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Pepe GJ, Albrecht ED. Microvascular Skeletal-Muscle Crosstalk in Health and Disease. Int J Mol Sci 2023; 24:10425. [PMID: 37445602 DOI: 10.3390/ijms241310425] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
As an organ system, skeletal muscle is essential for the generation of energy that underpins muscle contraction, plays a critical role in controlling energy balance and insulin-dependent glucose homeostasis, as well as vascular well-being, and regenerates following injury. To achieve homeostasis, there is requirement for "cross-talk" between the myogenic and vascular components and their regulatory factors that comprise skeletal muscle. Accordingly, this review will describe the following: [a] the embryonic cell-signaling events important in establishing vascular and myogenic cell-lineage, the cross-talk between endothelial cells (EC) and myogenic precursors underpinning the development of muscle, its vasculature and the satellite-stem-cell (SC) pool, and the EC-SC cross-talk that maintains SC quiescence and localizes ECs to SCs and angio-myogenesis postnatally; [b] the vascular-myocyte cross-talk and the actions of insulin on vasodilation and capillary surface area important for the uptake of glucose/insulin by myofibers and vascular homeostasis, the microvascular-myocyte dysfunction that characterizes the development of insulin resistance, diabetes and hypertension, and the actions of estrogen on muscle vasodilation and growth in adults; [c] the role of estrogen in utero on the development of fetal skeletal-muscle microvascularization and myofiber hypertrophy required for metabolic/vascular homeostasis after birth; [d] the EC-SC interactions that underpin myofiber vascular regeneration post-injury; and [e] the role of the skeletal-muscle vasculature in Duchenne muscular dystrophy.
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Affiliation(s)
- Gerald J Pepe
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA 23501, USA
| | - Eugene D Albrecht
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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2
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Is vascular insulin resistance an early step in diet-induced whole-body insulin resistance? Nutr Diabetes 2022; 12:31. [PMID: 35676248 PMCID: PMC9177754 DOI: 10.1038/s41387-022-00209-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/09/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
There is increasing evidence that skeletal muscle microvascular (capillary) blood flow plays an important role in glucose metabolism by increasing the delivery of glucose and insulin to the myocytes. This process is impaired in insulin-resistant individuals. Studies suggest that in diet-induced insulin-resistant rodents, insulin-mediated skeletal muscle microvascular blood flow is impaired post-short-term high fat feeding, and this occurs before the development of myocyte or whole-body insulin resistance. These data suggest that impaired skeletal muscle microvascular blood flow is an early vascular step before the onset of insulin resistance. However, evidence of this is still lacking in humans. In this review, we summarise what is known about short-term high-calorie and/or high-fat feeding in humans. We also explore selected animal studies to identify potential mechanisms. We discuss future directions aimed at better understanding the ‘early’ vascular mechanisms that lead to insulin resistance as this will provide the opportunity for much earlier screening and timing of intervention to assist in preventing type 2 diabetes.
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3
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Albrecht ED, Aberdeen GW, Babischkin JS, Prior SJ, Lynch TJ, Baranyk IA, Pepe GJ. Estrogen Promotes Microvascularization in the Fetus and Thus Vascular Function and Insulin Sensitivity in Offspring. Endocrinology 2022; 163:6553898. [PMID: 35325097 PMCID: PMC9272192 DOI: 10.1210/endocr/bqac037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Indexed: 11/19/2022]
Abstract
We have shown that normal weight offspring born to estrogen-deprived baboons exhibited insulin resistance, although liver and adipose function and insulin receptor and glucose transporter expression were unaltered. The blood microvessels have an important role in insulin action by delivering insulin and glucose to target cells. Although little is known about the regulation of microvessel development during fetal life, estrogen promotes capillary proliferation and vascular function in the adult. Therefore, we tested the hypothesis that estrogen promotes fetal microvessel development and thus vascular function and insulin sensitivity in offspring. Capillary/myofiber ratio was decreased 75% (P < 0.05) in skeletal muscle, a major insulin target tissue, of fetal baboons in which estradiol levels were depleted by administration of aromatase inhibitor letrozole. This was sustained after birth, resulting in a 50% reduction (P < 0.01) in microvessel expansion; 65% decrease (P < 0.01) in arterial flow-mediated dilation, indicative of vascular endothelial dysfunction; and 35% increase (P < 0.01) in blood pressure in offspring from estrogen-deprived baboons, changes prevented by letrozole and estradiol administration. Along with vascular dysfunction, peak insulin and glucose levels during a glucose tolerance test were greater (P < 0.05 to P < 0.01) and the homeostasis model of insulin resistance 2-fold higher (P < 0.01) in offspring of letrozole-treated than untreated animals, indicative of insulin resistance. This study makes the novel discovery that estrogen promotes microvascularization in the fetus and thus normal vascular development and function required for eliciting insulin sensitivity in offspring and that placental hormonal secretions, independent from improper fetal growth, are an important determinant of risk of developing insulin resistance.
