiponectin concentrations decreased across the three groups; IL-6 and adiponectin were inversely correlated (r= -0.63; p< 0.01). IL-6 was a predictor of SCGM CV% independent from age, sex, BMI, waist circumference, adiponectin and insulin concentrations (p= 0.01); adiponectin independently predicted SCGM mean glycaemia (p= 0.04). In conclusion, these results are in agreement with the hypothesis that the SCGM CV% might contribute to describe the individual metabolic conditions and to understand the pathogenesis of endothelial dysfunction in subjects with MS.