Abstract
Fourteen hypertensive (174.3/98.3 mmHg) non-diabetic patients were given a euglyceamic glucose clamp along with infusion of 0.9% NaCl and the prostacyclin (PGI2) analogue Iloporst (0.7 ng · kg · min−1). Substrate oxidation was also determined by indirect calorimetry. Over the last 60 min of the clamp, Iloprost vs saline improved whole body glucose disposal (WBGD) (35 vs 28.3 μmol · kg−1 LBM) and non-oxidative glucose metabolism (24.7 vs 18.1 μmol · kg−1 LBM · min−1). Iloprost delivery was associated with a significant decrease in membrane microviscosity (0.253 vs 0.205), but did not affect arterial blood pressure and heart rate. In nine patients, skeletal muscle blood flow (SMBF) and insulin-stimulated glucose uptake (GU) were also studied. At the end of the study, despite a similar SMBF (37 vs 38 ml · min−1 · kg−1), GU (0.55 vs 0.46 mmol · 1−1) was significantly increased by Iloprost infusion. Percentage decrease in membrane microviscosity was correlated with percentage increase in WBGD (r=0.65) and non-oxidative glucose metabolism (r=0.68). In conclusion, low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
O'Grady J, Warrington S, Moti MJ, Bunting S, Flowers R, Fowle ASE, Moncada A (1979) Effects of intravenous prostacyclin infusion in healthy volunteers. Some prelimanary observations. In: Vane JR, Bergstrom S (eds) Prostacyclin. Raven, Press, New York, pp 409–413
Longmore DB, Hoyle M, Gregory A, Bene HJG, Smith MA, Jones WA (1981) Prostacyclin administration during cardiopulmonary bypass in man. Lancet I: 800–801
Belch JJJ, Greer I, McLaren M, Soniobodi AR, Miller SRD, Starrock RD, Forber CD (1984) The effect of intravenous ZK-36–373, a stable prostacyclin analogue on normal volunteers. Prostaglandins 28:67–76
Ferrannini E, Buzzigoli G, Bonadonna R, Giorico MA, Oleggini M, Graziadei L, Pedrinelli R, Brandi L, Bevilacqua S (1987) Insulin resistance in essential hypertension. N Engl J Med 317:350–357
Axelrood L (1987) Insulin, prostaglandin and the pathogenesis of hypertension. Diabetes 40:1223–1227
Dutta-Roy AK, Kahn NN, Sinha K (1991) Interaction of receptor for prostaglandin E1 prostacyclin in human erythrocyte and platelets. Life Sci 49:1129–1139
National Diabetes Data Group (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28:1039–1057
Paolisso G, Di Maro G, D'Amore A, Passariello N, Gambardella A, Varricchio M, D'Onofrio F (1995) Low dose iloprost infusion improves insulin action in healthy subjects and non-insulin (type II) dependent diabetics. Diabetes Care (in press)
Ferrannini E (1988) The theoretical basis of indirect calorimetry, a review. Metab Clin Exp 37:287–301
Kury JG, Duportail G, Brauner G, Laustriat D (1985) In vivo determination of erythrocyte membrane microviscosity. Biochem Biophys Acta 845:60–67
Paolisso G, Di Maro G, Pizza G, D'Amore A, Sgambato S, Tesauro P, Varricchio M, D'Onofrio F (1992) Plasma GSH/GSSG affects glucose homeostasis in healthy subjects and non-insulin dependent diabetics. Am J Physiol 263:E435-E440
Bonadonna RC, Saccomani MP, Sealy L, Zych KS, Ferrannini E, Cobelli C, De Fronzo RA (1993) Glucose transport in human skeletal muscle. The “in vivo” response to insulin. Diabetes 42:191–198
De Fronzo RA, Ferrannini E, Hendler R, Felig P, Wahren J (1983) Regulation of splanchnic and peripheral glucose uptake by insulin and hyperglycaemia in man. Diabetes 32:35–45
Segal KR, Van Loan M, Fitzgerald PI, Hodgdon JA, Van Itallie TB (1988) Lean body mass estimation by bioelectrical impedance analysis: a four site cross-validation study. Am J Clin Nutr 47:7–14
Priuz WA, West DB, Cohen A, Silverberg G, Greewood MRC (1986) Intraarterial insulin infusion reduces adipose tissue blood flow. Fed Proc 45:601–606
West DB, Prinz WA, Greenwood MRC (1989) Regional changes in adipose tissue blood flow and metabolism in rats after a meal. Am J Physiol 257:R711–716
Madsen J, Malchon-Maller A (1983) Effect of glucose, insulin and nicotinic acid on adipose tissue blood flow in rats. Acta Physiol Scand 118:175–180
Anggard E, Larsson C (1973) Arachidonic acid lowers and indomethacin increases the blood pressure of the rabbit. J Pharm Pharmacol 25:653–666
Colina-Chourio J, McGliff JC, Nasjletti A (1979) Effect of indomethacin on blood pressure in normotensive unanesthetized rabbit: possible relation to prostaglandin synthesis inhibition. Clin Sci 57:359–365
Martin K, Zipser R, Horton R (1981) Effect of prostaglandin inhibition on the hypertensive action of sodium retaining steroids. Hypertension 3:622–628
Uehara Y, Tobian L, Iwei J, Ishii M, Suijmoto T (1979) Alteration of vascular prostacyclin and thromboxane A2 in Dahl genetic strain susceptible to salt-induced hypertension. Prostaglandins 33:727–738
Laasko M, Edelamn V, Brechtel G, Baron AD (1990) Decreased effect of insulin to stimulate skeletal muscle blood flow in obese men. A novel mechanism for insulin resistance. J Clin Invest 85:1844–1852
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Paolisso, G., Gambardella, A., Saccomanno, F. et al. Low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients. Eur J Clin Pharmacol 48, 333–338 (1995). https://doi.org/10.1007/BF00194947
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00194947