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Affiliation(s)
- Eugene D Albrecht
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
- Correspondence: Eugene Albrecht, PhD, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Bressler Research Laboratories 11-045A, 655 West Baltimore St, Baltimore, MD 21201, USA.
| | - Graham W Aberdeen
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Jeffery S Babischkin
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Steven J Prior
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD, USA
| | - Terrie J Lynch
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Irene A Baranyk
- Departments of Obstetrics, Gynecology, Reproductive Sciences and Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gerald J Pepe
- Department of Physiological Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
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Samocha-Bonet D, Wu B, Ryugo DK. Diabetes mellitus and hearing loss: A review. Ageing Res Rev 2021; 71:101423. [PMID: 34384902 DOI: 10.1016/j.arr.2021.101423] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 07/26/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
Diabetes (type 2) and sensorineural hearing loss are common health problems manifested with ageing. While both type 1 and type 2 diabetes have been associated with hearing loss, a causal link has been difficult to establish. Individuals with diabetes have twice the incidence of hearing loss compared to those without diabetes and those with prediabetes have a 30% higher rate of hearing loss. Whether hearing loss is associated with diabetes independent of glycemic control remains to be determined. Hearing loss has its own set of risk factors and shares others with diabetes. This review will summarize the complex relationship between diabetes and sensorineural hearing loss.
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Affiliation(s)
- Dorit Samocha-Bonet
- Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia; St Vincent's Clinical School, UNSW Sydney, Darlinghurst, NSW, 2010, Australia.
| | - Buffy Wu
- Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia; School of Medical Sciences, UNSW Sydney, Kensington, NSW, 2052, Australia
| | - David K Ryugo
- Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia; School of Medical Sciences, UNSW Sydney, Kensington, NSW, 2052, Australia; Department of Otolaryngology Head and Neck and Skull Base Surgery, St. Vincent's Hospital, Darlinghurst, NSW, 2010, Australia
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5
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Broatch JR, O'Riordan SF, Keske MA, Betik AC, Bishop DJ, Halson SL, Parker L. Reduced post-exercise muscle microvascular perfusion with compression is offset by increased muscle oxygen extraction: Assessment by contrast-enhanced ultrasound. FASEB J 2021; 35:e21499. [PMID: 33811697 DOI: 10.1096/fj.202002205rr] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/11/2022]
Abstract
The microvasculature is important for both health and exercise tolerance in a range of populations. However, methodological limitations have meant changes in microvascular blood flow are rarely assessed in humans during interventions designed to affect skeletal muscle blood flow such as the wearing of compression garments. The aim of this study is, for the first time, to use contrast-enhanced ultrasound to directly measure the effects of compression on muscle microvascular blood flow alongside measures of femoral artery blood flow and muscle oxygenation following intense exercise in healthy adults. It was hypothesized that both muscle microvascular and femoral artery blood flows would be augmented with compression garments as compared with a control condition. Ten recreationally active participants completed two repeated-sprint exercise sessions, with and without lower-limb compression tights. Muscle microvascular blood flow, femoral arterial blood flow (2D and Doppler ultrasound), muscle oxygenation (near-infrared spectroscopy), cycling performance, and venous blood samples were measured/taken throughout exercise and the 1-hour post-exercise recovery period. Compared with control, compression reduced muscle microvascular blood volume and attenuated the exercise-induced increase in microvascular velocity and flow immediately after exercise and 1 hour post-exercise. Compression increased femoral artery diameter and augmented the exercise-induced increase in femoral arterial blood flow during exercise. Markers of blood oxygen extraction in muscle were increased with compression during and after exercise. Compression had no effect on blood lactate, glucose, or exercise performance. We provide new evidence that lower-limb compression attenuates the exercise-induced increase in skeletal muscle microvascular blood flow following exercise, despite a divergent increase in femoral artery blood flow. Decreased muscle microvascular perfusion is offset by increased muscle oxygen extraction, a potential mechanism allowing for the maintenance of exercise performance.
