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. 1994 Sep;94(3):1172–1179. doi: 10.1172/JCI117433

Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. A novel action of insulin to increase nitric oxide release.

H O Steinberg 1, G Brechtel 1, A Johnson 1, N Fineberg 1, A D Baron 1
PMCID: PMC295191  PMID: 8083357

Abstract

The purpose of this study was to examine whether insulin's effect to vasodilate skeletal muscle vasculature is mediated by endothelium-derived nitric oxide (EDNO). N-monomethyl-L-arginine (L-NMMA), a specific inhibitor of NO synthase, was administered directly into the femoral artery of normal subjects at a dose of 16 mg/min and leg blood flow (LBF) was measured during an infusion of saline (NS) or during a euglycemic hyperinsulinemic clamp (HIC) designed to approximately double LBF. In response to the intrafemoral artery infusion of L-NMMA, LBF decreased from 0.296 +/- 0.032 to 0.235 +/- 0.022 liters/min during NS and from 0.479 +/- 0.118 to 0.266 +/- 0.052 liters/min during HIC, P < 0.03. The proportion of NO-dependent LBF during NS and HIC was approximately 20% and approximately 40%, respectively, P < 0.003 (NS vs. HIC). To elucidate whether insulin increases EDNO synthesis/release or EDNO action, vasodilative responses to graded intrafemoral artery infusions of the endothelium-dependent vasodilator methacholine chloride (MCh) or the endothelium-independent vasodilator sodium nitroprusside (SNP) were studied in normal subjects during either NS or HIC. LBF increments in response to intrafemoral artery infusions of MCh but not SNP were augmented during HIC versus NS, P < 0.03. In summary, insulin-mediated vasodilation is EDNO dependent. Insulin vasodilation of skeletal muscle vasculature most likely occurs via increasing EDNO synthesis/release. Thus, insulin appears to be a novel modulator of the EDNO system.

