Decrease in the plasma von Willebrand factor concentration following glucose ingestion: The role of insulin sensitivity

Elevated plasma von Willebrand factor (vWF) concentration is thought to be associated with increased prevalence of cardiovascular events in the insuli n resistance syndrome. We examined the effects of oral glucose challenge an d accompanying metabolic and hemodynamic changes on vWF levels with respect to insulin sensitivity. Forty normotensive and hypertensive subjects (mean age +/- SD, 40 +/-5 years) underwent a standard oral glucose tolerance tes t (OGTT). Plasma vWF antigen, glucose, insulin, catecholamines, and hemodyn amics were measured at rest, and at 30, 60, 90, and 120 minutes after gluco se intake, Insulin sensitivity was determined by the insulin sensitivity in dex (ISI0,120). Resting plasma vWF concentration was associated with screen ing systolic blood pressure (BP) (r=.43, P=.005). There were time effects f or all variables of interest, While vWF antigen (P=.044), epinephrine (P=.0 03), and diastolic BP (P=.001) decreased after glucose challenge, norepinep hrine (P=.009), systolic BP (P=.022), and heart rate (P<.001) increased. De cline in vWF (area under the curve) was associated with decrease in epineph rine (r=46, P=.004) and with screening systolic BP (r=.45, P=.004). However , neither resting plasma vWF levels nor vWF decrease following glucose inge stion were significantly associated with the ISI0,120, The plasma vWF conce ntration decreases following glucose ingestion. While mechanisms underlying this phenomenon may relate to sympathetic nervous system function, they se em not related to insulin sensitivity. Endothelial dysfunction such as caus ed by hypertension rather than metabolic dysregulation per se may underlie the elevated plasma vWF concentration found with insulin resistance. Copyri ght (C) 2001 by W.B. Saunders Company.