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(Hypertension. 1997;30:1156-1161.)
© 1997 American Heart Association, Inc.

Articles

Angiotensin II Affects Basal, Pulsatile, and Glucose-Stimulated Insulin Secretion in Humans

Danilo Fliser; Franz Schaefer; Daniela Schmid; Johannes D. Veldhuis; Eberhard Ritz

From the Departments of Internal Medicine (D.F., D.S., E.R.) and Pediatrics (F.S.), Ruperto-Carola University, Heidelberg, Germany, and Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Virginia Health Science Center and NSF Center for Biological Timing, Charlottesville, Va.

Correspondence to Danilo Fliser, MD, Department of Internal Medicine, Ruperto-Carola University, Bergheimerstr. 56a, 69115 Heidelberg, Germany.

Abstract Angiotensin II (Ang II) modulates the tissue response to insulin (insulin sensitivity), but the effect of Ang II on the secretion of insulin has not been investigated thus far. Nineteen healthy volunteers (17 male; mean age, 26±1 years) were studied. In a double-blind, randomized, placebo-controlled study, seven volunteers were allocated on three occasions in random order after an overnight fast to three interventions: (1) solvent (placebo) infusion; (2) infusion of 1.0 ng Ang II · kg^-1 · min^-1 (subpressor dose); and (3) infusion of 5.0 ng Ang II · kg^-1 · min^-1 (pressor dose). Frequent blood samples (each minute) were obtained for estimation of plasma insulin concentrations over a period of 120 minutes to assess basal and pulsatile insulin secretion. In an ancillary study, plasma glucose and insulin levels were measured after an oral glucose tolerance test while solvent (placebo) or Ang II was infused in 12 fasting healthy volunteers. Plasma insulin concentrations were measured immunoenzymatically (enzyme-linked immunosorbent assay). Insulin secretion pulses were analyzed with the deconvolution technique, and the regularity of insulin secretion was analyzed with the approximate entropy technique. Plasma insulin half-life was assessed using the hyperinsulinemic euglycemic clamp method. The pressor dose of Ang II reduced total, basal, and pulsatile insulin secretion, and this effect was highly significant (P<.01). The subpressor dose tended to suppress insulin secretion. The burst frequency (number of peaks) and the regularity of insulin secretion were not affected by administration of Ang II. After the oral glucose load, the insulinemic response was significantly lower and plasma glucose concentrations were significantly higher with infusion of Ang II compared with placebo. Ang II affects both the basal (nonpulsatile) and the pulsatile component of spontaneous insulin secretion and the glucose-stimulated insulin secretion in humans. This observation is of potential interest with respect to the interaction of Ang II and insulin, eg, in the genesis of hyperinsulinemia and hypertension.

Key Words: angiotensin II • glucose tolerance • hyperinsulinemia • insulin secretion

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