Cardioprotective Effects of Insulin

Ng, Keng Wooi; Allen, Meredith; Desai, Ajay; MacRae, Duncan; Pathan, Nazima

doi:10.1161/circulationaha.111.063784

Cited by 46 publications

(18 citation statements)

References 109 publications

(91 reference statements)

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“…Furthermore, insulin stimulation of the PI3K-Akt pathway has been reported to regulate numerous other cardiac processes, including hypertrophy, apoptosis and autophagy, as reviewed elsewhere [11,15]. Insulin infusion is used in the clinical setting to improve outcomes in acute coronary patients, yet the mode of action and efficacy of this is still uncertain [15].…”

Section: Cardiac Actions Of Insulinmentioning

confidence: 99%

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Examining the Role of Insulin in the Regulation of Cardiovascular Health

Salt

2012

Future Cardiol.

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Examining the role of insulin in the regulation of cardiovascular health SUMMARYA substantial body of evidence has reported insulin has direct actions on the cardiovascular system independent of its systemic effects on plasma glucose or lipids. In particular, insulin regulates endothelial synthesis of the vasoactive mediators nitric oxide and endothelin-1, yet the importance of this in the maintenance of cardiovascular health remains poorly understood.Recent studies using animals with targeted downregulation of insulin signaling in vascular tissues are improving our understanding of the role of insulin in vascular health. This article focuses on the direct actions of insulin in cardiovascular tissues, with particular emphasis on the molecular mechanisms of insulin action on endothelial function. The potential contribution of impaired vascular insulin action to the cardiovascular complications of diabetes will also be discussed.

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Section: Cardiac Actions Of Insulinmentioning

confidence: 99%

“…Insulin infusion is used in the clinical setting to improve outcomes in acute coronary patients, yet the mode of action and efficacy of this is still uncertain [15].…”

Section: Cardiac Actions Of Insulinmentioning

confidence: 99%

Examining the Role of Insulin in the Regulation of Cardiovascular Health

Salt

2012

Future Cardiol.

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“…In cardiac muscle, insulin promotes glucose uptake and its utilization via glycolysis and also participates in the regulation of long-chain fatty acid uptake and protein synthesis [4] . Traditionally, insulin has been considered to be cardioprotective [5] , [6] , [7] , [8] . However, some more recent studies reported that insulin have cardiac effects that would not be expected from a cardioprotective hormone.…”

Section: Introductionmentioning

confidence: 99%

Insulin down-regulates cardioprotective SUR2A in the heart-derived H9c2 cells: A possible explanation for some adverse effects of insulin therapy

Jovanović

Sukhodub

et al. 2018

Biochemistry and Biophysics Reports

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Some recent studies associated insulin therapy with negative cardiovascular events and shorter lifespan. SUR2A, a KATP channel subunit, regulate cardioprotection and cardiac ageing. Here, we have tested whether glucose and insulin regulate expression of SUR2A/KATP channel subunits and resistance to metabolic stress in heart H9c2 cells. Absence of glucose in culture media decreased SUR2A mRNA, while mRNAs of Kir6.2, Kir6.1, SUR1 and IES SUR2B were increased. 2-deoxyglucose (50 mM) decreased mRNAs of SUR2A, SUR2B and SUR1, did not affect IES SUR2A and IES SUR2B mRNAs and increased Kir6.2 mRNA. No glucose and 2-deoxyglucose (50 mM) decreased resistance to an inhibitor of oxidative phosphorylation, DNP (10 mM). 50 mM glucose did not alter KATP channel subunits nor cellular resistance to DNP (10 mM). Insulin (20 ng/ml) in both physiological and high glucose (50 mM) down-regulated SUR2A while upregulating Kir6.1 and Kir6.2 (in high glucose only). Insulin (20 ng/ml) in physiological and high glucose decreased cell survival in DNP (10 mM). As opposed to Kir6.2, infection with SUR2A resulted in titre-dependent cytoprotection. We conclude that insulin decreases resistance to metabolic stress in H9c2 cells by decreasing SUR2A expression. Lower cardiac SUR2A levels underlie increased myocardial susceptibility to metabolic stress and shorter lifespan.