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Affiliation(s)
- James R Broatch
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia.,Australia Institute of Sport, Canberra, ACT, Australia
| | - Shane F O'Riordan
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia.,Australia Institute of Sport, Canberra, ACT, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - David J Bishop
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Shona L Halson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Roy TK, Secomb TW. Effects of impaired microvascular flow regulation on metabolism-perfusion matching and organ function. Microcirculation 2020; 28:e12673. [PMID: 33236393 DOI: 10.1111/micc.12673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
Impaired tissue oxygen delivery is a major cause of organ damage and failure in critically ill patients, which can occur even when systemic parameters, including cardiac output and arterial hemoglobin saturation, are close to normal. This review addresses oxygen transport mechanisms at the microcirculatory scale, and how hypoxia may occur in spite of adequate convective oxygen supply. The structure of the microcirculation is intrinsically heterogeneous, with wide variations in vessel diameters and flow pathway lengths, and consequently also in blood flow rates and oxygen levels. The dynamic processes of structural adaptation and flow regulation continually adjust microvessel diameters to compensate for heterogeneity, redistributing flow according to metabolic needs to ensure adequate tissue oxygenation. A key role in flow regulation is played by conducted responses, which are generated and propagated by endothelial cells and signal upstream arterioles to dilate in response to local hypoxia. Several pathophysiological conditions can impair local flow regulation, causing hypoxia and tissue damage leading to organ failure. Therapeutic measures targeted to systemic parameters may not address or may even worsen tissue oxygenation at the microvascular level. Restoration of tissue oxygenation in critically ill patients may depend on restoration of endothelial cell function, including conducted responses.
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Affiliation(s)
- Tuhin K Roy
- Department of Anesthesiology & Perioperative Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Timothy W Secomb
- Department of Physiology, University of Arizona, Tucson, AZ, 85724, USA
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Parker L, Morrison DJ, Wadley GD, Shaw CS, Betik AC, Roberts‐Thomson K, Kaur G, Keske MA. Prior exercise enhances skeletal muscle microvascular blood flow and mitigates microvascular flow impairments induced by a high‐glucose mixed meal in healthy young men. J Physiol 2020; 599:83-102. [DOI: 10.1113/jp280651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/09/2020] [Indexed: 01/11/2023] Open
Affiliation(s)
- Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Dale J. Morrison
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Glenn D. Wadley
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Christopher S. Shaw
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Andrew C. Betik
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Katherine Roberts‐Thomson
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Gunveen Kaur
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
| | - Michelle A. Keske
- Institute for Physical Activity and Nutrition (IPAN) School of Exercise and Nutrition Sciences Deakin University Geelong Australia
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Pasman WJ, Memelink RG, de Vogel-Van den Bosch J, Begieneman MPV, van den Brink WJ, Weijs PJM, Wopereis S. Obese Older Type 2 Diabetes Mellitus Patients with Muscle Insulin Resistance Benefit from an Enriched Protein Drink during Combined Lifestyle Intervention: The PROBE Study. Nutrients 2020; 12:E2979. [PMID: 33003389 PMCID: PMC7601009 DOI: 10.3390/nu12102979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/24/2020] [Indexed: 12/25/2022] Open
Abstract
(1) Background: Recent research showed that subtypes of patients with type 2 diabetes may differ in response to lifestyle interventions based on their organ-specific insulin resistance (IR). (2) Methods: 123 Subjects with type 2 diabetes were randomized into 13-week lifestyle intervention, receiving either an enriched protein drink (protein+) or an isocaloric control drink (control). Before and after the intervention, anthropometrical and physiological data was collected. An oral glucose tolerance test was used to calculate indices representing organ insulin resistance (muscle, liver, and adipose tissue) and β-cell functioning. In 82 study-compliant subjects (per-protocol), we retrospectively examined the intervention effect in patients with muscle IR (MIR, n = 42) and without MIR (no-MIR, n = 40). (3) Results: Only in patients from the MIR subgroup that received protein+ drink, fasting plasma glucose and insulin, whole body, liver and adipose IR, and appendicular skeletal muscle mass improved versus control. Lifestyle intervention improved body weight and fat mass in both subgroups. Furthermore, for the MIR subgroup decreased systolic blood pressure and increased VO2peak and for the no-MIR subgroup, a decreased 2-h glucose concentration was found. (4) Conclusions: Enriched protein drink during combined lifestyle intervention seems to be especially effective on increasing muscle mass and improving insulin resistance in obese older, type 2 diabetes patients with muscle IR.
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Affiliation(s)
- Wilrike J. Pasman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Robert G. Memelink
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
| | | | - Mark P. V. Begieneman
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Willem J. van den Brink
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
| | - Peter J. M. Weijs
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (R.G.M.); (P.J.M.W.)
- Department of Nutrition and Dietetics, Amsterdam University Medical Centres, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Suzan Wopereis
- Netherlands Organisation for Applied Scientific Research (TNO), 3704 HE Zeist, The Netherlands; (M.P.V.B.); (W.J.v.d.B.); (S.W.)
