From the Division of Endocrinology and Metabolic Diseases (R.C.B., E.B.),
University of Verona and Azienda Ospedaliera di Verona (Italy); the Department
of Electronics and Informatics (M.P.S., C.C.) and the Division of Metabolic
Diseases (S.D.P.), University of Padua (Italy); and the Division of Diabetes
(R.A.D.), University of Texas Health Science Center and Audie L. Murphy
Veterans Administration Hospital, San Antonio, Tex.
Correspondence to Riccardo C. Bonadonna, MD, Division of Endocrinology and Metabolic Diseases, Ospedale Civile Maggiore, Piazzale Stefani 1, I-37126 Verona, Italy. E-mail malmetab{at}borgotrento.univr.it
Background—Conflicting evidence
exists concerning whether insulin-induced vasodilation plays a
mechanistic role in the regulation of limb glucose uptake. It can be
predicted that if insulin augments blood flow by causing tissue
recruitment, this mechanism would enhance limb glucose uptake.
Methods and Results—Twenty healthy subjects were studied with the
forearm perfusion technique in combination with the
euglycemic insulin clamp technique. Ten subjects were
studied at physiological insulin concentrations
(
Conclusions—Acceleration of forearm blood flow mediated by
supraphysiological
hyperinsulinemia is accompanied by tissue
recruitment, which may be a relevant determinant of forearm (muscle)
glucose uptake.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Role of Tissue-Specific Blood Flow and Tissue Recruitment in Insulin-Mediated Glucose Uptake of Human Skeletal Muscle
400 pmol/L) and the other 10 at
supraphysiological insulin concentrations (5600
pmol/L). Four additional subjects underwent a saline control study.
Pulse injections of a nonmetabolizable extracellular marker
(1-[3H]-L-glucose) were administered into the
brachial artery, and its washout curves were measured in one
ipsilateral deep forearm vein and used to estimate the extracellular
volume of distribution and hence the amount of muscle tissue drained by
the deep forearm vein. Both during saline infusion and at
physiological levels of
hyperinsulinemia we observed no changes in blood
flow and/or muscle tissue drained by the deep forearm vein. However,
supraphysiological
hyperinsulinemia accelerated total forearm blood
flow (45.0±1.8 versus 36.5±1.3 mL · min-1
· kg-1, P<0.01) and increased the amount
of muscle tissue drained by the deep forearm vein (305±46 versus
229±32 g, P<0.05). The amount of tissue newly
recruited by insulin was strongly correlated to the concomitant
increase in tissue glucose uptake (r=0.789,
P<0.01).
Key Words: blood flow • insulin • glucose • muscles
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