Insulin is a key determinant of elevated retinal arteriolar flicker response in insulin-resistant individuals
| Autor: | Walthard Vilser, Stefan R. Bornstein, Tjalf Ziemssen, Manja Reimann, Matthias Gruber |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Hemodynamics Vasodilation Biology Retina Body Mass Index chemistry.chemical_compound Insulin resistance Internal medicine Internal Medicine medicine Humans Insulin Glucose tolerance test Anthropometry medicine.diagnostic_test Retinal Vessels Retinal Glucose Tolerance Test Middle Aged Glucose clamp technique medicine.disease Healthy Volunteers Arterioles Endocrinology medicine.anatomical_structure chemistry Body Composition Glucose Clamp Technique Regression Analysis Female Insulin Resistance |
| Zdroj: | Diabetologia. 58:2154-2160 |
| ISSN: | 1432-0428 0012-186X |
| Popis: | Insulin may link metabolic disorders to retinal microvascular pathology. The aim of the present study was to investigate the impact of early insulin resistance on retinal microcirculation.Retinal diameter responses to flicker-light stimulation were investigated in 81 clinically healthy participants (32 ± 6 years [mean ± SD], 59% women) who were recruited according to their BMI. All participants underwent an OGTT and euglycaemic-hyperinsulinaemic clamp (40 mU/m(2) · min(-1) insulin dose). After stratification by low and high insulin sensitivity based on a clamp-derived glucose disposal rate of ≤ or4.9 mg/kg body mass, respectively, baseline retinal diameters and their relative changes to flicker stimulation were compared while controlling for mean arterial pressure, BMI and sex.The arterial vasodilator response at the end of flicker stimulation (p = 0.044) and the area under the arterial reaction curve during flicker stimulation (p = 0.015) were significantly higher in individuals with low vs high insulin sensitivity. Vasodilatory responses of retinal veins to flicker stimulation and baseline retinal diameters did not differ between insulin-sensitive and insulin-resistant participants (p 0.05). In a stepwise linear regression analysis, fasting insulin remained the only predictor of the arterial vasodilator response to flicker-light (p 0.01). Waist circumference also contributed, although to a lesser extent, to the arterial vasodilator response (p = 0.023).Insulin sensitivity is an important determinant of retinal microvascular function. We propose that the elevated arterial flicker response in insulin-resistant states is a result of higher circulating insulin levels. |
| Databáze: | OpenAIRE |
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