Høieggen A, Fossum E, Moan A, Rostrup M, Eide I K, Kjeldsen S E
Department of Internal Medicine, Ullevaal Hospital, University of Oslo, Norway.
Blood Press. 1999;8(4):227-32. doi: 10.1080/080370599439616.
It is controversial whether raised insulin within the physiological concentration range increases forearm blood flow (FBF). The aim of the present study was therefore to examine the effect of the isoglycemic hyperinsulinemic glucose clamp procedure on FBF and to relate the increase to the glucose disposal rate (GDR), i.e. insulin sensitivity. Borderline hypertensive young men were examined with the clamp technique or received saline infusion, and FBF was measured using plethysmography. It is of particular interest to study this group of subjects because their GDR correlates to a number of metabolic and hemodynamic variables, and these subjects hyperreact to stressful stimuli. There was no correlation between deltaFBF during clamp and GDR (r = -0.002, p = 0.99, n = 28). While serum insulin increased from 107 +/- 5 to 628 +/- 31 pmol/l in the hyperinsulinemic group and remained unchanged (135 +/- 11 vs 116 +/- 11 pmol/l) in the saline group, FBF increased from 3.5 +/- 0.3 to a maximum of 5.1 +/- 0.4 ml/min/100 ml (p < 0.001, n = 28) and from 2.8 +/- 0.5 to a maximum of 4.5 +/- 0.5 ml/min/100 ml (p = 0.01, n = 8), respectively. The increase in FBF (delta%) was similar in the two groups (p = 0.9). Thus, we could not demonstrate any relationship between insulin sensitivity and increments in FBF during hyperinsulinemic glucose clamp in borderline hypertensive young men. The moderate increases in FBF during insulin infusion with serum concentrations within the physiological range seem to be time-dependent and not caused by hyperinsulinemia.
生理浓度范围内胰岛素升高是否会增加前臂血流量(FBF)存在争议。因此,本研究的目的是检查等血糖高胰岛素葡萄糖钳夹术对FBF的影响,并将增加量与葡萄糖处置率(GDR),即胰岛素敏感性相关联。对临界高血压青年男性进行钳夹技术检查或接受生理盐水输注,并使用体积描记法测量FBF。研究这组受试者特别有意义,因为他们的GDR与许多代谢和血流动力学变量相关,并且这些受试者对压力刺激反应过度。钳夹期间的FBF变化量(deltaFBF)与GDR之间无相关性(r = -0.002,p = 0.99,n = 28)。高胰岛素组血清胰岛素从107±5 pmol/l增加到628±31 pmol/l,而生理盐水组保持不变(135±11 vs 116±11 pmol/l),FBF分别从3.5±0.3增加到最大5.1±0.4 ml/min/100 ml(p < 0.001,n = 28)和从2.8±0.5增加到最大4.5±0.5 ml/min/100 ml(p = 0.01,n = 8)。两组FBF的增加百分比(delta%)相似(p = 0.9)。因此,我们无法证明临界高血压青年男性在高胰岛素葡萄糖钳夹期间胰岛素敏感性与FBF增加之间存在任何关系。在胰岛素输注期间,血清浓度在生理范围内时FBF的适度增加似乎与时间有关,而非由高胰岛素血症引起。