| Sažetak | Introduction: Type 2 Diabetes Mellitus (T2DM) is a prevalent cause of morbidity and mortality, particularly due to chronic complications development, most commonly cardiovascular diseases. Among markers for assessment of clinical and subclinical signs of cardiovascular disease, the presence of arteriosclerosis, and stiffening of arterial walls as indicated by the arterial stiffness, was proven to be an important predictor of adverse cardiovascular events. Carotid-femoral pulse wave velocity (PWV) is considered as gold standard for arterial stiffness measurement. On the other side, moderate red wine (RW) consumption was shown to have cardioprotective effects by multiple epidemiologic and experimental studies.
Objective: The objective of this study was to examine the effects of moderate daily red wine intake on arterial stiffness and hemodynamic parameters in participants with well controlled T2DM.
Subjects and Methods: 18 well controlled-T2DM participants (taking metformin alone or with oral antidiabetic drugs as chronic therapy) were included in the cross-over interventional study during five weeks; the first two weeks being the drive-in period with no alcohol consumption (control), followed by three weeks of moderate, 300 ml per day, consumption of red wine Plavac mali with meals (intervention). At the end of each experimental period we assessed anthropometric data (body mass index), performed biochemical blood analysis (fasting plasma glucose, and HbA1c), while oscillometric and tonometric measurements of arterial stiffness (pulse wave velocity, peripheral and central augmentation indices) and hemodynamic parameters (heart rate, peripheral and central systolic, diastolic and pulse pressure) were performed by Arteriograph and SphygmoCor devices, respectively.
Results: Moderate RW consumption in well-controlled T2DM participants induced significant decrease of PWV (7.42±1.44 m/s for control, no alcohol period vs. 6.98±1.44 m/s for intervention, wine consumption period, P=0.013) and peripheral arterial diastolic pressure (79.72±11.47 mmHg in control, no alcohol period vs. 76.39±11.15 mmHg for intervention, wine consumption period, P=0.034), while other arterial stiffness and hemodynamic parameters were not significantly changed although showing a trend of decline.
Conclusion: In a cohort of subjects with well controlled T2DM, in whom clinical symptoms of cardiovascular disease were not yet expressed, there was a decrease in PWV. This indicates an improvement in arterial stiffness even after moderate consumption of red wine of relatively short duration. |
| Sažetak (hrvatski) | Uvod: Šećerna bolest tipa 2 važan je uzrok obolijevanja i smrtnosti posebice zbog razvoja kroničnih komplikacija od kojih su najčešće kardiovaskularne bolesti. Među markerima za procjenu kliničkih i subkliničkih znakova kardiovaskularnih bolesti, smanjenje arterijske elastičnosti, arterioskleroza, i pojava ukrućivanja stijenke arterija, engl. arterial stiffness, pokazalo se pouzdanim prediktorom kardiovaskularnog rizika. Karotidno-femoralna brzina pulsnog vala smatra se zlatnim standardom procjene arterijske elastičnosti/krutosti. S druge strane, kardioprotektivni učinci umjerene konzumacije crnog vina pokazani su u epidemiološkim i eksperimentalnim istraživanjima.
Cilj: Istražiti učinke umjerene konzumacije crnog vina na hemodinamske parametre i parametre arterijske elastičnosti u ispitanika oboljelih od šećerne bolesti tipa 2, kod kojih je bolest dobro nadzirana.
Ispitanici i metode: U ukriženo intervencijsko istraživanje uključeno je 18 ispitanika s dobro nadziranom šećernom bolesti tipa 2 (uz kroničnu terapiju metforminom) tijekom pet tjedana: dva tjedna bez konzumacije ikakvih alkoholnih pića, drive-in faza pokusa (kontrolna), nakon kojega je slijedilo tri tjedna umjerene konzumacije crnog vina sorte Plavac mali od 300 ml dnevno uz obrok (intervencija). Na kraju svake faze pokusa ispitanicima su izmjereni antropometrijski parametri (indeks tjelesne mase), učinjena biokemijska analiza krvi (plazmatska koncentracija glukoze natašte i koncentracija HbA1c), a hemodinamski parametri (srčana frekvencija, periferni i središnji sistolički, dijastolički i pulsni tlak) i parametri arterijske elastičnosti (brzina pulsnog vala, periferni i središnji augmentacijski indeksi) određeni su oscilometrijskom (Arteriograph) i tonometrijskom (SphygmoCor) metodom.
Rezultati: Nakon umjerene konzumacije vina došlo je do smanjenja brzine pulsnog vala (7,42±1,44 m/s u kontrolnoj fazi pokusa bez konzumacije alkoholnih pića vs. 6,98±1,44 m/s nakon intervencije, P=0,013) i perifernog dijastoličkog tlaka (79,72±11,47 mmHg u kontrolnoj fazi pokusa bez konzumacije alkoholnih pića vs. 76,39±11,15 mmHg nakon intervencije, P=0,034), dok su promjene ostalih hemodinamskih parametara i parametara arterijske elastičnosti bili statistički neznačajne, unatoč ostvarenom trendu smanjena.
Zaključci: U kohorti ispitanika s dobro nadziranom šećernom bolesti tipa 2, kod kojih još nisu izraženi klinički simptomi kardiovaskularne bolesti, došlo je do smanjenja brzine pulsnog vala. To ukazuje na poboljšanje arterijske elastičnosti čak i nakon umjerene konzumacije crnog vina relativno kratkog trajanja. |