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Parker L, Morrison DJ, Betik AC, Roberts-Thomson K, Kaur G, Wadley GD, Shaw CS, Keske MA. High-glucose mixed-nutrient meal ingestion impairs skeletal muscle microvascular blood flow in healthy young men. Am J Physiol Endocrinol Metab 2020; 318:E1014-E1021. [PMID: 32286881 DOI: 10.1152/ajpendo.00540.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Oral glucose ingestion leads to impaired muscle microvascular blood flow (MBF), which may contribute to acute hyperglycemia-induced insulin resistance. We investigated whether incorporating lipids and protein into a high-glucose load would prevent postprandial MBF dysfunction. Ten healthy young men (age, 27 yr [24, 30], mean with lower and upper bounds of the 95% confidence interval; height, 180 cm [174, 185]; weight, 77 kg [70, 84]) ingested a high-glucose (1.1 g/kg glucose) mixed-nutrient meal (10 kcal/kg; 45% carbohydrate, 20% protein, and 35% fat) in the morning after an overnight fast. Femoral arterial blood flow was measured via Doppler ultrasound, and thigh MBF was measured via contrast-enhanced ultrasound, before meal ingestion and 1 h and 2 h postprandially. Blood glucose and plasma insulin were measured at baseline and every 15 min throughout the 2-h postprandial period. Compared with baseline, thigh muscle microvascular blood volume, velocity, and flow were significantly impaired at 60 min postprandial (-25%, -27%, and -46%, respectively; all P < 0.05) and to a greater extent at 120 min postprandial (-37%, -46%, and -64%; all P < 0.01). Heart rate and femoral arterial diameter, blood velocity, and blood flow were significantly increased at 60 min and 120 min postprandial (all P < 0.05). Higher blood glucose area under the curve was correlated with greater MBF dysfunction (R2 = 0.742; P < 0.001). Ingestion of a high-glucose mixed-nutrient meal impairs MBF in healthy individuals for up to 2 h postprandial.
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Affiliation(s)
- Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Dale J Morrison
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Katherine Roberts-Thomson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Gunveen Kaur
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Glenn D Wadley
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Christopher S Shaw
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Bussey CT, Babakr AA, Iremonger RR, van Hout I, Wilkins GT, Lamberts RR, Erickson JR. Carvedilol and metoprolol are both able to preserve myocardial function in type 2 diabetes. Physiol Rep 2020; 8:e14394. [PMID: 32170823 PMCID: PMC7070160 DOI: 10.14814/phy2.14394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/13/2020] [Accepted: 02/16/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Increasing cohorts of patients present with diabetic cardiomyopathy, and with no targeted options, treatment often rely on generic pharmaceuticals such as β-blockers. β-blocker efficacy is heterogenous, with second generation β-blocker metoprolol selectively inhibiting β1 -AR, while third generation β-blocker carvedilol has α1 -AR inhibition, antioxidant, and anti-apoptotic actions alongside nonselective β-AR inhibition. These additional properties have led to the hypothesis that carvedilol may improve cardiac contractility in the diabetic heart to a greater extent than metoprolol. The present study aimed to compare the efficacy of metoprolol and carvedilol on myocardial function in animal models and cardiac tissue from patients with type 2 diabetes and preserved ejection fraction. METHODS Echocardiographic examination of cardiac function and assessment of myocardial function in isolated trabeculae was carried out in patients with and without diabetes undergoing coronary artery bypass grafting (CABG) who were prescribed metoprolol or carvedilol. Equivalent measures were undertaken in Zucker Diabetic Fatty (ZDF) rats following 4 weeks treatment with metoprolol or carvedilol. RESULTS Patients receiving carvedilol compared to metoprolol had no difference in cardiac function, and no difference was apparent in myocardial function between β-blockers. Both β-blockers similarly improved myocardial function in diabetic ZDF rats treated for 4 weeks, without significantly affecting in vivo cardiac function. CONCLUSIONS Metoprolol and carvedilol were found to have no effect on cardiac function in type 2 diabetes with preserved ejection fraction, and were similarly effective in preventing myocardial dysfunction in ZDF rats.
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Affiliation(s)
- Carol T Bussey
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Aram A Babakr
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Rachael R Iremonger
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Isabelle van Hout
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Gerard T Wilkins
- Department of Medicine-HeartOtago, Dunedin School of Medicine, Dunedin Hospital, Dunedin, New Zealand
| | - Regis R Lamberts
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Jeffrey R Erickson
- Department of Physiology-HeartOtago, Otago School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
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11
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Roberts-Thomson KM, Betik AC, Premilovac D, Rattigan S, Richards SM, Ross RM, Russell RD, Kaur G, Parker L, Keske MA. Postprandial microvascular blood flow in skeletal muscle: Similarities and disparities to the hyperinsulinaemic-euglycaemic clamp. Clin Exp Pharmacol Physiol 2019; 47:725-737. [PMID: 31868941 DOI: 10.1111/1440-1681.13237] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 12/12/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022]
Abstract
Skeletal muscle contributes to ~40% of total body mass and has numerous important mechanical and metabolic roles in the body. Skeletal muscle is a major site for glucose disposal following a meal. Consequently, skeletal muscle plays an important role in postprandial blood glucose homeostasis. Over the past number of decades, research has demonstrated that insulin has an important role in vasodilating the vasculature in skeletal muscle in response to an insulin infusion (hyperinsulinaemic-euglycaemic clamp) or following the ingestion of a meal. This vascular action of insulin is pivotal for glucose disposal in skeletal muscle, as insulin-stimulated vasodilation increases the delivery of both glucose and insulin to the myocyte. Notably, in insulin-resistant states such as obesity and type 2 diabetes, this vascular response of insulin in skeletal muscle is significantly impaired. Whereas the majority of work in this field has focussed on the action of insulin alone on skeletal muscle microvascular blood flow and myocyte glucose metabolism, there is less understanding of how the consumption of a meal may affect skeletal muscle blood flow. This is in part due to complex variations in glucose and insulin dynamics that occurs postprandially-with changes in humoral concentrations of glucose, insulin, amino acids, gut and pancreatic peptides-compared to the hyperinsulinaemic-euglycaemic clamp. This review will address the emerging body of evidence to suggest that postprandial blood flow responses in skeletal muscle may be a function of the nutritional composition of a meal.
