Effects of insulin on glucose uptake and leg blood flow in patients with sickle cell disease and normal subjects

Maaten, Jan C. ter; Serné, Erik H.; Bakker, Stephan J. L.; Eps, Wim Statius van; Donker, A. J. M.; Gans, Rijk O. B.

doi:10.1053/meta.2001.21681

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…The physiologic background of this observation is still unknown, while some proposed mechanisms include sodium and water wasting as a result of medullary defect, systemic vasodilation compensating for microcirculatory flow disturbances, increased production of prostaglandins and nitric oxide (NO), and reduced vascular reactivity …”

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confidence: 99%

“…[3][4][5] The physiologic background of this observation is still unknown, while some proposed mechanisms include sodium and water wasting as a result of medullary defect, systemic vasodilation compensating for microcirculatory flow disturbances, increased production of prostaglandins and nitric oxide (NO), and reduced vascular reactivity. [6][7][8][9] One of the main components of the BP phenotype is arterial stiffness. Whether it precedes BP rise or comes after long-time exposure to high BP is not known.…”

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confidence: 99%

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Arterial Stiffness and Peripheral and Central Blood Pressure in Patients With Sickle Cell Disease

Pikilidou

Yavropoulou

Αντωνίου

et al. 2015

J of Clinical Hypertension

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Blood pressure (BP) in patients with sickle cell disease (SCD) has been reported to be lower than in persons in the general population. Data on arterial stiffness, which is an important risk factor for the progression of BP, are inconclusive for this patient population. Forty‐five adult patients with SCD and 40 controls matched for sex, age, and body mass index were studied. Brachial systolic BP (SBP) and diastolic BP (DBP) were significantly lower in the patient group (SBP 115.1±13.8 mm Hg vs 121.9±11.3 mm Hg and DBP 68.5±8.0 mm Hg vs 80.6±9.1 mm Hg, P<.05, respectively). Augmentation index (AIx), however, was significantly higher in SCD patients compared with healthy controls (24.9±9.6 for patients vs 12.4±10.8 for controls, P<.001), while carotid femoral pulse wave velocity was comparable between the two groups. The study shows that mechanisms other than arterial elasticity are involved in the low BP phenotype of patients with SCD.

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confidence: 99%

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confidence: 99%

Arterial Stiffness and Peripheral and Central Blood Pressure in Patients With Sickle Cell Disease

Pikilidou

Yavropoulou

Αντωνίου

et al. 2015

J of Clinical Hypertension

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“…Given i) the link between capillary density and glucose uptake 31 and the fact that patients with SCD have lower capillary density 5 as well as ii) the links between insulin, hemodynamics and glucose uptake 32 and the observed hemodynamic disturbances in patients with SCD 6,33 , one may expect insulin resistance and lower glucose uptake in patients with SCD. Contrary to this hypothesis, insulin resistance and glucose uptake do not differ between SCD patients and control subjects 34 . Other studies even found lower insulin resistance 35 and higher insulin sensitivity 36 in SCD patients than in control subjects.…”

Section: Endurance Training Improves Metabolic Flexibilitymentioning

confidence: 77%

Endurance training improves oxygen uptake/demand mismatch, metabolic flexibility and recovery in patients with sickle cell disease

Mougin,

Riccetti,

Merlet

et al. 2024

haematol

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Patients with sickle cell disease (SCD) display lower slope coefficients of the oxygen uptake (V_O2) vs. work rate (W) relationship (delineating an O2 uptake/demand mismatch) and a poor metabolic flexibility. Because endurance training (ET) increases the microvascular network and oxidative enzymes activity including one involved in lipid oxidation, ET might improve the slope coefficient of the V_O2 vs. W curve and the metabolic flexibility of SCD patients. ET may also contribute to improve patient post-exercise cardiopulmonary and metabolic recovery. Fifteen patients with SCD performed a submaximal incremental test on a cycle ergometer before (SIT1) and after (SIT2) 8 weeks of ET. Minute ventilation, ventilation rate (VR), heart rate (HR), V_O2, CO2 production, respiratory exchange ratio, carbohydrate/lipid utilization and partitioning (including %Lipidox) and blood lactate concentration ([lactate]b) were measured during and after SIT1 and SIT2. At baseline, the slope coefficient of the V_O2 vs. W curve positively correlated with total hemoglobin, mean corpuscular hemoglobin and percentage of HbF. After training, the slope coefficient of the V_O2 vs. W curve was significantly higher and the [lactate]b increase was delayed. If patients’ energy metabolism apparently relied largely on carbohydrate sources during SIT1, %Lipidox tended to increase at low exercise intensities during SIT2, supporting a training-induced improvement of metabolic flexibility in patients with SCD. Post-exercise recovery of VR, V_E/V_CO2, HR and [lactate]b was faster after training. We concluded that ET in patients with SCD i) ameliorated the oxygen uptake/demand mismatch, ii) blunted the metabolic inflexibility, and iii) improved post-exercise cardiopulmonary and metabolic responses.

