Physical fitness, muscle morphology, and insulin-stimulated limb blood flow in normal subjects.

The response of limb blood flow to insulin is highly variable even in normal subjects. We examined whether physical fitness or differences in muscle morphology contribute to this variation. Maximal aerobic power, muscle fiber composition and capillarization, and the response of forearm glucose extraction and blood flow to a sequential hyperinsulinemic euglycemic clamp (serum insulin 374 +/- 10, 816 +/- 23, and 2,768 +/- 78 pmol/l) were determined in 16 normal males (age 25 +/- 1 yr, body mass index 24 +/- 1 kg/m2). Maximal aerobic power correlated positively with the proportion of type I fibers (r = 0.67, P < 0.01) and negatively with the proportion of type IIb fibers (r = -0.73, P < 0.01). Fiber composition but not blood flow correlated significantly with forearm and whole body glucose uptake. All doses of insulin significantly increased forearm blood flow, maximally by 123 +/- 21%. The ratio of capillaries per fiber was significantly correlated with basal and insulin-stimulated blood flow (0.58- 0.76, P < 0.05-0.01). Mean arterial blood pressure and the insulin-induced increase in blood flow were inversely correlated (r = -0.59, P < 0.05). We conclude that variation in glucose extraction is significantly determined by muscle fiber composition, whereas variation in insulin-stimulated blood flow is closely associated with muscle capillarization.