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  • 1
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    American Physiological Society ; 2010
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 299, No. 6 ( 2010-12), p. E947-E952
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 299, No. 6 ( 2010-12), p. E947-E952
    Kurzfassung: Defective insulin-dependent vasodilation might contribute importantly to metabolic and vascular abnormalities of the metabolic syndrome (MetS). However, despite extensive investigation, the precise mechanisms involved in insulin's vasoactive effects have not been fully elucidated. Therefore, this study sought to better characterize insulin's physiological actions on vascular reactivity and their potential derangement in the MetS. Forearm blood flow responses to graded doses of acetylcholine, sodium nitroprusside, and verapamil were assessed by strain-gauge plethysmography in patients with obesity-related MetS ( n = 20) and in matched controls ( n = 18) before and after intra-arterial infusion of insulin (0.2 mU·kg −1 ·min −1 ). Possible involvement of increased oxidative stress in the impaired insulin-stimulated vasodilator responsiveness of patients with MetS ( n = 12) was also investigated using vitamin C (25 mg/min). In control subjects, significant potentiation of the vasodilator responses to acetylcholine, nitroprusside, and verapamil was observed after insulin infusion (all P 〈 0.05). However, no significant change in vasodilator reactivity to either of these drugs was observed following hyperinsulinemia in patients with MetS (all P 〉 0.05). Interestingly, administration of vitamin C to patients with MetS during hyperinsulinemia significantly enhanced the vasodilator responsiveness to acetylcholine, nitroprusside, and verapamil (all P 〈 0.05 vs. hyperinsulinemia alone). In conclusion, insulin exerts a generalized facilitatory action on vasodilator reactivity, and this effect is impaired in patients with MetS likely because of increased oxidative stress. Given the importance of vasodilator reactivity in affecting glucose disposal and vascular homeostasis, this defect may then contribute to the development of metabolic and vascular complications in insulin-resistant states.
    Materialart: Online-Ressource
    ISSN: 0193-1849 , 1522-1555
    Sprache: Englisch
    Verlag: American Physiological Society
    Publikationsdatum: 2010
    ZDB Id: 1477331-4
    SSG: 12
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
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    American Physiological Society ; 2015
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 309, No. 9 ( 2015-11-01), p. E787-E792
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 309, No. 9 ( 2015-11-01), p. E787-E792
    Kurzfassung: Patients with metabolically healthy obesity (MHO) do not present the cluster of metabolic abnormalities that define the metabolic syndrome (MetS). Whether MHO is associated with lower impairment of vasoreactivity than the MetS is unknown. For this purpose, forearm blood flow (FBF) responses were measured by strain-gauge plethysmography during the intra-arterial infusion of acetylcholine (ACh), sodium nitroprusside (SNP), and/or the selective endothelin type A (ET A ) receptor blocker BQ-123 in 119 obese individuals with MHO ( n = 34) or with the MetS ( n = 85) and in healthy lean controls ( n = 56). ACh and SNP caused a significant vasodilation in both obese and lean participants (all P 〈 0.001). However, the response to both agents was significantly lower in the obese than in the control group (both P 〈 0.001). Among the obese participants, the reactivity to ACh was higher in MHO than in MetS patients, whereas the responsiveness to SNP was equally impaired in both groups ( P = 0.45). Infusion of BQ-123 significantly increased FBF in obese patients ( P 〈 0001), but not in the lean participants; hence, FBF following ET A receptor blockade was higher in both obese groups than in controls (both P 〈 0.001). FBF response to BQ-123 was significantly higher in patients with the MetS than in those with MHO ( P = 0.007). In conclusion, patients with MHO have abnormal vascular reactivity, although their endothelial dysfunction is less pronounced than in patients with the MetS. These findings indicate that obesity is associated with vascular damage independent of those metabolic abnormalities underlying the MetS.
