Hemodynamic actions of insulin: beyond the endothelium

Montero, David

doi:10.3389/fphys.2013.00389

Cited by 10 publications

(7 citation statements)

References 41 publications

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“…Previous studies in the general population suggested that dietary fibre is predictive of lower blood pressure (29) , which might be due to the improved postprandial glucose excursions, insulin resistance (30) and endothelial dysfunction (31) . Our data indicated a positive association of fibre intake and DBP at baseline and during follow-up.…”

Section: Discussionmentioning

confidence: 99%

Dietary fibre and mortality risk in patients on peritoneal dialysis

Yuan

et al. 2019

Br J Nutr

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Higher fibre intake reduced all-cause and cardiovascular mortality among healthy population, but such data in dialysis patients are limited. We aimed to examine these associations in patients on peritoneal dialysis (PD). This single-centre prospective cohort study enrolled 881 incident PD patients between October 2002 and August 2014. All patients were followed until death, transfer to haemodialysis, renal transplantation or until being censored in June 2018. Demographic data were collected at baseline. Biochemical, dietary and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study. The outcomes were defined as all-cause and cardiovascular death. Cox proportional regression models were applied to explore the relationship between fibre intake and outcomes. Participants with higher fibre intake were more likely to be younger, male and have better residual renal function and serum lipids at baseline. They were prone to maintain better nutrient status, higher blood pressure and lower inflammatory status at baseline and afterwards. Neither baseline nor time-averaged fibre intake did show protective effects on all-cause mortality after multivariate adjustment in the whole cohort. Among non-diabetic PD patients, an independent association between fibre intake and all-cause mortality was found, in which each 1 g/d increase in time-averaged fibre intake correlated to 13 % of reduction in all-cause mortality. We did not observe any benefits of fibre intake in the CVD mortality for both whole cohort and subgroups. The present study revealed that higher dietary fibre intake appeared to have a protective effect on all-cause mortality in non-diabetic PD patients, which suggest that PD patients should be encouraged to eat a diet rich in fibres.

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Section: Discussionmentioning

confidence: 99%

Dietary fibre and mortality risk in patients on peritoneal dialysis

Yuan

et al. 2019

Br J Nutr

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“…The early finding that the insulin receptor is expressed on vascular endothelium at all levels of the arterial tree further supported an insulin-stimulated, NO-mediated vasodilation 82 . Independent from endothelium insulin may also cause vasodilation by acting directly on vascular smooth muscle cells (VSMC) 83 .…”

Section: Effects Of Insulin On the Vasculature And Vascular Insulin Rmentioning

confidence: 99%

The impact of insulin resistance on the kidney and vasculature

et al. 2016

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Insulin resistance is a systemic disorder that affects many organs and insulin-regulated pathways. The disorder is characterized by a reduced action of insulin despite increased insulin concentrations (hyperinsulinaemia). The effects of insulin on the kidney and vasculature differ in part from the effects on classical insulin target organs. Insulin causes vasodilation by enhancing endothelial nitric oxide production through activation of the phosphatidylinositol 3-kinase pathway. In insulin-resistant states, this pathway is impaired and the mitogen-activated protein kinase pathway stimulates vasoconstriction. The action of insulin on perivascular fat tissue and the subsequent effects on the vascular wall are not fully understood, but the hepatokine fetuin-A, which is released by fatty liver, might promote the proinflammatory effects of perivascular fat. The strong association of salt-sensitive arterial hypertension with insulin resistance indicates an involvement of the kidney in the insulin resistance syndrome. The insulin receptor is expressed on renal tubular cells and podocytes and insulin signalling has important roles in podocyte viability and tubular function. Renal sodium transport is preserved in insulin resistance and contributes to the salt-sensitivity of blood pressure in hyperinsulinaemia. Therapeutically, renal and vascular insulin resistance can be improved by an integrated holistic approach aimed at restoring overall insulin sensitivity and improving insulin signalling.

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“…This suggests that only certain endothelial dilator pathways, at least some involved in the POCR response, are essential for our inquiry. Moreover, glucose and insulin delivery to the myocyte may be determined by the rhythmic change in tone of smooth muscle cells of terminal arterioles (25,51). In this line, exercise training enhances microvascular SMF at rest and after acute exercise (12).…”

Section: Discussionmentioning

confidence: 98%