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Affiliation(s)
- Katherine M Roberts-Thomson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Andrew C Betik
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Dino Premilovac
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Stephen Rattigan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Renee M Ross
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Ryan D Russell
- Department of Health and Human Performance, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Gunveen Kaur
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Lewan Parker
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Michelle A Keske
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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12
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Kolka CM. The vascular endothelium plays a role in insulin action. Clin Exp Pharmacol Physiol 2019; 47:168-175. [PMID: 31479553 DOI: 10.1111/1440-1681.13171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 08/23/2019] [Accepted: 08/27/2019] [Indexed: 12/30/2022]
Abstract
The endocrine system relies on the vasculature for delivery of hormones throughout the body, and the capillary microvasculature is the site where the hormones cross from the blood into the target tissue. Once considered an inert wall, various studies have now highlighted the functions of the capillary endothelium to regulate transport and therefore affect or maintain the interstitial environment. The role of the capillary may be clear in areas where there is a continuous endothelium, yet there also appears to be a role of endothelial cells in tissues with a sinusoidal structure. Here we focused on the most common endocrine disorder, diabetes, and several of the target organs associated with the disease, including skeletal muscle, liver and pancreas. However, it is important to note that the ability of hormones to cross the endothelium to reach their target tissue is a component of all endocrine functions. It is also a consideration in organs throughout the body and may have greater impact for larger hormones with target tissues containing a continuous endothelium. We noted that the blood levels do not always equal interstitial levels, which is what the cells are exposed to, and discussed how this may change in diseases such as obesity and insulin resistance. The capillary endothelium is, therefore, an essential and understudied aspect of endocrinology and metabolism that can be altered in disease, which may be an appropriate target for treatment.
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Affiliation(s)
- Cathryn M Kolka
- Department of Biomedical Science, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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13
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Hu D, Remash D, Russell RD, Greenaway T, Rattigan S, Squibb KA, Jones G, Premilovac D, Richards SM, Keske MA. Impairments in Adipose Tissue Microcirculation in Type 2 Diabetes Mellitus Assessed by Real-Time Contrast-Enhanced Ultrasound. Circ Cardiovasc Imaging 2019; 11:e007074. [PMID: 29650791 DOI: 10.1161/circimaging.117.007074] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 02/22/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND In obesity and type 2 diabetes mellitus (T2D), adipose tissue expansion (because of larger adipocytes) results in reduced microvascular density which is thought to lead to adipocyte hypoxia, inflammation, and reduced nutrient delivery to the adipocyte. Adipose tissue microvascular responses in humans with T2D have not been extensively characterized. Furthermore, it has not been determined whether impaired microvascular responses in human adipose tissue are most closely associated with adiposity, inflammation, or altered metabolism. METHODS AND RESULTS Overnight-fasted healthy controls (n=24, 9 females/15 males) and people with T2D (n=21, 8 females/13 males) underwent a body composition scan (dual-energy X-ray absorptiometry), an oral glucose challenge (50 g glucose) and blood analysis of clinical chemistries and inflammatory markers. Abdominal subcutaneous adipose tissue microvascular responses were measured by contrast-enhanced ultrasound at baseline and 1-hour post-oral glucose challenge. Adipose tissue microvascular blood volume was significantly elevated in healthy subjects 1-hour post-oral glucose challenge; however, this effect was absent in T2D. Adipose tissue microvascular blood flow was lower in people with T2D at baseline and was significantly blunted post-oral glucose challenge compared with controls. Adipose tissue microvascular blood flow was negatively associated with truncal fat (%), glucoregulatory function, fasting triglyceride and nonesterified fatty acid levels, and positively associated with insulin sensitivity. Truncal fat (%), systolic blood pressure, and insulin sensitivity were the only correlates with microvascular blood volume. Systemic inflammation was not associated with adipose tissue microvascular responses. CONCLUSIONS Impaired microvascular function in adipose tissue during T2D is not conditionally linked to systemic inflammation but is associated with other characteristics of the metabolic syndrome (obesity, insulin resistance, hyperglycemia, and dyslipidemia).
