van Gurp P J, Rongen G A, Lenders J W M, Al Nabawy A K M, Timmers H J L M, Tack C J
Division of General Internal Medicine, Department of Internal Medicine, University Medical Center St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Eur J Appl Physiol. 2005 Mar;93(5-6):648-54. doi: 10.1007/s00421-004-1247-6. Epub 2004 Nov 25.
An increase in capillary blood flow and pressure in response to diabetes mellitus may lead to microangiopathy. We hypothesize that these haemodynamic changes are caused by a decreased activity of the sympathetic nervous system due to episodes of sustained hyperglycaemia. Twelve healthy volunteers consecutively underwent a hyperglycaemic experiment (HYPER), with the plasma glucose level maintained at 20 mmol.l(-1) for 6 h by combined infusion of somatostatin, insulin and glucose; and a normoglycaemic experiment (NORMO), with similar infusions but with the plasma glucose maintained at fasting level. During both experiments, sympathetic nervous system (SNS) activity was measured by assessing the plasma catecholamine levels, microneurography, power spectral analysis and forearm blood flow (FBF). In an age- and weight matched group, fasting and 6-h sympathetic activity was measured without infusion of somatostatin and insulin (CONTROL). During HYPER, forearm blood flow increased from 2.45 (0.21) to 3.10 (0.48) ml.dl(-1).min(-1) ( P <0.05), but did not change in NORMO or CONTROL. The HYPER conditions did not change the plasma noradrenaline levels or the muscle sympathetic nerve activity [42 (4), 50 (10) and 45 (5) bursts/100 beats, HYPER, NORMO and CONTROL respectively]. Also, the power spectral analysis was similar under all experimental conditions. All results are expressed as the mean (SEM). In conclusion, sustained hyperglycaemia in normal subjects induces moderate vasodilation in skeletal muscle, but this increased blood flow can not be attributed to a decreased sympathetic tone.
糖尿病引起的毛细血管血流增加和压力升高可能会导致微血管病变。我们推测,这些血流动力学变化是由持续高血糖发作导致的交感神经系统活性降低引起的。12名健康志愿者依次进行了高血糖实验(HYPER),通过联合输注生长抑素、胰岛素和葡萄糖将血浆葡萄糖水平维持在20 mmol·l⁻¹ 6小时;以及正常血糖实验(NORMO),输注类似物质但将血浆葡萄糖维持在空腹水平。在两个实验过程中,通过评估血浆儿茶酚胺水平、微神经ography、功率谱分析和前臂血流量(FBF)来测量交感神经系统(SNS)活性。在一个年龄和体重匹配的组中,在不输注生长抑素和胰岛素的情况下测量空腹和6小时的交感活性(对照)。在HYPER期间,前臂血流量从2.45(0.21)增加到3.10(0.48)ml·dl⁻¹·min⁻¹(P<0.05),但在NORMO或对照中没有变化。HYPER条件下血浆去甲肾上腺素水平或肌肉交感神经活性没有改变[分别为42(4)、50(10)和45(5)次爆发/100次心跳,HYPER、NORMO和对照]。此外,在所有实验条件下功率谱分析相似。所有结果均表示为平均值(SEM)。总之,正常受试者的持续高血糖会导致骨骼肌中度血管舒张,但这种血流量增加不能归因于交感神经张力降低。