Menzies Research Institute Tasmania, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7000, Australia.
Cardiovasc Res. 2013 Apr 1;98(1):28-36. doi: 10.1093/cvr/cvt015. Epub 2013 Jan 23.
Enhanced microvascular perfusion of skeletal muscle is important for nutrient exchange and contributes ∼40% insulin-mediated muscle glucose disposal. High fat-fed (36% fat wt./wt.) rats are a commonly used model of insulin-resistance that exhibit impairment of insulin-mediated microvascular recruitment and muscle glucose uptake, which is accompanied by myocyte insulin-resistance. Distinguishing the contribution of impaired microvascular recruitment and impaired insulin action in the myocyte to decreased muscle glucose uptake in these high-fat models is difficult. It is unclear whether microvascular and myocyte insulin-resistance develop simultaneously. To assess this, we used a rat diet model with a moderate increase (two-fold) in dietary fat.
Sprague Dawley rats fed normal (4.8% fat wt./wt., 5FD) or high (9.0% fat wt./wt., 9FD) fat diets for 4 weeks were subject to euglycaemic hyperinsulinemic clamp (10 mU/min/kg insulin or saline) or isolated hindlimb perfusion (1.5 or 15 nM insulin or saline). Body weight, epididymal fat mass, and fasting plasma glucose were unaffected by diet. Fasting plasma insulin and non-esterified fatty acid concentrations were significantly elevated in 9FD. Glucose infusion rate and muscle glucose uptake were significantly impaired during insulin clamps in 9FD. Insulin-stimulated microvascular recruitment was significantly blunted in 9FD. Insulin-mediated muscle glucose uptake between 5FD and 9FD were not different during hindlimb perfusion.
Impaired insulin-mediated muscle glucose uptake in vivo can be the direct result of reduced microvascular blood flow responses to insulin, and can result from small (two-fold) increases in dietary fat. Thus, microvascular insulin-resistance can occur independently to the development of myocyte insulin-resistance.
骨骼肌的微血管灌注增强对于营养物质交换很重要,约占胰岛素介导的肌肉葡萄糖摄取的 40%。高脂肪喂养(脂肪重量/体重的 36%)大鼠是胰岛素抵抗的常用模型,表现为胰岛素介导的微血管募集和肌肉葡萄糖摄取受损,同时伴有肌细胞胰岛素抵抗。在这些高脂肪模型中,区分微血管和肌细胞胰岛素抵抗对肌肉葡萄糖摄取减少的贡献是困难的。尚不清楚微血管和肌细胞胰岛素抵抗是否同时发生。为了评估这一点,我们使用了一种大鼠饮食模型,其中饮食中的脂肪含量适度增加(两倍)。
4 周内,SD 大鼠分别喂食正常(脂肪重量/体重的 4.8%,5FD)或高脂肪(脂肪重量/体重的 9.0%,9FD)饮食,然后进行正常血糖高胰岛素钳夹(10 mU/min/kg 胰岛素或生理盐水)或离体后肢灌注(1.5 或 15 nM 胰岛素或生理盐水)。饮食对体重、附睾脂肪质量和空腹血糖无影响。9FD 大鼠的空腹胰岛素和非酯化脂肪酸浓度显著升高。9FD 大鼠胰岛素钳夹时葡萄糖输注率和肌肉葡萄糖摄取明显受损。9FD 大鼠的胰岛素刺激微血管募集明显减弱。在离体后肢灌注期间,5FD 和 9FD 之间的胰岛素介导的肌肉葡萄糖摄取没有差异。
体内胰岛素介导的肌肉葡萄糖摄取受损可能是直接由于胰岛素介导的微血管血流反应减少所致,并且可能是由于饮食中脂肪的小幅度(两倍)增加所致。因此,微血管胰岛素抵抗可以独立于肌细胞胰岛素抵抗的发生而发生。