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Affiliation(s)
- Donghua Hu
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Devika Remash
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Ryan D Russell
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Timothy Greenaway
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Stephen Rattigan
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Kathryn A Squibb
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Graeme Jones
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Dino Premilovac
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Stephen M Richards
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.)
| | - Michelle A Keske
- Menzies Institute for Medical Research (D.H., R.D.R., S.R., K.A.S., G.J., S.M.R., M.A.K.) and School of Medicine (D.R., T.G., D.P., S.M.R.), University of Tasmania, Hobart, TAS Australia; Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley, Brownsville TX, (R.D.R.); Royal Hobart Hospital, TAS, Australia (T.G.); Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia (M.A.K.); and Department of Pharmacology, Anhui Medical University, Hefei, China (D.H.).
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14
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Dempsey PC, Larsen RN, Dunstan DW, Owen N, Kingwell BA. Sitting Less and Moving More: Implications for Hypertension. Hypertension 2019; 72:1037-1046. [PMID: 30354827 DOI: 10.1161/hypertensionaha.118.11190] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paddy C Dempsey
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, United Kingdom (P.C.D.).,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia (P.C.D., N.O.)
| | - Robyn N Larsen
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.)
| | - David W Dunstan
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, Victoria (D.W.D.)
| | - Neville Owen
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia (P.C.D., N.O.)
| | - Bronwyn A Kingwell
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.)
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15
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Jansson L, Carlsson PO. Pancreatic Blood Flow with Special Emphasis on Blood Perfusion of the Islets of Langerhans. Compr Physiol 2019; 9:799-837. [PMID: 30892693 DOI: 10.1002/cphy.c160050] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The pancreatic islets are more richly vascularized than the exocrine pancreas, and possess a 5- to 10-fold higher basal and stimulated blood flow, which is separately regulated. This is reflected in the vascular anatomy of the pancreas where islets have separate arterioles. There is also an insulo-acinar portal system, where numerous venules connect each islet to the acinar capillaries. Both islets and acini possess strong metabolic regulation of their blood perfusion. Of particular importance, especially in the islets, is adenosine and ATP/ADP. Basal and stimulated blood flow is modified by local endothelial mediators, the nervous system as well as gastrointestinal hormones. Normally the responses to the nervous system, especially the parasympathetic and sympathetic nerves, are fairly similar in endocrine and exocrine parts. The islets seem to be more sensitive to the effects of endothelial mediators, especially nitric oxide, which is a permissive factor to maintain the high basal islet blood flow. The gastrointestinal hormones with pancreatic effects mainly influence the exocrine pancreatic blood flow, whereas islets are less affected. A notable exception is incretin hormones and adipokines, which preferentially affect islet vasculature. Islet hormones can influence both exocrine and endocrine blood vessels, and these complex effects are discussed. Secondary changes in pancreatic and islet blood flow occur during several conditions. To what extent changes in blood perfusion may affect the pathogenesis of pancreatic diseases is discussed. Both type 2 diabetes mellitus and acute pancreatitis are conditions where we think there is evidence that blood flow may contribute to disease manifestations. © 2019 American Physiological Society. Compr Physiol 9:799-837, 2019.
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Affiliation(s)
- Leif Jansson
- Uppsala University, Department of Medical Cell Biology, Uppsala, Sweden
| | - Per-Ola Carlsson
- Uppsala University, Department of Medical Cell Biology, Uppsala, Sweden.,Uppsala University, Department of Medical Sciences, Uppsala, Sweden
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16
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Climie RE, Wheeler MJ, Grace M, Lambert EA, Cohen N, Owen N, Kingwell BA, Dunstan DW, Green DJ. Simple intermittent resistance activity mitigates the detrimental effect of prolonged unbroken sitting on arterial function in overweight and obese adults. J Appl Physiol (1985) 2018; 125:1787-1794. [DOI: 10.1152/japplphysiol.00544.2018] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Prolonged sitting contributes to cardiovascular disease (CVD) risk. The underlying mechanisms are unknown but may include changes in arterial function and vasoactive mediators. We examined the effects of prolonged unbroken sitting, relative to regular active interruptions to sitting time, on arterial function in adults at increased CVD risk. In a randomized crossover trial, 19 sedentary overweight/obese adults (mean ± SD age 57 ± 12 yr) completed 2 laboratory-based conditions: 5 h uninterrupted sitting (SIT) and 5 h sitting interrupted every 30 min by 3 min of simple resistance activities (SRA). Femoral artery function [flow-mediated dilation (FMD)], blood flow, and shear rate were measured at 0 h, 30 min, 1 h, 2 h, and 5 h. Brachial FMD was assessed at 0 and 5 h. Plasma was collected hourly for measurement of endothelin-1 (ET-1), nitrates/nitrites, vascular cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1). There was a significant decline in femoral artery FMD, averaged over 5 h in the SIT condition, relative to SRA ( P < 0.001). Plasma ET-1 total area under the curve over 5 h increased in the SIT condition compared with SRA ( P = 0.006). There was no significant difference between conditions in femoral or brachial shear rate, brachial FMD, nitrates/nitrites, VCAM-1, or ICAM-1 ( P > 0.05 for all). Five hours of prolonged sitting, relative to regular interruptions to sitting time, impaired femoral artery vasodilator function and increased circulating ET-1 in overweight/obese adults. There is the need to build on this evidence beyond acute observations to better understand the potential longer-term vascular-related consequences of prolonged sitting. NEW & NOTEWORTHY This is the first study to examine the effect of prolonged sitting on arterial function in adults at increased cardiovascular disease risk. We have shown that 5 h of prolonged sitting, relative to regular interruptions to sitting time, impaired femoral artery vasodilator function and increased circulating endothelin-1 in overweight/obese adults. There is now the need to build on this evidence beyond acute observations to better understand the potential longer-term vascular-related consequences of prolonged sitting.