    Materialart: Online-Ressource
    ISSN: 0193-1849 , 1522-1555
    Sprache: Englisch
    Verlag: American Physiological Society
    Publikationsdatum: 2015
    ZDB Id: 1477331-4
    SSG: 12
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    In: Diabetes Care, American Diabetes Association, Vol. 36, No. 3 ( 2013-03-01), p. 683-689
    Kurzfassung: Patients with the metabolic syndrome (MetS) have impaired insulin-induced enhancement of vasodilator responses. The incretin hormone glucagon-like peptide 1 (GLP-1), beyond its effects on blood glucose, has beneficial actions on vascular function. This study, therefore, aimed to assess whether GLP-1 affects insulin-stimulated vasodilator reactivity in patients with the MetS. RESEARCH DESIGN AND METHODS Forearm blood flow responses to acetylcholine (ACh) and sodium nitroprusside (SNP) were assessed in MetS patients before and after the addition of GLP-1 to an intra-arterial infusion of saline (n = 5) or insulin (n = 5). The possible involvement of oxidative stress in the vascular effects of GLP-1 in this setting was investigated by infusion of vitamin C (n = 5). The receptor specificity of GLP-1 effect during hyperinsulinemia was assessed by infusing its metabolite GLP-1(9-36) (n = 5). The metabolic actions of GLP-1 were also tested by analyzing forearm glucose disposal during hyperinsulinemia (n = 5). RESULTS In MetS patients, GLP-1 enhanced endothelium-dependent and -independent responses to ACh and SNP, respectively, during hyperinsulinemia (P & lt; 0.001 for both), but not during saline (P & gt; 0.05 for both). No changes in vasodilator reactivity to ACh and SNP were seen after GLP-1 was added to insulin and vitamin C (P & gt; 0.05 for both) and after GLP-1(9-36) was given during hyperinsulinemia (P & gt; 0.05 for both). Also, GLP-1 did not affect forearm glucose extraction and uptake during hyperinsulinemia (P & gt; 0.05 for both). CONCLUSIONS In patients with the MetS, GLP-1 improves insulin-mediated enhancement of endothelium-dependent and -independent vascular reactivity. This effect may be influenced by vascular oxidative stress and is possibly exerted through a receptor-mediated mechanism.
    Materialart: Online-Ressource
    ISSN: 0149-5992 , 1935-5548
    Sprache: Englisch
    Verlag: American Diabetes Association
    Publikationsdatum: 2013
    ZDB Id: 1490520-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
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    The Endocrine Society ; 2013
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 98, No. 3 ( 2013-03-01), p. 1235-1241
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 98, No. 3 ( 2013-03-01), p. 1235-1241
    Materialart: Online-Ressource
    ISSN: 0021-972X , 1945-7197
    RVK:
    Sprache: Englisch
    Verlag: The Endocrine Society
    Publikationsdatum: 2013
    ZDB Id: 2026217-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
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    Ovid Technologies (Wolters Kluwer Health) ; 2011
    In:  Journal of Hypertension Vol. 29, No. 9 ( 2011-09), p. 1743-1748
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 9 ( 2011-09), p. 1743-1748
    Materialart: Online-Ressource
    ISSN: 0263-6352
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2011
    ZDB Id: 2017684-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Kurzfassung: Impaired insulin-mediated vasodilation in the skeletal muscle may be involved in the development of hypertension in patients with metabolic syndrome (MetS) and contribute to insulin resistance by diminishing the glucose uptake. Rho-kinase, an effector of the small G protein Rho A, plays an important role in hypertension and is reported to interfere with insulin signaling through serine phosphorylation of insulin receptor substrate-1 in blood vessels. We therefore examined the role of Rho-kinase in the pathophysiology of impaired vascular reactivity in patients with MetS by evaluating the effect of Rho-kinase inhibition on NO-dependent vasodilation during hyperinsulinemia. Forearm blood flow (FBF) responses to acetylcholine (ACh), a stimulus for endothelial release of NO, and sodium nitroprusside (SNP), an exogenous NO donor, were assessed during insulin administration (0.1 mU/Kg/min) using the forearm perfusion technique in patients with MetS (n=10) and matched controls (n=10). Patients with MetS were then randomized to intra-arterial infusion of either fasudil (inhibitor of Rho-kinase, 200 μg/min) or placebo and reactivity to ACh and SNP was reassessed. During hyperinsulinemia, vasodilator responses to both ACh and SNP were blunted in patients with MetS (both P 〉 0.001 vs. controls). In patients who received fasudil, its administration did not change unstimulated FBF (P=0.75 vs. insulin alone); the vasodilator response to ACh, however, was significantly enhanced by fasudil (P=0.009 vs. insulin alone), while the response to SNP was not significantly changed (P=0.56). In patients with MetS who received placebo, vascular reactivity to both ACh and SNP was not different than before (both P 〉 0.05). In conclusion, Rho-kinase inhibition during hyperinsulinemia improves endothelium-dependent vasodilator responsiveness in patients with MetS. This suggests that, under those conditions, intravascular activation of Rho-kinase is involved in the pathophysiology of endothelial dysfunction and may constitute a critical mediator linking metabolic and hemodynamic abnormalities in insulin resistance. As a consequence, targeting Rho-kinase might beneficially impact both vascular function and insulin sensitivity in patients with MetS.
