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We examined the mechanisms of enhanced insulin sensitivity in 9 male healthy athletes (age, 25 +/- 1 yr; maximal aerobic power [VO2max], 57.6 +/- 1.0 ml/kg per min) as compared with 10 sedentary control subjects (age, 28 +/- 2 yr; VO2max, 44.1 +/- 2.3 ml/kg per min). In the athletes, whole body glucose disposal (240-min insulin clamp) was 32% (P &lt; 0.01) and nonoxidative glucose disposal (indirect calorimetry) was 62% higher (P &lt; 0.01) than in the controls. Muscle glycogen content increased by 39% in the athletes (P &lt; 0.05) but did not change in the controls during insulin clamp. VO2max correlated with whole body (r = 0.60, P &lt; 0.01) and nonoxidative glucose disposal (r = 0.64, P &lt; 0.001). In the athletes forearm blood flow was 64% greater (P &lt; 0.05) than in the controls, whereas their muscle capillary density was normal. Basal blood flow was related to VO2max (r = 0.63, P &lt; 0.05) and glucose disposal during insulin infusion (r = 0.65, P &lt; 0.05). The forearm glucose uptake in the athletes was increased by 3.3-fold (P &lt; 0.01) in the basal state and by 73% (P &lt; 0.05) during insulin infusion. Muscle glucose transport protein (GLUT-4) concentration was 93% greater in the athletes than controls (P &lt; 0.01) and it was related to VO2max (r = 0.61, P &lt; 0.01) and to whole body glucose disposal (r = 0.60, P &lt; 0.01). Muscle glycogen synthase activity was 33% greater in the athletes than in the controls (P &lt; 0.05), and the basal glycogen synthase fractional activity was closely related to blood flow (r = 0.88, P &lt; 0.001).

the journal of clinical investigation/the journal of clinical investigation

Mechanism of enhanced insulin sensitivity in athletes. Increased blood flow, muscle glucose transport protein (GLUT-4) concentration, and glycogen synthase activity.