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March 15, 2012Journal of Hypertension

Insulin–endothelial interactions

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Key result

In healthy individuals, insulin infusion did not alter flow-mediated dilatation, but co-infusion with clonidine increased vascular responses to glyceryltrinitrate by 45%.

Why the study?

Does insulin infusion affect endothelium-independent and endothelium-dependent vasodilation in healthy individuals, and is this mediated by sympathetic activation?

Population

Healthy individuals (n=5 per group in the discussed study by Morgantini et al.)

Comparison

Insulin infusion with euglycemic clamp, with or… vs Control

Design

Editorial

Authors

NANitin T. AggarwalGGGuıdo Grassı

Discussion

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Member takes

Overview

Should not alter vascular testing in practice; hypothesis-generating for sympathetic mediation of insulin effects in health.

Structured PICO

Does insulin infusion affect endothelium-independent and endothelium-dependent vasodilation in healthy individuals, and is this mediated by sympathetic activation?

P
Population
5 healthy individuals undergoing insulin infusion with clamped plasma glucose levels.
I
Intervention
Insulin infusion (0.25 mU/kg per min) with euglycemic clamp, with or without clonidine (0.0052 μg/min per kg)
C
Comparator
Control
O
Outcome
Flow-mediated dilatation and endothelium-independent vascular relaxations (response to sublingual glyceryl trinitrate)surrogate

This editorial highlights evidence that in healthy individuals, insulin-induced decreases in endothelium-independent vascular relaxations may be mediated by sympathetic activation.

Limitations

  • Circulating plasma levels of adrenergic neurotransmitters cannot be regarded as faithful markers of sympathetic drive.
  • Limited number of individuals per group (n=5), resulting in insufficient statistical power to detect significant differences.
  • Use of circulating plasma catecholamines instead of sympathetic nerve traffic recording or regional norepinephrine spillover to assess sympathetic function
  • Small sample size (n=5 per group) leading to borderline differences or lack of statistical power

Cite This Study

Aggarwal et al. (2012) conducted an editorial in Healthy individuals (n=5). Insulin infusion vs. Control was evaluated on Flow-mediated dilatation and vasodilatatory responses to sublingual glyceryl trinitrate. In healthy individuals, insulin infusion did not alter flow-mediated dilatation, but co-infusion with clonidine increased vascular responses to glyceryltrinitrate by 45%.

synapsesocial.com/papers/6a7d970c0631e052c4b86d97https://doi.org/10.1097/hjh.0b013e32835077d5
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Insulin Causes Endothelial Dysfunction in Humans2002 · 409 citations
  2. 2Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans.1991 · 1,085 citations
  3. 3Dissociation of sympathoexcitatory and vasodilator actions of modestly elevated plasma insulin levels1995 · 91 citations
  4. 4Insulin impairs endothelium-dependent vasodilation independent of insulin sensitivity or lipid profile2004 · 57 citations
  5. 5Insulin, nitric oxide and the sympathetic nervous system1999 · 67 citations