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Affiliation(s)
- Rachel E. Climie
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michael J. Wheeler
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
| | - Megan Grace
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Elisabeth A. Lambert
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Neale Cohen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Bronwyn A. Kingwell
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Central Clinical School and Department of Physiology, School of Medicine, Nursing and Health Services, Monash University, Melbourne, Victoria, Australia
| | - David W. Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Daniel J. Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, Western Australia, Australia
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17
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Hu D, Russell RD, Remash D, Greenaway T, Rattigan S, Squibb KA, Jones G, Ross RM, Roberts CK, Premilovac D, Richards SM, Keske MA. Are the metabolic benefits of resistance training in type 2 diabetes linked to improvements in adipose tissue microvascular blood flow? Am J Physiol Endocrinol Metab 2018; 315:E1242-E1250. [PMID: 30351988 DOI: 10.1152/ajpendo.00234.2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The microcirculation in adipose tissue is markedly impaired in type 2 diabetes (T2D). Resistance training (RT) often increases muscle mass and promotes a favorable metabolic profile in people with T2D, even in the absence of fat loss. Whether the metabolic benefits of RT in T2D are linked to improvements in adipose tissue microvascular blood flow is unknown. Eighteen sedentary people with T2D (7 women/11 men, 52 ± 7 yr) completed 6 wk of RT. Before and after RT, overnight-fasted participants had blood sampled for clinical chemistries (glucose, insulin, lipids, HbA1c, and proinflammatory markers) and underwent an oral glucose challenge (OGC; 50 g glucose × 2 h) and a DEXA scan to assess body composition. Adipose tissue microvascular blood volume and flow were assessed at rest and 1 h post-OGC using contrast-enhanced ultrasound. RT significantly reduced fasting blood glucose ( P = 0.006), HbA1c ( P = 0.007), 2-h glucose area under the time curve post-OGC ( P = 0.014), and homeostatic model assessment of insulin resistance ( P = 0.005). This was accompanied by a small reduction in total body fat ( P = 0.002), trunk fat ( P = 0.023), and fasting triglyceride levels ( P = 0.029). Lean mass ( P = 0.003), circulating TNF-α ( P = 0.006), and soluble VCAM-1 ( P < 0.001) increased post-RT. There were no significant changes in adipose tissue microvascular blood volume or flow following RT; however those who did have a higher baseline microvascular blood flow post-RT also had lower fasting triglyceride levels ( r = -0.476, P = 0.045). The anthropometric, glycemic, and insulin-sensitizing benefits of 6 wk of RT in people with T2D are not associated with an improvement in adipose tissue microvascular responses; however, there may be an adipose tissue microvascular-linked benefit to fasting triglyceride levels.