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“…The 2% prevalence of systemic hypertension reported in this study from Cameroon also agrees with previous reports from both high and low incomes settings, which have reported the prevalence of systemic hypertension in SCD patients to be lower than that of the general population (2–8% vs. 28%, respectively) ( 13 – 15 ). Potential explanations of low prevalence of RSH and systemic hypertension in SCD patients include Sodium and water wasting due to the medullary defect, ( 16 ) systemic vasodilatation compensating for microcirculatory flow disturbances, ( 14 ) increased production of prostaglandins and nitric oxide, ( 17 ) reduced vascular reactivity, ( 16 ) and pre-mature deaths that remove those individuals whose BP might reach hypertensive levels in middle adulthood ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and risk factors of relative systemic hypertension and hypertension among sickle cell patients in Cameroon

Nguweneza

Bitoungui²,

Mnika³

et al. 2022

Front. Med.

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Increased blood pressure (BP) has been associated with higher risk of stroke and mortality in Sickle Cell Disease (SCD). We investigated risk factors associated with Relative Systemic Hypertension (RSH) or systemic hypertension in SCD patients in Cameroon. Using R, Multivariate multinomial logistic regression modeling was used to examine the effects of the demographic, anthropometric, clinical, and laboratory factors to determine risk factors. A total of 815 individuals with SCD, including 380 (46.6%) males were analyzed. At baseline, the median age [interquartile range] was 18.0 [12.0–25.0] years, ranging from 3 to 66 years. Approximately three-quarters of the patients (n = 645; 79.1%) had normal BP, 151 (18.5%) had RSH and 19 (2.3%) had hypertension. Age (P < 0.001) and gender (P = 0.022) were significantly different across the BP categories. Weight (P < 0.001), height (P < 0.001), BMI (P < 0.001), pulse pressure (P = 0.020), history of stroke (P = 0.012), hemoglobin level (P = 0.002), red blood cell count (P = 0.031), creatinine (P < 0.001), and (estimated glomerular filtration rate) eGFR (P = 0.002) was also significantly different across the three BP categories. After adjustment, the significantly associated factors of RSH in the SCD patients were age [OR = 1.03, (95% CI = 1.01–1.06), P < 0.010], male gender [OR = 1.54, (95% CI = 1.04–2.27), P = 0.029], BMI [OR = 1.10, (95% CI = 1.04–1.17), P = 0.001]. After adjustment, the independent variables significantly associated factors of Hypertension in the SCD patients were age [OR = 1.05, (95% CI = 1.01–1.10), P = 0.034], male gender [OR = 3.31, (95% CI = 1.04–10.52), P = 0.042], BMI [OR = 1.14, (95% CI = 1.01–1.29), P = 0.027]. Creatinine was significantly associated with RSH [OR =1.31 (1.05–1.63), P = 0.016]. SCD patients with RSH or hypertension maybe at increased risk of renal dysfunction. We found relatively high prevalence of RSH and hypertension (20.8%) in SCD patients in Cameroon. Tailored Interventions that consider major risk factors (age, gender, and BMI) may lower BP pressure and prevent severe complications.

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Effects of insulin on glucose uptake and leg blood flow in patients with sickle cell disease and normal subjects

Cited by 7 publications

References 26 publications

Arterial Stiffness and Peripheral and Central Blood Pressure in Patients With Sickle Cell Disease

Arterial Stiffness and Peripheral and Central Blood Pressure in Patients With Sickle Cell Disease

Endurance training improves oxygen uptake/demand mismatch, metabolic flexibility and recovery in patients with sickle cell disease

Clinical characteristics and risk factors of relative systemic hypertension and hypertension among sickle cell patients in Cameroon

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