Influence of parasympatheitc dysfunction and hyperinsulinemia on the hemodynamic response to an isometric exercise in non—insulin-dependent diabetic patients

Valensi, P.; Nguyễn, Thị Nhạn; Idriss, S.; Cazes, P; Karam, G.; Pariès, J.; Miossec, P.; Attali, Jean-Raymond

doi:10.1016/s0026-0495(98)90347-x

Cited by 26 publications

(16 citation statements)

References 41 publications

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“…Plasma insulin concentrations were signi®cantly higher in the latter group, which suggests that the BP response to the handgrip test was limited due to the vasodilator effect of insulin. 18 In the PS obese patients in the present study, the BP response was actually reduced, which could have been the result of a vasodilator effect of insulin. Thus, in insulin resistant subjects parasympathetic dysfunction appears to be protective against an excessive BP response to isometric exercise, probably through a combination of a decrease in sympathetic activity and a predominant vasodilator effect of insulin.…”

Section: Handgrip Test In Obese Patients P Valensi Et Almentioning

confidence: 48%

“…We recently found a signi®cant association between parasympathetic dysfunction and higher plasma insulin concentrations in patients with non insulin dependent diabetes mellitus (NIDDM). 18 The role of sympathetic activation in the cardiac effect of insulin has been shown with insulin i.v. infusion and hyperinsulinaemic euglycaemic clamping, 20,31,32 and is supported by plasma noradrenaline measurements, microneurographic recordings 32 ± 34 and total body noradrenaline spillover measurements.…”

Section: Discussionmentioning

confidence: 99%

“…The test was performed with a dynamometer by a subject in a sitting position for 10 min, as previously described. 14,18 For each subject, the maximal voluntary contraction was ®rst determined. The subject was then asked to maintain 30% of the maximal handgrip contraction for 5 min, while breathing quietly at the same rate as at rest.…”

Section: Methodsmentioning

confidence: 99%

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Haemodynamic response to an isometric exercise test in obese patients: Influence of autonomic dysfunction

et al. 1999

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OBJECTIVE: To investigate blood pressure (BP) and heart rate (HR) responses to an isometric exercise test in obese non diabetic patients and to correlate the results with vagal function and plasma insulin concentration. SUBJECTS: 63 obese patients, 36 of whom had abnormal cardiac parasympathetic control (PS ), and 35 healthy control subjects. METHODS: Analysis of HR variations during three standardized tests: deep-breathing, lying-to-standing and Valsalva. Isometric contraction (handgrip) for 5 min. RESULTS: In the PS obese patients, resting HR and body mass index (BMI) were signi®cantly higher than in the PS 7 subjects and there was a trend to higher plasma insulin concentrations. Age-matched comparison showed that during the handgrip test, the increase in HR at the ®rst minute was signi®cantly higher in the PS 7 obese patients than in the controls. The increase in BP was signi®cantly lower in the PS obese patients than in age-and-BMImatched PS 7 obese patients. CONCLUSION: These data suggest that 1) there is an increase in cardiac vagal tone in PS 7 obese patients, since the early increase in HR at 1 min of the handgrip test, results from the withdrawal of vagal tone; 2) BP response to an isometric contraction is impaired in PS obese patients due to a lower sympathetic activation; 3) high plasma insulin concentrations may also contribute to limiting the BP response; and 4) autonomic disorders may account for alterations in the haemodynamic changes during exercise.

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Section: Handgrip Test In Obese Patients P Valensi Et Almentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

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Haemodynamic response to an isometric exercise test in obese patients: Influence of autonomic dysfunction

et al. 1999

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“…Parasympathetic dysfunction has been associated with severe insulin resistance [10], which predates the overt development of type 2 diabetes mellitus by many years [11]. The impairment of the parasympathetic nervous system has recently been considered as an aetiological factor in the pathological process, rather than just a consequence of diabetes [12].…”

Section: Introductionmentioning

confidence: 99%

Insulin resistance induced by sucrose feeding in rats is due to an impairment of the hepatic parasympathetic nerves

et al. 2005

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“…Confirming these data, we obtained a positive correlation between reduced cardiac vagal tonus and insulin resistance in female rats, reinforcing the relationship between autonomic and metabolic dysfunctions. Importantly, Valensi et al (18) demonstrated that hepatic parasympathetic impairment was associated with the development of insulin resistance, which predates the overt development of type 2 diabetes.…”

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confidence: 99%

Parasympathetic dysfunction is associated with insulin resistance in fructose-fed female rats

Brito

Ponciano

Figueroa

et al. 2008

Braz J Med Biol Res

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The objective of the present study was to identify metabolic, cardiovascular and autonomic changes induced by fructose overload administered in the drinking water of rats for 8 weeks. Female Wistar rats (200-220 g) were divided into 2 groups: control (N = 8) and fructose-fed rats (N = 5; 100 mg/L fructose in drinking water for 8 weeks). The autonomic control of heart rate was evaluated by pharmacological blockade using atropine (3 mg/kg) and propranolol (4 mg/kg). The animals were submitted to an intravenous insulin tolerance test (ITT) and to blood glucose measurement. The fructose overload induced a significant increase in body weight (~10%) and in fasting glycemia (~28%). The rate constant of glucose disappearance (KITT) during ITT was lower in fructose-fed rats (3.25 ± 0.7%/min) compared with controls (4.95 ± 0.3%/min, P < 0.05) indicating insulin resistance. The fructose-fed group presented increased arterial pressure compared to controls (122 ± 3 vs 108 ± 1 mmHg, P < 0.05) and a reduction in vagal tonus (31 ± 9 vs 55 ± 5 bpm in controls, P < 0.05). No changes in sympathetic tonus were observed. A positive correlation, tested by the Pearson correlation, was demonstrable between cardiac vagal tonus and KITT (r = 0.8, P = 0.02). These data provided new information regarding the role of parasympathetic dysfunction associated with insulin resistance in the development of early metabolic and cardiovascular alterations induced by a high fructose diet.

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Influence of parasympatheitc dysfunction and hyperinsulinemia on the hemodynamic response to an isometric exercise in non—insulin-dependent diabetic patients

Cited by 26 publications

References 41 publications

Haemodynamic response to an isometric exercise test in obese patients: Influence of autonomic dysfunction

Haemodynamic response to an isometric exercise test in obese patients: Influence of autonomic dysfunction

Insulin resistance induced by sucrose feeding in rats is due to an impairment of the hepatic parasympathetic nerves

Parasympathetic dysfunction is associated with insulin resistance in fructose-fed female rats

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