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Affiliation(s)
- Donghua Hu
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- Department of Pharmacology, Anhui Medical University , Hefei , China
| | - Ryan D Russell
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- Department of Health and Human Performance, College of Health Services, University of Texas Rio Grande Valley , Brownsville, Texas
| | - Devika Remash
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - Timothy Greenaway
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
- Royal Hobart Hospital , Hobart, Tasmania , Australia
| | - Stephen Rattigan
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Kathryn A Squibb
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Renee M Ross
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - Christian K Roberts
- Geriatric Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Dino Premilovac
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - Stephen M Richards
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - Michelle A Keske
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University , Geelong , Australia
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18
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Delbeck S, Vahlsing T, Leonhardt S, Steiner G, Heise HM. Non-invasive monitoring of blood glucose using optical methods for skin spectroscopy-opportunities and recent advances. Anal Bioanal Chem 2018; 411:63-77. [PMID: 30283998 DOI: 10.1007/s00216-018-1395-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 12/29/2022]
Abstract
Diabetes mellitus is a widespread disease with greatly rising patient numbers expected in the future, not only for industrialized countries but also for regions in the developing world. There is a need for efficient therapy, which can be via self-monitoring of blood glucose levels to provide tight glycemic control for reducing the risks of severe health complications. Advancements in diabetes technology can nowadays offer different sensor approaches, even for continuous blood glucose monitoring. Non-invasive blood glucose assays have been promised for many years and various vibrational spectroscopy-based methods of the skin are candidates for achieving this goal. Due to the small spectral signatures of the glucose hidden among a largely variable background, the largest signal-to-noise ratios and multivariate calibration are essential to provide the method applicability for self-monitoring of blood glucose. Besides multiparameter approaches, recently presented devices based on photoplethysmography with wavelengths in the visible and near-infrared range are evaluated for their potential of providing reliable blood glucose concentration predictions. Graphical abstract ᅟ.
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Affiliation(s)
- Sven Delbeck
- Interdisciplinary Center for Life Sciences, South-Westphalia University of Applied Sciences, Frauenstuhlweg 31, 58644, Iserlohn, Germany
| | - Thorsten Vahlsing
- Bundesanstalt für Materialforschung und -prüfung (BAM), Acoustic and Electromagnetic Methods, Unter den Eichen 87, 12205, Berlin, Germany.,Chair for Medical Information Technology, Helmholtz Institute of Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - Steffen Leonhardt
- Chair for Medical Information Technology, Helmholtz Institute of Biomedical Engineering, RWTH Aachen University, Pauwelsstr. 20, 52074, Aachen, Germany
| | - Gerald Steiner
- Faculty of Medicine Carl Gustav Carus, Clinical Sensoring and Monitoring, Technical University of Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - H Michael Heise
- Interdisciplinary Center for Life Sciences, South-Westphalia University of Applied Sciences, Frauenstuhlweg 31, 58644, Iserlohn, Germany.
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19
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Russell RD, Hu D, Greenaway T, Sharman JE, Rattigan S, Richards SM, Keske MA. Oral glucose challenge impairs skeletal muscle microvascular blood flow in healthy people. Am J Physiol Endocrinol Metab 2018; 315:E307-E315. [PMID: 29763373 DOI: 10.1152/ajpendo.00448.2017] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Skeletal muscle microvascular (capillary) blood flow increases in the postprandial state or during insulin infusion due to dilation of precapillary arterioles to augment glucose disposal. This effect occurs independently of changes in large artery function. However, acute hyperglycemia impairs vascular function, causes insulin to vasoconstrict precapillary arterioles, and causes muscle insulin resistance in vivo. We hypothesized that acute hyperglycemia impairs postprandial muscle microvascular perfusion, without disrupting normal large artery hemodynamics, in healthy humans. Fifteen healthy people (5 F/10 M) underwent an oral glucose challenge (OGC, 50 g glucose) and a mixed-meal challenge (MMC) on two separate occasions (randomized, crossover design). At 1 h, both challenges produced a comparable increase (6-fold) in plasma insulin levels. However, the OGC produced a 1.5-fold higher increase in blood glucose compared with the MMC 1 h postingestion. Forearm muscle microvascular blood volume and flow (contrast-enhanced ultrasound) were increased during the MMC (1.3- and 1.9-fold from baseline, respectively, P < 0.05 for both) but decreased during the OGC (0.7- and 0.6-fold from baseline, respectively, P < 0.05 for both) despite a similar hyperinsulinemia. Both challenges stimulated brachial artery flow (ultrasound) and heart rate to a similar extent, as well as yielding comparable decreases in diastolic blood pressure and total vascular resistance. Systolic blood pressure and aortic stiffness remained unaltered by either challenge. Independently of large artery hemodynamics, hyperglycemia impairs muscle microvascular blood flow, potentially limiting glucose disposal into skeletal muscle. The OGC reduced microvascular blood flow in muscle peripherally and therefore may underestimate the importance of skeletal muscle in postprandial glucose disposal.
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Affiliation(s)
- Ryan D Russell
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- Department of Health and Human Performance, College of Health Affairs, University of Texas Rio Grande Valley , Brownsville, Texas
| | - Donghua Hu
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Timothy Greenaway
- Royal Hobart Hospital , Hobart, Tasmania , Australia
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - James E Sharman
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Stephen Rattigan
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
| | - Stephen M Richards
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- School of Medicine, University of Tasmania , Hobart, Tasmania , Australia
| | - Michelle A Keske
- Menzies Institute for Medical Research, University of Tasmania , Hobart, Tasmania , Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition. Deakin University , Geelong, Victoria , Australia
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