    Materialart: Online-Ressource
    ISSN: 0009-7322 , 1524-4539
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2008
    ZDB Id: 1466401-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Kurzfassung: Obese patients have vascular dysfunction related to impaired nitric oxide (NO)-dependent vasodilation and increased endothelin (ET)-1 activity. Obestatin is a gastrointestinal peptide with favorable metabolic actions linked to obesity and diabetes; it has also been shown to exert cardiovascular benefits in experimental models by producing vascular relaxation via specific activation of endothelium-dependent NO signaling. Here we tested the hypothesis that obestatin might have advantageous impacts on the NO pathway and the ET-1 system in patients with central obesity. To this purpose, forearm blood flow responses to intra-arterial infusion of graded doses of exogenous obestatin (0.2; 0.4; 0.8; 1,6; 3.2 nmol/min, each dose given for 5 min) were assessed in lean subjects (n=5) and in patients with central obesity (n=14), during the concurrent infusion of saline and after NO inhibition by L-NMMA (4 μmol/min for 15 min). In another group of obese patients (n=10), vascular responses to selective blockade of ET A receptors (BQ-123, 10 nmol/min for 60 min) were measured in the absence and the presence of obestatin (0.8 nmol/min). In lean subjects, before NO synthase inhibition obestatin resulted in a progressive increase in forearm flow (60% at the highest dose; P 〈 0.001 vs. baseline); obestatin-induced vasodilation, however, was completely abolished by L-NMMA (P 〈 0.001 vs. saline). Similarly, in obese patients obestatin induced a significant vasodilation (45%; P 〈 0.001 vs. baseline), which was blunted by L-NMMA (16%; P 〈 0.01 vs. saline). Before obestatin, in obese patients ET A receptor blockade resulted in a marked vasodilation (39% flow increase at 60 min; P 〈 0.001 vs. baseline), which was totally abrogated in the presence of obestatin (P 〈 0.001 vs. absence). In conclusion, obestatin produces vasorelaxation in healthy humans via specific activation of endothelium-dependent NO signaling. This beneficial effect of obestatin is preserved in obese arteries, where it is associated with inhibition of ET-1 signaling. These actions of obestatin, therefore, may be important in the normal regulation of vascular function and are clearly relevant to obesity, a condition characterized by increased prevalence of hypertension and cardiovascular complications.
    Materialart: Online-Ressource
    ISSN: 0009-7322 , 1524-4539
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2014
    ZDB Id: 1466401-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
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    American Physiological Society ; 2012
    In:  American Journal of Physiology-Endocrinology and Metabolism Vol. 303, No. 6 ( 2012-09-15), p. E806-E811
    In: American Journal of Physiology-Endocrinology and Metabolism, American Physiological Society, Vol. 303, No. 6 ( 2012-09-15), p. E806-E811
    Kurzfassung: In patients with the metabolic syndrome (MetS), the facilitatory effect of insulin on forearm vasodilator responsiveness to different stimuli is impaired. Whether the RhoA/Rho kinase (ROCK) pathway is involved in this abnormality is unknown. We tested the hypotheses that, in MetS patients, ROCK inhibition with fasudil restores insulin-stimulated vasodilator reactivity and that oxidative stress plays a role in this mechanism. Endothelium-dependent and -independent forearm blood flow responses to acetylcholine (ACh) and sodium nitroprusside (SNP), respectively, were assessed in MetS patients ( n = 8) and healthy controls ( n = 5) before and after the addition of fasudil (200 μg/min) to an intra-arterial infusion of insulin (0.1 mU/kg/min). In MetS patients ( n = 5), fasudil was also infused without hyperinsulinemia. The possible involvement of oxidative stress in the effect of fasudil during hyperinsulinemia was investigated in MetS patients ( n = 5) by infusing vitamin C (25 mg/min). In MetS patients, compared with saline, fasudil enhanced endothelium-dependent and -independent vasodilator responses during insulin infusion ( P 〈 0.001 and P = 0.008, respectively), but not in the absence of hyperinsulinemia ( P = 0.25 and P = 0.13, respectively). By contrast, fasudil did not affect vasoreactivity to ACh and SNP during hyperinsulinemia in controls ( P = 0.11 and P = 0.56, respectively). In MetS patients, fasudil added to insulin and vitamin C did not further enhance vasodilation to ACh and SNP ( P = 0.15 and P = 0.43, respectively). In the forearm circulation of patients with the MetS, ROCK inhibition by fasudil improves endothelium-dependent and -independent vasodilator responsiveness during hyperinsulinemia; increased oxidative stress seems to be involved in the pathophysiology of this phenomenon.
