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Titolo:
INSULIN-RESISTANCE AND VASODILATION IN ESSENTIAL-HYPERTENSION - STUDIES WITH ADENOSINE
Autore:
NATALI A; BONADONNA R; SANTORO D; GALVAN AQ; BALDI S; FRASCERRA S; PALOMBO C; GHIONE S; FERRANNINI E;
Indirizzi:
UNIV PISA,CNR,INST CLIN PHYSIOL,METAB UNIT,VIA SAVI 8 I-56100 PISA ITALY UNIV PISA,CNR,INST CLIN PHYSIOL,HYPERTENS UNIT I-56100 PISA ITALY
Titolo Testata:
The Journal of clinical investigation
fascicolo: 4, volume: 94, anno: 1994,
pagine: 1570 - 1576
SICI:
0021-9738(1994)94:4<1570:IAVIE->2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
MUSCLE BLOOD-FLOW; SKELETAL-MUSCLE; GLUCOSE-UPTAKE; MICROVASCULAR RAREFACTION; HUMANS; SENSITIVITY; METABOLISM;
Keywords:
ESSENTIAL HYPERTENSION; INSULIN RESISTANCE; ADENOSINE; FOREARM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
A. Natali et al., "INSULIN-RESISTANCE AND VASODILATION IN ESSENTIAL-HYPERTENSION - STUDIES WITH ADENOSINE", The Journal of clinical investigation, 94(4), 1994, pp. 1570-1576

Abstract

Insulin-mediated vasodilation has been proposed as a determinant of in vivo insulin sensitivity. We tested whether sustained vasodilation with adenosine could overcome the muscle insulin resistance present in mildly overweight patients with essential hypertension. Using the forearm technique, we measured the response to a 40-min local intraarterial infusion of adenosine given under fasting conditions (n = 6) or superimposed on a euglycemic insulin clamp (n = 8). In the fasting state, adenosine-induced vasodilation (forearm blood how from 2.6+/-0.6 to 6.0+/-1.2 ml min(-1)dl(-1), P < 0.001) was associated with a 45% rise inmuscle oxygen consumption (5.9+/-1.0 vs 8.6+/-1.7 mu mol min(-1)dl(-1), P < 0.05), and a doubling of forearm glucose uptake (0.47+/-0.15 to1.01+/-0.28 mu mol min(-1)dl(-1), P < 0.05). The latter effect remained significant also when expressed as a ratio to concomitant oxygen balance (0.08+/-0.03 vs 0.13+/-0.04 mu mol mu mol(-1), P < 0.05), whereas for all other metabolites (lactate, pyruvate, FFA, glycerol, citrate, and beta-hydroxybutyrate) this ratio remained unchanged. During euglycemic hyperinsulinemia, whole-body glucose disposal was stimulated (to 19+/-3 mu mol min(-1)kg(-1)), but forearm blood flow did not increase significantly above baseline (2.91+/-0.2 vs 3.1+/-0.2 ml min(-1)dl(-1), P = NS). Forearm oxygen balance increased (by 30%, P < 0.05) and forearm glucose uptake rose fourfold (from 0.5 to 2.3 mu mol min(-1)dl(-1), P < 0.05). Superimposing an adenosine infusion into one forearm resulted in a 100% increase in blood flow (from 2.9+/-0.2 to 6.1+/-0.9 ml min(-1)dl(-1), P < 0.001); there was, however, no further stimulation of oxygen or glucose uptake compared with the control forearm. During the clamp, the ratio of glucose to oxygen uptake was similar in thecontrol and in the infused forearms (0.27+/-0.11 and 0.23+/-0.09, respectively), and was not altered by adenosine (0.31+/-0.9 and 0.29+/-0.10). We conclude that in insulin-re15-76sistant patients with hypertension, adenosine-induced vasodilation recruits oxidative muscle tissuesand exerts a modest, direct metabolic effect to promote muscle glucose uptake in the fasting state. Despite these effects, however, adenosine does not overcome muscle insulin resistance.

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Documento generato il 28/11/20 alle ore 21:32:36