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Insulin enhances arterial endothelial function in healthy adults
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Arterial endothelial function is enhanced with insulin in healthy people, but impaired in those with metabolic syndrome, recent study findings show.
In patients with metabolic syndrome, vascular insulin resistance may contribute to an increased risk for cardiovascular disease, according to the researchers.
Eugene J. Barrett, MD, of the University of Virginia School of Medicine, and colleagues evaluated 18 adults (mean age, 46 years) with metabolic syndrome and 16 age-matched healthy controls to assess differences in endothelial response of conduit arteries, resistance and microvascular arterioles to insulin between the two groups.
Eugene J. Barrett
Endothelial function in the conduit arteries was measured with brachial flow-mediated dilation; in resistance arterioles with forearm postischemic flow velocity; and in the microvascular arterioles with contrast-enhanced ultrasound. At baseline and after insulin clamp, conduit artery stiffness and plasma concentration of 92 CVD biomarkers were measured.
At baseline, plasma glucose and insulin concentrations were higher in the metabolic syndrome group compared with controls. There were reductions in serum free fatty acids postprandially and with the insulin clamp in both groups; however, greater reductions were seen in the metabolic syndrome group who were metabolically insulin resistant (P < .01).
The metabolic syndrome group had higher pulse wave velocity at baseline (P < .01) and at 240 minutes (P = .01) compared with controls. During insulin clamp, pulse wave velocity increased between 120 minutes and 240 minutes in the metabolic syndrome group, but not in controls (P = .03).
During insulin clamp, endothelial function improved at each level of arterial vasculature in controls, but not the metabolic syndrome group. At baseline and at the end of insulin clamp, 13 of the 92 CVD biomarkers differed (P < .001).
“Impaired insulin action on blood vessels throughout the arterial tree can contribute to the increased vascular disease seen in metabolic syndrome patients,” Barrett told Endocrine Today. “Lifestyle and perhaps pharmacologic treatments that improve vascular insulin sensitivity should be employed to mitigate vascular disease risk.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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