Effect of repaglinide on endothelial dysfunction during a glucose tolerance test in subjects with impaired glucose tolerance

BACKGROUND: Impaired glucose tolerance (IGT) is associated with increased cardiovascular risk. The pathophysiological mechanisms linking post-challenge hyperglycemia to accelerated atherosclerosis, however remain to be elucidated. METHODS: A prospective, open, randomised, cross-over study was performed to investigate the effect of 2 mg repaglinide on hyperglycemia and endothelial function during an oral glucose tolerance test (75 g glucose) in 12 subjects with diagnosed IGT. Blood samples for determination of plasma glucose were drawn fasting, 1 and 2 hours after glucose ingestion. Endothelial function was assessed by measuring flow-mediated dilatation (FMD) of the brachial artery with high-resolution ultrasound. RESULTS: Administration of repaglinide resulted in a significant reduction of plasma glucose at 2 hours (172.8+/-48.4 vs. 138.3+/-41.2 mg/dl; p < 0.001). The flow-mediated dilatation (FMD) 2 hours after the glucose-load was significantly reduced in comparison to fasting in the control group (6.21+/-2.69 vs. 7.98+/-2.24 %; p = 0.028), whereas after theadministration of repaglinide the FMD was not significantly different to fasting values (7.24+/-2.57 vs. 8.18+/-2.93 %; p = n.s.). Linear and logistic regression analysis revealed that only the change of glucose was significantly correlated to the change of FMD observed (p < 0.001). Regression analysis after grouping for treatment and time confirmed the strong negative association of the changes of plasma glucose and FMD and indicate that the effect of repaglinide observed is based on the reduction glycemia. CONCLUSION: In subjects with IGT, the endothelial dysfunction observed after a glucose challenge is related to the extent of hyperglycemia. Reduction of hyperglycemia by repaglinide reduces endothelial dysfunction in a glucose dependent manner

In situ study of dynamic recrystallization and hot deformation behavior of a multiphase titanium aluminide alloy

Hot-compression tests were conducted in a high-energy synchrotron x-ray beam to study in situ and in real time microstructural changes in the bulk of a β-solidifying titanium aluminide alloy. The occupancy and spottiness of the diffraction rings have been evaluated in order to access grain growth and refinement, orientation relationships, subgrain formation, dynamic recovery, and dynamic recrystallization, as well as phase transformations. This method has been applied to an alloy consisting of two coexisting phases at high temperature and it was found that the bcc β-phase recrystallizes dynamically, much faster than the hcp α-phase, which deforms predominantly through crystallographic slip underpinned by a dynamic recovery process with only a small component of dynamic recrystallization. The two phases deform to a very large extent independently from each other. The rapid recrystallization dynamics of the β-phase combined with the easy and isotropic slip characteristics of the bcc structure explain the excellent deformation behavior of the material, while the presence of two phases effectively suppresses grain growth