Istituto di Fisiologia Clinica     
Iozzo P., Chareonthaitawee P., Rimoldi O., Betteridge D. J., Camici P. G., Ferrannini E. Mismatch between insulin-mediated glucose uptake and blood flow in the heart of patients with Type II diabetes. In: Diabetologia, vol. 45 pp. 1404 - 1409. springer, 2002.
Aims/hypothesis. We investigated the effect of physiological hyperinsulinaemia on global and regional myocardial blood flow and glucose uptake in five patients with Type II (non-insulin-dependent) diabetes mellitus and seven healthy control subjects. Methods. Myocardial blood flow was assessed by positron emission tomography with oxygen-15 labelled water (H215O) either before or after 1 h of euglycaemic hyperinsulinaemia. Myocardial glucose uptake was assessed by positron emission tomography and fluorine-18 labelled fluorodeoxyglucose (18FDG). Results. During hyperinsulinaemia, myocardial blood flow increased from 0.91-0.03 to 1.00-0.03 ml.min-1.g-1 in control subjects (p<0.005) and from 0.81-0.02 to 0.95-0.04 ml.min-1.g-1 in diabetic patients (p<0.0005). Corresponding glucose uptakes were 0.56-0.01 and 0.36-0.02 Ámol.min-1.g-1 (p<0.0001), respectively. During hyperinsulinaemia, the regional distribution of myocardial blood flow and glucose uptake showed higher values in the septum and anterolateral wall (short axis) and in the mid-ventricle (long axis) in control subjects, and insulin action was circumscribed to these regions. In diabetic patients, the regional distribution of glucose uptake was similar; however, insulin-induced increase of myocardial blood flow was mainly directed to the postero-inferior areas (short axis) and to the base (long axis) of the heart, thus cancelling the predominance of the anterior wall observed before insulin administration. Conclusion/interpretation. These results provide evidence that insulin-mediated regulation of global myocardial blood flow is preserved in Type II diabetic patients. In contrast, the regional re-distribution of myocardial blood flow induced by insulin is directed to different target areas when compared with healthy subjects, thereby resulting in a mismatch between blood flow and glucose metabolism.
URL: http://www.springerlink.com/content/rmt5q31m50nr5vha/fulltext.pdf
Subject Insulin
myocardial glucose metabolism
myocardial perfusion

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