The Effects of Plasma Insulin and Glucose on Myocardial Blood Flow in Patients With Type 1 Diabetes Mellitus
| Autor: | Donna Lesniak, Pilar Herrero, Robert J. Gropler, Bastiaan Heere, Victor G. Davila-Roman, Jasper Bennik, Muthayyah Srinivasan, Janet B. McGill |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty endocrine system diseases medicine.medical_treatment 030209 endocrinology & metabolism 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Coronary Circulation Internal medicine Blood plasma Hyperinsulinemia Humans Insulin Medicine Aged Type 1 diabetes business.industry nutritional and metabolic diseases Blood flow Middle Aged Glucose clamp technique medicine.disease Coronary Vessels 3. Good health Vasodilation Diabetes Mellitus Type 1 Endocrinology Positron-Emission Tomography Circulatory system Glucose Clamp Technique Female Hemoglobin business Cardiology and Cardiovascular Medicine |
| Zdroj: | Journal of the American College of Cardiology. (1):42-48 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2005.03.056 |
| Popis: | ObjectivesThe objective of this study was to determine the impact of insulin and glucose on myocardial vasodilator function in patients with type 1 diabetes mellitus (T1DM).BackgroundThe relative importance of plasma insulin and glucose levels on the abnormal vasodilator function observed in T1DM is unknown.MethodsTwenty T1DM patients underwent positron emission tomography studies to measure myocardial blood flow (MBF) (in ml/g/min) at rest (MBFr) and during adenosine (MBFa), both under baseline metabolic conditions and then during either hyperinsulinemic-euglycemic clamp (HE) (n = 10; 40 ± 9 years, 8 female subjects, hemoglobin A1c [HbA1c] 7.8 ± 1.1%) or hyperinsulinemic-hyperglycemic clamp (HH) (n = 10; 44 ± 12 years, 8 female subjects, hemoglobin A1c 7.7 ± 0.6%).ResultsBoth groups showed similar MBFr and MBFa under baseline metabolic conditions (p = NS). Compared with baseline conditions, MBFr increased in the HH group (p < 0.005), whereas it did not change in the HE group. Compared with baseline conditions, MBFa decreased in the HH group (p < 0.05) but did not change in the HE group. Myocardial perfusion reserve (MPR) (MBFa /MBFr) was similar between the HE and HH groups at baseline (p = NS). During clamp, MPR tended to decrease in the HH group (p < 0.1) but did not change in the HE group (p = NS) when compared with baseline conditions. However, during the clamp MPR was significantly lower in the HH group when compared with the HE group (p < 0.0001).ConclusionsIn the short term, hyperglycemia has a deleterious effect on myocardial vasodilator function, which outweighs the beneficial effect of hyperinsulinemia. |
| Databáze: | OpenAIRE |
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