Hyperinsulinemia fails to augment ET-1 action in the skeletal muscle vascular bed in vivo in humans

Am J Physiol Endocrinol Metab. 2008 Dec;295(6):E1510-7. doi: 10.1152/ajpendo.90549.2008. Epub 2008 Oct 28.

Abstract

Endogenous endothelin action is augmented in human obesity and type 2 diabetes and contributes to endothelial dysfunction and impairs insulin-mediated vasodilation in humans. We hypothesized that insulin resistance-associated hyperinsulinemia could preferentially drive endothelin-mediated vasoconstriction. We applied hyperinsulinemic-euglycemic clamps with higher insulin dosing in obese subjects than lean subjects (30 vs. 10 mU.m(-2).min(-1), respectively), with the goal of matching insulin's nitric oxide (NO)-mediated vascular effects. We predicted that, under these circumstances, insulin-stimulated endothelin-1 (ET-1) action (assessed with the type A endothelin receptor antagonist BQ-123) would be augmented in proportion to hyperinsulinemia. NO bioactivity was assessed using the nitric oxide synthase inhibitor N(G)-monomethyl-l-arginine. Insulin-mediated vasodilation and insulin-stimulated NO bioavailability were well matched across groups by this approach. As expected, steady-state insulin levels were approximately threefold higher in obese than lean subjects (109.2 +/- 10.2 pmol/l vs. 518.4 +/- 84.0, P = 0.03). Despite this, the augmentation of insulin-mediated vasodilation by BQ-123 was not different between groups. ET-1 flux across the leg was not augmented by insulin alone but was increased with the addition of BQ-123 to insulin (P = 0.01 BQ-123 effect, P = not significant comparing groups). Endothelin antagonism augmented insulin-stimulated NO bioavailability and NOx flux, but not differently between groups and not proportional to hyperinsulinemia. These findings do not support the hypothesis that insulin resistance-associated hyperinsulinemia preferentially drives endothelin-mediated vasoconstriction.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antihypertensive Agents / pharmacology
  • Endothelin Receptor Antagonists
  • Endothelin-1 / antagonists & inhibitors
  • Endothelin-1 / metabolism
  • Endothelin-1 / physiology*
  • Female
  • Humans
  • Hyperinsulinism / complications
  • Hyperinsulinism / metabolism*
  • Hyperinsulinism / physiopathology*
  • Insulin / pharmacology
  • Male
  • Muscle, Skeletal / blood supply*
  • Muscle, Skeletal / metabolism
  • Muscle, Skeletal / physiopathology
  • Nitric Oxide / metabolism
  • Obesity / complications
  • Obesity / physiopathology
  • Peptides, Cyclic / pharmacology
  • Vasoconstriction / drug effects
  • Vasoconstriction / physiology
  • omega-N-Methylarginine / pharmacology

Substances

  • Antihypertensive Agents
  • Endothelin Receptor Antagonists
  • Endothelin-1
  • Insulin
  • Peptides, Cyclic
  • omega-N-Methylarginine
  • Nitric Oxide
  • cyclo(Trp-Asp-Pro-Val-Leu)