Systemic and Local Adrenergic Regulation of Muscle Glucose Utilization During Hypoglycemia in Healthy Subjects
| Autor: | John M. Dopp, Bradley G. Phillips, Christine A. Sinkey, Robert P. Hoffman |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Glucose uptake Adrenergic beta-Antagonists Vasodilation Propranolol Fatty Acids Nonesterified Hypoglycemia Veins Phentolamine Insulin resistance Heart Rate Hyperinsulinism Internal medicine Receptors Adrenergic beta Internal Medicine medicine Humans Insulin Lactic Acid Muscle Skeletal Adrenergic alpha-Antagonists business.industry Hemodynamics Arteries Receptors Adrenergic alpha medicine.disease Glucose Endocrinology Epinephrine Glucose Clamp Technique Female medicine.symptom business Blood Flow Velocity Vasoconstriction medicine.drug |
| Zdroj: | Diabetes. 51:734-742 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/diabetes.51.3.734 |
| Popis: | Adrenergic responses are crucial for hypoglycemic recovery. Epinephrine increases glucose production, lipolysis, and peripheral insulin resistance as well as blood flow and glucose delivery. Sympathetic activation causes vasoconstriction and reduces glucose delivery. To determine the effects of α- and β-adrenergic activity on muscle glucose uptake during hypoglycemia, we studied forearm blood flow (FBF) (plethysmography), arteriovenous glucose difference (AV-diff), and forearm glucose uptake (FGU) during insulin infusion with 60 min of euglycemia followed by 60 min of hypoglycemia. Twelve healthy subjects (27 ± 5 years of age) were randomized to intravenous propranolol (IV PROP, 80 μg/min), intravenous phentolamine (IV PHEN, 500 μg/min), intra-arterial propranolol (IA PROP, 25 μg/min), intra-arterial phentolamine (IA PHEN, 12 μg/min per 100 ml forearm tissue), and saline (SAL). FBF increased during hypoglycemia with SAL (P < 0.001) but not with IA or IV PROP. FGU (P = 0.015) and AV-diff (P = 0.099) fell during hypoglycemia with IA PROP but not with IV PROP. FBF increased during hypoglycemia with IA and IV PHEN (P < 0.005). AV-diff fell during hypoglycemia with IA and IV PHEN (P < 0.01), but FGU was unchanged. Blood pressure fell (P < 0.001), and adrenergic and neuroglycopenic symptoms increased with IV PHEN (P < 0.01). Thus, systemic but not local propranolol prevents a decrease in forearm glucose extraction during hypoglycemia, suggesting that epinephrine increases peripheral muscular insulin resistance through systemic effects. α-Adrenergic activation inhibits vasodilation and helps maintain brain glucose delivery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|