Postprandial endothelial activation in healthy subjects and in type 2 diabetic patients: Role of fat and carbohydrate meals

• Published in: Journal of the American College of Cardiology 2002-04, Vol.39 (7), p.1145-1150
• Main Authors: Nappo, Francesco, Esposito, Katherine, Cioffi, Michele, Giugliano, Giovanni, Molinari, Anna Maria, Paolisso, Giuseppe, Marfella, Raffaele, Giugliano, Dario
• Format: Article
• Language: English
• Subjects: Adult; Antioxidants - administration & dosage; Antioxidants - pharmacology; Ascorbic Acid - administration & dosage; Ascorbic Acid - pharmacology; Associated diseases and complications; Biological and medical sciences; Blood Glucose - analysis; Cardiology; Cell adhesion & migration; Cholesterol; Cross-Over Studies; Diabetes Mellitus, Type 2 - metabolism; Diabetes. Impaired glucose tolerance; Dietary Carbohydrates - pharmacology; Dietary Fats - pharmacology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelium, Vascular - metabolism; Female; Humans; Intercellular Adhesion Molecule-1 - blood; Interleukin-6 - blood; Male; Meals; Medical sciences; Metabolic disorders; Middle Aged; Postprandial Period; Tumor Necrosis Factor-alpha - analysis; Variance analysis; Vascular Cell Adhesion Molecule-1 - blood; Vitamin E - administration & dosage; Vitamin E - pharmacology
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/S0735-1097(02)01741-2

To compare the effect of a high-fat meal and a high-carbohydrate meal (pizza), with and without antioxidant vitamins, on endothelial activation in healthy subjects and in patients with type 2 diabetes mellitus. The postprandial state is becoming increasingly acknowledged to affect some early events of atherogenesis. In a randomized, observer-blinded, crossover study, 20 newly diagnosed type 2 diabetic patients and 20 age- and gender-matched healthy subjects received two meals at one-week intervals: a high-fat meal (760 calories) and an isoenergetic high-carbohydrate meal (non-cheese pizza). In all subjects, the same meals were repeated immediately following ingestion of vitamin E, 800 IU, and ascorbic acid, 1,000 mg. In normal subjects, the high-fat meal increased the plasma levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1), which were prevented by vitamins. No change in these parameters occurred after pizza ingestion or pizza ingestion with vitamins. In diabetic patients, basal concentrations of glucose, cytokines and adhesion molecules were significantly higher than in nondiabetic controls. Both meals significantly increased cytokine and adhesion molecule levels, but the increase was more sustained following the high-fat meal. There was no significant change from baseline when vitamin supplementation accompanied each meal. There was a relationship between changes in serum triglycerides and changes in TNF-α (r = 0.39, p < 0.01), IL-6 (r = 0.28, p < 0.05) and VCAM-1 (r = 0.25, p < 0.05), and between changes in plasma glucose and changes in IL-6 (r = 0.36, p < 0.01) and ICAM-1 (r = 0.31, p < 0.02). An oxidative mechanism mediates endothelial activation induced by post-meal hyperlipidemia and hyperglycemia.