Prolonged (48-Hour) Modest Hyperinsulinemia Decreases Nocturnal Heart Rate Variability and Attenuates the Nocturnal Decrease in Blood Pressure in Lean, Normotensive Humans

Petrova, Maja; Townsend, Raymond R.; Teff, Karen L.

doi:10.1210/jc.2005-1752

Cited by 17 publications

(16 citation statements)

References 36 publications

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“…These data provide interesting insights into the consequences of prolonged mild elevations in plasma glucose and insulin such as may occur during overfeeding conditions on food intake, hunger and post-prandial responses to a test meal. The effects of the prolonged 48-h glucose infusion on the plasma insulin and glucose levels during the 48-h period have been previously reported but all other data presented in this paper are new 10 .…”

Section: Introductionmentioning

confidence: 54%

48-h Glucose infusion in humans: Effect on hormonal responses, hunger and food intake

Teff¹,

Petrova²,

Havel³

et al. 2007

Physiology & Behavior

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Experimentally-induced hyperglycemia by prolonged glucose infusion allows investigation of the effects of sustained stimulation of the pancreatic β-cell on insulin secretion and sensitivity. Hormonal responses to a meal following prolonged glucose infusions have not been investigated. To determine if a 48-h glucose infusion alters hormonal responses to a test meal as well as food intake and hunger in normal weight individuals, 16 subjects (8 men, 8 women, age 18-30 y, mean BMI=21.7±1.6 kg/ m 2 ) were infused for 48-h with either saline (50 ml/h) or 15% glucose (200 mg/m 2 /min). Subjects ingested a 600 kcal mixed nutrient meal 3-h after infusion termination. Blood samples were taken during the 48-h and for 4 hours following food ingestion. The 48-h glucose infusion elicited a metabolic profile of a glucose intolerant obese subjects, with increased plasma glucose, insulin and leptin (all P<0.01) and increased HOMA-IR (P<0.001). During meal ingestion, early insulin secretion was increased (P<0.05) but postprandial glucose (P<0.01) and insulin (P<0.01) excursions were lower following the glucose infusion. Postprandial plasma triglyceride concentrations were increased after glucose compared with saline. Food intake and hunger ratings were not different between the two conditions. Plasma leptin levels were inversely correlated with hunger (P<0.03) in both conditions and with food intake (P<0.003) during the glucose condition only. Thus, a 48-h glucose infusion does not impair postprandial hormonal responses, alter food intake or hunger in normal weight subjects. The glucose-induced increases in plasma leptin result in a stronger inverse relationship between plasma leptin and hunger as well as food intake. These data are the first to demonstrate a relationship between leptin and hunger in normal weight, non-calorically restricted human subjects.

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Section: Introductionmentioning

confidence: 54%

48-h Glucose infusion in humans: Effect on hormonal responses, hunger and food intake

Teff¹,

Petrova²,

Havel³

et al. 2007

Physiology & Behavior

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“…This is supported by the findings that experimentally evoked hyperinsulinemia decreases dipping among healthy and normal-weight adults. 8 In addition, adult non-dipper essential hypertensive patients had higher fS-insulin and P-glucose levels and a higher HOMA index than dipper patients. 20 In this study, we found no association between P-glucose and dipping.…”

Section: Discussionmentioning

confidence: 96%

“…Experimentally evoked hyperinsulinemia has been found to decrease dipping among healthy and normal-weight adults. 8 Among children, chronic poor glycemic control may place patients with type 1 diabetes at risk for higher nocturnal BP 4 and fasting insulin (fS-insulin) or HOMA is positively associated with sleep BP among obese children. 9 Obese, but otherwise healthy, adolescents are at higher risk of unfavorable glucose metabolism 10 as well as reduced nocturnal BP dipping 2 compared with normal-weight peers.…”

Section: Introductionmentioning

confidence: 99%

Association between nocturnal blood pressure dipping and insulin metabolism in obese adolescents

