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Insulin‐mediated increases in renal plasma flow are impaired in insulin‐resistant normal subjects
Author(s) -
Ter Maaten J. C.,
Bakker S. J. L.,
Serné E. H.,
Moshage H. J.,
Donker A. J. M.,
Gans R. O. B.
Publication year - 2000
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1046/j.1365-2362.2000.00749.x
Subject(s) - medicine , endocrinology , insulin , insulin resistance , hyperinsulinemia , pancreatic hormone , glucose uptake , vasodilation , glucose clamp technique , hyperinsulinism , renal blood flow , kidney
Impaired vasodilatation in skeletal muscle is a possible mechanism linking insulin resistance to blood pressure regulation. Increased renal vascular resistance has been demonstrated in the offspring of essential hypertensives. We assessed whether insulin‐mediated renal vasodilatation is impaired in insulin‐resistant normal subjects. In two groups of 10 insulin‐resistant and 10 insulin‐sensitive normal subjects, we compared the effects of sequential physiological and supraphysiological insulin dosages (50 and 150 mU kg −1 h −1 ) on renal plasma flow (RPF) and leg blood flow using the euglycaemic clamp technique, 131 I‐labelled Hippuran clearances and venous occlusion plethysmography. Time‐control experiments were performed in the same subjects. Whole‐body glucose uptake amounted to 4·9 ± 2·1 and 11·0 ± 2·4 mg kg −1 min −1 in the insulin‐resistant and to 12·7 ± 2·3 and 17·4 ± 2·6 mg kg −1 min −1 in the insulin‐sensitive subjects during physiological and supraphysiological hyperinsulinaemia, respectively. RPF increased more in insulin‐sensitive compared to insulin‐resistant subjects during physiological hyperinsulinaemia (13·7 vs. 6·8%, P < 0·05). RPF increased to comparable levels during supraphysiological hyperinsulinaemia. Insulin‐mediated changes in leg blood flow did not differ between groups. In the combined group, we found a positive correlation between insulin‐mediated glucose uptake and changes in RPF during physiological hyperinsulinaemia ( r = 0·57, P = 0·009), whereas insulin‐mediated glucose uptake correlated with changes in leg blood flow during supraphysiological hyperinsulinaemia ( r = 0·54. P = 0·017). Our results suggest that the sensitivities of the skeletal muscle and renal vascular bed differ for insulin's vasodilatory action. Insulin‐mediated increases in RPF are impaired in insulin‐resistant but otherwise normal subjects during physiological hyperinsulinaemia.