    Materialart: Online-Ressource
    ISSN: 0193-1849 , 1522-1555
    Sprache: Englisch
    Verlag: American Physiological Society
    Publikationsdatum: 2012
    ZDB Id: 1477331-4
    SSG: 12
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 5 ( 2009-11), p. 995-1000
    Kurzfassung: Obesity is associated with endothelial dysfunction related to decreased NO bioavailability, increased endothelin 1 vasoconstrictor activity, and decreased circulating ghrelin. Therefore, we tested whether exogenous ghrelin may have benefits to improve the balance between endothelin 1 and NO in patients with obesity-related metabolic syndrome. Vasoactive actions of endothelin 1 and NO were assessed in 8 patients with metabolic syndrome and 8 matched controls by evaluating forearm blood flow responses (strain-gauge plethysmography) to intra-arterial infusion of BQ-123 (endothelin A receptor antagonist; 10 nmol/min), followed by N G -monomethyl- l -arginine (NO synthase inhibitor; 4 μmol/min), before and after infusion of ghrelin (200 ng/min). In the absence of ghrelin, the vasodilator response to BQ-123 was greater in patients than in controls ( P 〈 0.001), whereas infusion of N G -monomethyl- l -arginine induced smaller vasoconstriction in patients than in controls ( P =0.006). Importantly, exogenous ghrelin decreased the vasodilator response to BQ-123 ( P =0.007 versus saline) and enhanced the magnitude of changes in forearm blood flow induced by N G -monomethyl- l -arginine ( P =0.003) in patients but not in controls (both P 〉 0.05). The favorable effect of ghrelin on endothelin A–dependent vasoconstriction was likely related to the stimulation of NO production, because no change in the vascular effect of BQ-123 was observed after ghrelin ( P =0.44) in 5 patients with metabolic syndrome during continuous infusion of the NO donor sodium nitroprusside (0.2 μg/min). In patients with metabolic syndrome, ghrelin has benefits to normalize the balance between vasoconstrictor (endothelin 1) and vasodilating (NO) mediators, thus suggesting that this peptide has important peripheral actions to preserve vascular homeostasis in humans.
    Materialart: Online-Ressource
    ISSN: 0194-911X , 1524-4563
    Sprache: Englisch
    Verlag: Ovid Technologies (Wolters Kluwer Health)
    Publikationsdatum: 2009
    ZDB Id: 2094210-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
    In: Diabetes Care, American Diabetes Association, Vol. 31, No. 7 ( 2008-07-01), p. 1439-1441
    Kurzfassung: OBJECTIVE—Obesity is associated with chronic inflammation due to overproduction of proinflammatory cytokines, including tumor necrosis factor (TNF)-α. We assessed the effects of TNF-α neutralization by infliximab on vascular reactivity during hyperinsulinemia in obesity-related metabolic syndrome. RESEARCH DESIGN AND METHODS—Vascular responses to intra-arterial infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) were assessed in patients with metabolic syndrome, before and after administration of infliximab. RESULTS—Patients had blunted vasodilator responses to ACh and SNP during hyperinsulinemia compared with control subjects; a potentiation of the responsiveness to both ACh and SNP, however, was observed in patients following infliximab. The antioxidant vitamin C improved the vasodilator response to ACh in patients with metabolic syndrome, but its effect was not further enhanced by concurrent administration of infliximab. CONCLUSIONS—TNF-α neutralization ameliorates vascular reactivity in metabolic syndrome during hyperinsulinemia, likely in relation to decreased oxidative stress, thereby suggesting an involvement of inflammatory cytokines in vascular dysfunction of these patients.
    Materialart: Online-Ressource
    ISSN: 0149-5992 , 1935-5548
    Sprache: Englisch
    Verlag: American Diabetes Association
    Publikationsdatum: 2008
    ZDB Id: 1490520-6
    Standort Signatur Einschränkungen Verfügbarkeit
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