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(Hypertension. 1999;33:554-558.)
© 1999 American Heart Association, Inc.

Scientific Contribution

Insulin-Mediated Vasodilation and Glucose Uptake Are Functionally Linked in Humans

Stephen J. Cleland; John R. Petrie; Shinichiro Ueda; Henry L. Elliott; John M. C. Connell

Correspondence to Dr Stephen J Cleland, Department of Medicine and Therapeutics, Western Infirmary, Glasgow G11 6NT, Scotland, UK. E-mail scleland{at}clinmed.gla.ac.uk

Abstract—Intra-arterial infusion of insulin in physiological doses causes forearm vasodilation which is augmented by co-infusion of D-glucose, leading us to speculate that local insulin-mediated vasodilation may depend on insulin-mediated glucose uptake. We have examined the relationship between whole-body insulin sensitivity and forearm vasodilation in response to local infusion of insulin/glucose, thus avoiding any confounding effects of sympathetic stimulation on peripheral blood flow. Eighteen healthy, normotensive male volunteers (age, 26±5.4 years) attended on two separate occasions for measurement of: (1) whole-body insulin sensitivity with use of the hyperinsulinemic euglycemic clamp; (2) forearm vasodilation in response to an intra-arterial infusion of insulin/glucose with use of bilateral venous occlusion plethysmography. Insulin-mediated glucose uptake (M) for the group (mean±SD) was 10.0±2.2 mg · kg^-1 · min^-1, and the percentage change in forearm blood flow ratio (%FBFR) for the group (median, interquartile range) was 28.2% (13.6, 48.6). In univariate analysis, M was significantly correlated with %FBFR (r_s=0.60, P<0.05), but not with body mass index (BMI) (r_s=-0.42), age (r=-0.39) or mean arterial pressure (r=0.13). In multiple regression analysis, %FBFR remained a significant independent predictor of M (R² (adj)=0.48, t=3.23, P<0.01) in a model involving BMI, age, and blood pressure. These data support the concept of a significant functional relationship between insulin's metabolic and vascular actions, possibly at an endothelial level.

Key Words: insulin resistance • endothelial function • forearm blood flow • human study • euglycemic clamp • plethysmography

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