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“…Some experimental studies found that IR may be part of the antioxidant defense mechanism [6]. Hyperinsulinemia exerts cardioprotective effects via glucose-dependent and independent mechanisms, including aversion of glucose toxicity, positive inotropy, modulation of apoptosis, infl ammation and coronary fl ow [7]. W. Dinh et al registrated that ranges of global LS didn't differ between IR and non-IR patients in a cross-sectional study [8].…”

Section: Resultsmentioning

confidence: 99%

Speckle tracking echocardiography in hypertensive males with glucose metabolism disorders

Kolesnyk

2014

ZMJ

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T ype 2 diabetes mellitus (DM) and arterial hypertension (HTN) are major medical and public health problems worldwide. The total number of people with DM will rise from 171 million in 2000 to 552 million by 2030 [1]. The number of adults with HTN is predicted to increase by 60% to a total of 1.56 billion people by 2025 [2]. HTN is present in approximately 60% of patients with type 2 DM [3]. 80% of diabetic patients die from cardiovascular complications. Both diseases affect the same major target organs. Myocardial envolvement is characterized by microvascular disease, altered metabolism and increased fi brosis that lead to gradual decline in left ventricular (LV) function. Early alterations of myocardium should be diagnosed early and treated aggressively to prevent microvascular and macrovascular morbidity and mortality.Insulin resistance (IR) is a key pathogenetic mechanism of type 2 DM and exists for many years even in normoglycemic patients. Impaired fasting glucose (IFG), or 'pre-diabetes', refl ect the natural history of progression from normoglycaemia to type 2 DM. The hypertensive patients with IR and pre-diabetes may have long-standing subclinical myocardial dysfunction before onset of DM [4]. Speckle-tracking echocardiography is a modern ultrasound technique which allows to investigate early myocardial changes in patients even without LV hypertrophy and diastolic dysfunction. Compared to standard echocardiography parameters, myocardial strain and strain rate (SR) analyses are more sensitive indices of LV function. At present, there is a lack of studies concerning the development of structural and functional myocardial abnormalities in patients with different glucose abnormalities like IR, pre-diabetes and type 2 DM.The aim of our study was to assess changes in LV function with speckle tracking echocardiography in hypertensive patients with different types of glucose metabolism abnormalities. Aim. Early left ventricle (LV) abnormalities are hardly detectable by means of standard echocardiography in patients with hypertension (HTN) and glucose metabolism disorders. The objective of this study was to assess changes in LV function with speckle tracking echocardiography in hypertensive males with different types of glucose metabolism abnormalities. Materials and methodsMethods and results. We recruited 158 hypertensive males with different glycemic status. The multidirectional LV strain was assessed by two-dimensional speckle tracking echocardiography. The patients with HTN and type 2 diabetes mellitus demonstrated signifi cant reduction of LV global longitudinal strain and early diastolic strain rate despite preserved LV ejection fraction.Conclusion. Speckle tracking echocardiography can identify subclinical myocardial alterations in hypertensive males with glucose metabolism abnormalities. Спекл-трекінг ехокардіографія в чоловіків з артеріальною гіпертензією та порушеннями метаболізму глюкози М.Ю. КолесникСтандартна ехокардіографія не має достатньої чутливості для оцінювання впливу порушень метаболізму глю...

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Cardioprotective Effects of Insulin

Cited by 46 publications

References 109 publications

Examining the Role of Insulin in the Regulation of Cardiovascular Health

Examining the Role of Insulin in the Regulation of Cardiovascular Health

Insulin down-regulates cardioprotective SUR2A in the heart-derived H9c2 cells: A possible explanation for some adverse effects of insulin therapy

Speckle tracking echocardiography in hypertensive males with glucose metabolism disorders

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