{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:14:20Z","timestamp":1789146860388,"version":"build-2803163510"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,10,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Endothelial dysfunction is a consequence of type 2 diabetes mellitus, but it is unclear whether endothelial dysfunction of conductance versus resistance vessels may also precede type 2 diabetes mellitus development.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a population\u2010based cohort of 15\u00a0010 individuals from the GHS (Gutenberg Health Study) (aged 35\u201374\u00a0years at enrollment in 2007\u20132012), we identified 1610 cases of incident pre\u2013diabetes mellitus and 386 cases of incident type 2 diabetes mellitus by hemoglobin A\n              <jats:sub>1c<\/jats:sub>\n              (HbA\n              <jats:sub>1c<\/jats:sub>\n              ) and\/or medical history between 2012 and 2017. Endothelial function of conductance and resistance vessels was measured by flow\u2010mediated dilation and digital volume plethysmography\u2013derived reactive hyperemia index, respectively. Multivariable regression modeling was used to estimate \u03b2 coefficients of HbA\n              <jats:sub>1c<\/jats:sub>\n              levels at follow\u2010up and relative risks of incident (pre\u2013)diabetes mellitus. Reactive hyperemia index was independently associated with HbA\n              <jats:sub>1c<\/jats:sub>\n              after multivariable adjustment for baseline HbA\n              <jats:sub>1c<\/jats:sub>\n              , sex, age, socioeconomic status, arterial hypertension, waist\/height ratio, pack\u2010years of smoking, non\u2013high\u2010density lipoprotein\/high\u2010density lipoprotein ratio, physical activity, family history of myocardial infarction\/stroke, prevalent cardiovascular disease, medication use, and C\u2010reactive protein (\u03b2=\u22120.020;\n              <jats:italic>P<\/jats:italic>\n              =0.0029). The adjusted relative risk per SD decline in reactive hyperemia index was 1.08 (95% CI, 1.02\u20131.15;\n              <jats:italic>P<\/jats:italic>\n              =0.012) for incident pre\u2013diabetes mellitus and 1.16 (95% CI, 1.01\u20131.34;\n              <jats:italic>P<\/jats:italic>\n              =0.041) for incident type 2 diabetes mellitus. Flow\u2010mediated dilation independently increased the relative risk for developing pre\u2013diabetes mellitus by 8% (95% CI, 1.02\u20131.14;\n              <jats:italic>P<\/jats:italic>\n              =0.012), but it was not independently associated with incident type 2 diabetes mellitus (relative risk, 1.01; 95% CI, 0.86\u20131.19;\n              <jats:italic>P<\/jats:italic>\n              =0.92) and with HbA\n              <jats:sub>1c<\/jats:sub>\n              (\u03b2=\u22120.003;\n              <jats:italic>P<\/jats:italic>\n              =0.59).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Endothelial dysfunction of resistance rather than conductance vessels may precede the development of (pre\u2013)diabetes mellitus. Assessment of endothelial function by digital volume plethysmography may help to identify subjects at risk for development of type 2 diabetes mellitus.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.119.012509","type":"journal-article","created":{"date-parts":[[2019,10,4]],"date-time":"2019-10-04T09:08:08Z","timestamp":1570180088000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Endothelial Function Assessed by Digital Volume Plethysmography Predicts the Development and Progression of Type 2 Diabetes Mellitus"],"prefix":"10.1161","volume":"8","author":[{"given":"Omar","family":"Hahad","sequence":"first","affiliation":[{"name":"Center for Cardiology\u2013Cardiology I University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp S.","family":"Wild","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"German Center for Cardiovascular Research partner site Rhine\u2010Main Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen H.","family":"Prochaska","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"German Center for Cardiovascular Research partner site Rhine\u2010Main Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schulz","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Hermanns","sequence":"additional","affiliation":[{"name":"Preventive Cardiology and Preventive Medicine Center for Cardiology University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl J.","family":"Lackner","sequence":"additional","affiliation":[{"name":"German Center for Cardiovascular Research partner site Rhine\u2010Main Mainz Germany"},{"name":"Institute of Clinical Chemistry and Laboratory Medicine University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz 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Cardiology\u2013Cardiology I University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"German Center for Cardiovascular Research partner site Rhine\u2010Main Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Deanfield","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science University College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Center for Cardiology\u2013Cardiology I University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"Center for Thrombosis and Hemostasis University Medical Center of the Johannes Gutenberg\u2013University Mainz Mainz Germany"},{"name":"German Center for Cardiovascular Research partner site Rhine\u2010Main Mainz 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