Westerståhl

Marcus

2009

Int J Obes

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Objective: The purpose of this study was to analyze the relationship between insulin-glucose metabolism, nocturnal blood pressure (BP) dipping and cardiac left ventricular mass (LVM) in obese adolescents without diabetes. Methods: A cohort of 206 obese adolescents (mean age 15.4 years (s.d. 1.6), mean body mass index (BMI) 38 kg m -2 (s.d. 5.8), 53% girls) under clinical care were included in the study. Body fat was assessed by dual X-ray absorptiometry (DEXA). Blood samples were drawn for analyses of fasting insulin (fS-insulin), fasting glucose and glycosylated hemoglobin Alc. Homeostatic model assessment index (HOMA index) was calculated. Insulin sensitivity and acute insulin response (AIR) were calculated from the performed frequently sampled intravenous glucose tolerance test. An ambulatory BP measurement was performed and 24 h daytime and nighttime values were calculated. Non-dipping was defined as a nocturnal BP reduction of o10%. Ultrasound was used to measure heart LVM and LVM index (LVMI) was calculated (LVM Â height À2.7 ). Results: Systolic non-dipping was present in 50% (n ¼ 103) of the subjects. Systolic and diastolic dipping was negatively associated with measures of insulin metabolism (HOMA index, fS-insulin and AIR). These associations were present independently of gender, age, daytime BP or body mass index standard deviation score. Dipping (P ¼ 0.7-0.9) or measures of insulin-glucose metabolism (P ¼ 0.3-1.0) were not associated with LVMI in this population. Conclusion: Non-dipping is common among obese adolescents. We found a negative association between nocturnal BP fall (dipping) and measures of insulin metabolism independently of the degree of obesity or daytime BP level among severely obese, non-diabetic adolescents without diagnosed hypertension. Our findings suggest the importance of keeping the insulin levels under observation even in allegedly healthy obese adolescents in clinical care, as a part of the prevention of morbidity associated with obesity.

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“…In normalweight and normotensive individuals short-term hyperinsulinemia, which is one of the features of pre-diabetes, was already able to induce a decrease in heart rate variability [53]. Hyperinsulinemia is one of the features of pre-diabetes and the possibility exists that the early impairement of the cardiovascular reflex function occurring in both IGT and hyperinsulinemia/insulinresistance may be the cross-bridge between the increased cardiovascular disease risk and the early changes in glucose tolerance [53].…”

Section: Impaired Autonomic Function In Metabolic Syndrome and Diabetesmentioning

confidence: 99%

“…Hyperinsulinemia is one of the features of pre-diabetes and the possibility exists that the early impairement of the cardiovascular reflex function occurring in both IGT and hyperinsulinemia/insulinresistance may be the cross-bridge between the increased cardiovascular disease risk and the early changes in glucose tolerance [53].…”

Section: Impaired Autonomic Function In Metabolic Syndrome and Diabetesmentioning

confidence: 99%

Links between Autonomic Dysfunction and Metabolic Syndrome

Giampetruzzi¹,

Garruti²

2016

J Metabolic Synd

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The autonomic nervous system (ANS) plays a key role in the control of a number of vital functions including cardiovascular, endocrine/neurovascular, gastrointestinal, genitourinary, pupil and thermoregulatory functions. Its abnormalities have been associated with early mortality, sudden death, silent myocardial infarction, gastrointestinal diseases.The manifestation of the ANS dysfunction in several human diseases is underestimated. Evidences exist on the important role of ANS dysfunctions in different clinically relevant conditions, including diabetes mellitus, chronic functional constipation, scleroderma, thalassemia major.Beside the classical evaluation in patients with diabetes mellitus, little is known about the effects of metabolic factors on ANS dysfunction. The metabolic syndrome (MetS) includes a cluster of frequent abnormalities (impaired fasting glycaemia, dyslipidemia, arterial hypertension and increased visceral adiposity) predisposing to the atherosclerotic changes and increased cardiovascular mortality. Early signs of autonomic dysfunction are often found in subjects with MetS even in the absence of diabetes. Epidemiological studies demonstrated that diabetics display a cardiovascular risk which is twice that of sex-and age-matched non-diabetic population. Manifestations of such a high cardiovascular risk of subjects with DM are the frequent silent myocardial infarctions (MI)s of diabetics which are often due to impaired cardiovascular autonomic function. Only recently major attention has been given to the interactions between impaired glucose tolerance (IGT) and cardiovascular autonomic dysfunctions. When increased waist circumference (one of the features of the MetS) and IGT are both present, cardiovascular autonomic dysfunction also occurs. Some adipokines (e.g. adiponectin) seem to play a role in cardiovascular risk and autonomic dysfunction. This review will therefore focus on some subtle aspects linking ANS dysfunction and MetS.

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Prolonged (48-Hour) Modest Hyperinsulinemia Decreases Nocturnal Heart Rate Variability and Attenuates the Nocturnal Decrease in Blood Pressure in Lean, Normotensive Humans

Abstract: Prolonged mild hyperinsulinemia disrupts the circadian rhythm of cardiac autonomic activity. Early changes in the neural control of cardiac activity may provide a potential mechanism mediating the pathophysiological link between impaired glucose tolerance and cardiovascular disease.

Cited by 17 publications

References 36 publications

48-h Glucose infusion in humans: Effect on hormonal responses, hunger and food intake

48-h Glucose infusion in humans: Effect on hormonal responses, hunger and food intake

Association between nocturnal blood pressure dipping and insulin metabolism in obese adolescents

Links between Autonomic Dysfunction and Metabolic Syndrome

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