Type 2 diabetic individuals have impaired leg blood flow responses to exercise - Role of endothelium-dependent vasodilation

被引:132
作者
Kingwell, BA
Formosa, M
Muhlmann, M
Bradley, SJ
McConell, GK
机构
[1] Baker Heart Res Inst, Alfred & Baker Med Unit, Prahran, Vic 3181, Australia
[2] La Trobe Univ, Sch Physiotherapy, Bundoora, Vic 3083, Australia
[3] Monash Univ, Dept Physiol, Clayton, Vic 3168, Australia
关键词
D O I
10.2337/diacare.26.3.899
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - Diabetic individuals have impaired endothelium-dependent forearm vasodilatory responses to ischemia, acetylcholine, and other endothelium-dependent agonists. The functional significance of impaired endothelium-dependent dilation in diabetic individuals is uncertain but is most likely to be manifest during leg muscle exercise and may have relevance to peripheral vascular disease and leg ischemia, which is prevalent in diabetic individuals. The current study aimed to determine the relationship between leg blood flow (LBF) responses to endothelium-dependent vasodilation and dynamic large muscle exercise. RESEARCH DESIGN AND METHODS - LBF responses (thermodilution) to intrafemoral arterial infusions of an endothelium-dependent (acetylcholine) and endothelium-independent (sodium nitroprusside) vasodilator and a standardized 25-min cycling bout at 60% Vo(2peak) were compared in nine male type 2 diabetic subjects and nine age-, sex-, Vo(2peak)-, and weight-matched control subjects. RESULTS - LBF responses to acetylcholine and exercise but not sodium nitroprusside were significantly (P < 0.05) attenuated in patients with diabetes compared with healthy control subjects, The percentage increase in LBF in response to exercise and acetylcholine were significantly correlated (r = 0.54, P = 0.02). Furthermore, resting plasma glucose was significantly related to the LBF response to exercise (r = -0.66, P = 0.003) independently of insulin, HbA(1c), lipids, BMI, and blood pressure. CONCLUSIONS - The increase in LBF during exercise is substantially attenuated in type 2 diabetic compared with matched control subjects. Impaired endothelium-dependent vasodilation secondary to elevated plasma glucose may underlie this observation. This mechanism may be of importance in determining the leg ischemic threshold in diabetic individuals with peripheral vascular disease.
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页码:899 / 904
页数:6
相关论文
共 35 条
  • [1] Endothelium-dependent vasodilatation is impaired in both microcirculation and macrocirculation during acute hyperglycemia
    Akbari, CM
    Saouaf, R
    Barnhill, DF
    Newman, PA
    LoGerfo, FW
    Veves, A
    [J]. JOURNAL OF VASCULAR SURGERY, 1998, 28 (04) : 687 - 694
  • [2] MAXIMAL PERFUSION OF SKELETAL-MUSCLE IN MAN
    ANDERSEN, P
    SALTIN, B
    [J]. JOURNAL OF PHYSIOLOGY-LONDON, 1985, 366 (SEP): : 233 - 249
  • [3] Vasodilator reserve - A functional assessment of coronary health
    Bache, RJ
    [J]. CIRCULATION, 1998, 98 (13) : 1257 - 1260
  • [4] Combined inhibition of nitric oxide and prostaglandins reduces human skeletal muscle blood flow during exercise
    Boushel, R
    Langberg, H
    Gemmer, C
    Olesen, J
    Crameri, R
    Scheede, C
    Sander, M
    Kjær, M
    [J]. JOURNAL OF PHYSIOLOGY-LONDON, 2002, 543 (02): : 691 - 698
  • [5] Nitric oxide synthase inhibition reduces leg glucose uptake but not blood flow during dynamic exercise in humans
    Bradley, SJ
    Kingwell, BA
    McConell, GK
    [J]. DIABETES, 1999, 48 (09) : 1815 - 1821
  • [6] IN-VIVO CHARACTERIZATION OF MUSCARINIC RECEPTOR SUBTYPES THAT MEDIATE VASODILATATION IN PATIENTS WITH ESSENTIAL-HYPERTENSION
    BRUNING, TA
    CHANG, PC
    HENDRIKS, MGC
    VERMEIJ, P
    PFAFFENDORF, M
    VANZWIETEN, PA
    [J]. HYPERTENSION, 1995, 26 (01) : 70 - 77
  • [7] NONINVASIVE DETECTION OF ENDOTHELIAL DYSFUNCTION IN CHILDREN AND ADULTS AT RISK OF ATHEROSCLEROSIS
    CELERMAJER, DS
    SORENSEN, KE
    GOOCH, VM
    SPIEGELHALTER, DJ
    MILLER, OI
    SULLIVAN, ID
    LLOYD, JK
    DEANFIELD, JE
    [J]. LANCET, 1992, 340 (8828) : 1111 - 1115
  • [8] New classification and criteria for diagnosis of diabetes mellitus - Position statement from the Australian Diabetes Society, New Zealand Society for the Study of Diabetes, Royal College of Pathologists of Australasia and Australasian Association of Clinical Biochemists
    Colman, PG
    Thomas, DW
    Zimmet, PZ
    Welborn, TA
    Garcia-Webb, P
    Moore, MP
    [J]. MEDICAL JOURNAL OF AUSTRALIA, 1999, 170 (08) : 375 - 378
  • [9] Effects of short-term reduction in serum cholesterol with simvastatin in patients with stable angina pectoris and mild to moderate hypercholesterolemia
    deDivitiis, M
    Rubba, P
    DiSomma, S
    Liguori, V
    Galderisi, M
    Montefusco, S
    Carreras, G
    Vincenzo, G
    Carotenuto, A
    Iannuzzo, G
    deDivitiis, O
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (07) : 763 - 768
  • [10] Control of skeletal muscle perfusion at the onset of dynamic exercise
    Delp, MD
    [J]. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE, 1999, 31 (07) : 1011 - 1018