Division of Endocrinology, Diabetology and Nephrology, Department of Internal Medicine, Internal Medicine IV, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.
Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, Tübingen, Germany.
Sci Rep. 2021 Oct 13;11(1):20306. doi: 10.1038/s41598-021-99183-2.
Parasympathetic nervous system innervates peripheral organs including pancreas, hepatic portal system, and gastrointestinal tract. It thereby contributes to the regulation of whole-body glucose metabolism especially in the postprandial state when it promotes secretion of insulin and enhances its action in major target organs. We now aimed to evaluate the effect of parasympathetic modulation on human glucose metabolism. We used slow deep breathing maneuvers to activate the parasympathetic nervous system and tested for effects on metabolism during an oral glucose tolerance test in a randomized, controlled, cross-over trial in 15 healthy young men. We used projections towards the heart as a readout for parasympathetic activity. When analyzing heart rate variability, there was a significant increase of RMSSD (root mean square of successive differences) when participants performed slow deep breathing compared to the control condition, indicating a modulation of parasympathetic activity. However, no statistically significant effects on peripheral glucose metabolism or energy expenditure after the glucose tolerance test were detected. Of note, we detected a significant association between mean heart rate and serum insulin and C-peptide concentrations. While we did not find major effects of slow deep breathing on glucose metabolism, our correlational results suggest a link between the autonomic nervous system and insulin secretion after oral glucose intake. Future studies need to unravel involved mechanisms and develop potential novel treatment approaches for impaired insulin secretion in diabetes.
副交感神经系统支配外周器官，包括胰腺、肝门静脉系统和胃肠道。它因此有助于调节全身葡萄糖代谢，特别是在餐后状态下，促进胰岛素分泌并增强其在主要靶器官中的作用。我们现在旨在评估副交感神经调节对人体葡萄糖代谢的影响。我们使用缓慢深呼吸运动来激活副交感神经系统，并在 15 名健康年轻男性中进行的一项随机、对照、交叉试验中，在口服葡萄糖耐量试验期间测试其对代谢的影响。我们使用朝向心脏的投影作为副交感神经活动的读出。在分析心率变异性时，与对照条件相比，参与者进行缓慢深呼吸时 RMSSD（连续差异的均方根）显著增加，表明副交感神经活动得到调节。然而，在葡萄糖耐量试验后，对周围葡萄糖代谢或能量消耗没有检测到统计学上的显著影响。值得注意的是，我们检测到平均心率与血清胰岛素和 C 肽浓度之间存在显著关联。虽然我们没有发现缓慢深呼吸对葡萄糖代谢有重大影响，但我们的相关性结果表明，口服葡萄糖摄入后自主神经系统与胰岛素分泌之间存在联系。未来的研究需要阐明涉及的机制，并为糖尿病中受损的胰岛素分泌开发潜在的新治疗方法。
