Clerk Lucy H, Vincent Michelle A, Lindner Jonathan R, Clark Michael G, Rattigan Stephen, Barrett Eugene J
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA.
Diabetes Metab Res Rev. 2004 Jan-Feb;20(1):3-12. doi: 10.1002/dmrr.414.
Whether a discrete vascular action of insulin in skeletal muscle integrally participates in insulin-mediated glucose disposal has been extensively examined but remains a contentious issue. Here, we review some of the data both supporting and questioning the role of insulin-mediated increases in limb blood flow in glucose metabolism. We advance the hypothesis that controversy has arisen, at least in part, from a failure to recognize that insulin exerts at least three separate actions on the peripheral vasculature, each with its own characteristic dose and time responsiveness. We summarize how, viewed in this manner, certain points of contention can be resolved. We also advance the hypothesis that an action on the precapillary arteriole may play the dominant role in mediating perfusion-dependent effects of insulin on glucose metabolism in muscle.
胰岛素在骨骼肌中的离散血管作用是否整体参与胰岛素介导的葡萄糖处置已得到广泛研究，但仍是一个有争议的问题。在此，我们回顾了一些支持和质疑胰岛素介导的肢体血流增加在葡萄糖代谢中作用的数据。我们提出一个假说，即争议的出现至少部分源于未能认识到胰岛素对周围血管系统至少有三种不同作用，每种作用都有其独特的剂量和时间反应性。我们总结了以这种方式看待时如何解决某些争议点。我们还提出一个假说，即对毛细血管前小动脉的作用可能在介导胰岛素对肌肉葡萄糖代谢的灌注依赖性效应中起主导作用。