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Selected References

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  1. Anderson E. A., Hoffman R. P., Balon T. W., Sinkey C. A., Mark A. L. Hyperinsulinemia produces both sympathetic neural activation and vasodilation in normal humans. J Clin Invest. 1991 Jun;87(6):2246–2252. doi: 10.1172/JCI115260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baron A. D., Brechtel-Hook G., Johnson A., Hardin D. Skeletal muscle blood flow. A possible link between insulin resistance and blood pressure. Hypertension. 1993 Feb;21(2):129–135. doi: 10.1161/01.hyp.21.2.129. [DOI] [PubMed] [Google Scholar]
  3. Baron A. D., Brechtel G., Wallace P., Edelman S. V. Rates and tissue sites of non-insulin- and insulin-mediated glucose uptake in humans. Am J Physiol. 1988 Dec;255(6 Pt 1):E769–E774. doi: 10.1152/ajpendo.1988.255.6.E769. [DOI] [PubMed] [Google Scholar]
  4. Baron A. D., Steinberg H., Brechtel G., Johnson A. Skeletal muscle blood flow independently modulates insulin-mediated glucose uptake. Am J Physiol. 1994 Feb;266(2 Pt 1):E248–E253. doi: 10.1152/ajpendo.1994.266.2.E248. [DOI] [PubMed] [Google Scholar]
  5. Bennet W. M., Connacher A. A., Scrimgeour C. M., Jung R. T., Rennie M. J. Euglycemic hyperinsulinemia augments amino acid uptake by human leg tissues during hyperaminoacidemia. Am J Physiol. 1990 Aug;259(2 Pt 1):E185–E194. doi: 10.1152/ajpendo.1990.259.2.E185. [DOI] [PubMed] [Google Scholar]
  6. Bockman C. S., Jeffries W. B., Pettinger W. A., Abel P. W. Enhanced release of endothelium-derived relaxing factor in mineralocorticoid hypertension. Hypertension. 1992 Sep;20(3):304–313. doi: 10.1161/01.hyp.20.3.304. [DOI] [PubMed] [Google Scholar]
  7. Buchanan T. A., Thawani H., Kades W., Modrall J. G., Weaver F. A., Laurel C., Poppiti R., Xiang A., Hsueh W. Angiotensin II increases glucose utilization during acute hyperinsulinemia via a hemodynamic mechanism. J Clin Invest. 1993 Aug;92(2):720–726. doi: 10.1172/JCI116642. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Calver A., Collier J., Moncada S., Vallance P. Effect of local intra-arterial NG-monomethyl-L-arginine in patients with hypertension: the nitric oxide dilator mechanism appears abnormal. J Hypertens. 1992 Sep;10(9):1025–1031. [PubMed] [Google Scholar]
  9. Calver A., Collier J., Vallance P. Inhibition and stimulation of nitric oxide synthesis in the human forearm arterial bed of patients with insulin-dependent diabetes. J Clin Invest. 1992 Dec;90(6):2548–2554. doi: 10.1172/JCI116149. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Creager M. A., Gallagher S. J., Girerd X. J., Coleman S. M., Dzau V. J., Cooke J. P. L-arginine improves endothelium-dependent vasodilation in hypercholesterolemic humans. J Clin Invest. 1992 Oct;90(4):1248–1253. doi: 10.1172/JCI115987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Creager M. A., Liang C. S., Coffman J. D. Beta adrenergic-mediated vasodilator response to insulin in the human forearm. J Pharmacol Exp Ther. 1985 Dec;235(3):709–714. [PubMed] [Google Scholar]
  12. D'Orléans-Juste P., Dion S., Mizrahi J., Regoli D. Effects of peptides and non-peptides on isolated arterial smooth muscles: role of endothelium. Eur J Pharmacol. 1985 Aug 7;114(1):9–21. doi: 10.1016/0014-2999(85)90515-1. [DOI] [PubMed] [Google Scholar]
  13. Felber J. P., Meyer H. U., Curchod B., Iselin H. U., Rousselle J., Maeder E., Pahud P., Jéquier E. Glucose storage and oxidation in different degrees of human obesity measured by continuous indirect calorimetry. Diabetologia. 1981;20(1):39–44. doi: 10.1007/BF00253814. [DOI] [PubMed] [Google Scholar]
  14. Feletou M., Vanhoutte P. M. Endothelium-dependent hyperpolarization of canine coronary smooth muscle. Br J Pharmacol. 1988 Mar;93(3):515–524. doi: 10.1111/j.1476-5381.1988.tb10306.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Ferrannini E., Buzzigoli G., Bonadonna R., Giorico M. A., Oleggini M., Graziadei L., Pedrinelli R., Brandi L., Bevilacqua S. Insulin resistance in essential hypertension. N Engl J Med. 1987 Aug 6;317(6):350–357. doi: 10.1056/NEJM198708063170605. [DOI] [PubMed] [Google Scholar]
  16. Ferrannini E., Haffner S. M., Stern M. P. Insulin sensitivity and hypertension. J Hypertens Suppl. 1990 Dec;8(7):S169–S174. [PubMed] [Google Scholar]
  17. Ferrannini E., Taddei S., Santoro D., Natali A., Boni C., Del Chiaro D., Buzzigoli G. Independent stimulation of glucose metabolism and Na+-K+ exchange by insulin in the human forearm. Am J Physiol. 1988 Dec;255(6 Pt 1):E953–E958. doi: 10.1152/ajpendo.1988.255.6.E953. [DOI] [PubMed] [Google Scholar]
  18. Furchgott R. F., Zawadzki J. V. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature. 1980 Nov 27;288(5789):373–376. doi: 10.1038/288373a0. [DOI] [PubMed] [Google Scholar]
  19. Imaizumi T., Hirooka Y., Masaki H., Harada S., Momohara M., Tagawa T., Takeshita A. Effects of L-arginine on forearm vessels and responses to acetylcholine. Hypertension. 1992 Oct;20(4):511–517. doi: 10.1161/01.hyp.20.4.511. [DOI] [PubMed] [Google Scholar]
  20. Jamerson K. A., Julius S., Gudbrandsson T., Andersson O., Brant D. O. Reflex sympathetic activation induces acute insulin resistance in the human forearm. Hypertension. 1993 May;21(5):618–623. doi: 10.1161/01.hyp.21.5.618. [DOI] [PubMed] [Google Scholar]
  21. Kannel W. B., Brand N., Skinner J. J., Jr, Dawber T. R., McNamara P. M. The relation of adiposity to blood pressure and development of hypertension. The Framingham study. Ann Intern Med. 1967 Jul;67(1):48–59. doi: 10.7326/0003-4819-67-1-48. [DOI] [PubMed] [Google Scholar]
  22. Laakso M., Edelman S. V., Brechtel G., Baron A. D. Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance. J Clin Invest. 1990 Jun;85(6):1844–1852. doi: 10.1172/JCI114644. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Laakso M., Edelman S. V., Brechtel G., Baron A. D. Impaired insulin-mediated skeletal muscle blood flow in patients with NIDDM. Diabetes. 1992 Sep;41(9):1076–1083. doi: 10.2337/diab.41.9.1076. [DOI] [PubMed] [Google Scholar]
  24. McVeigh G. E., Brennan G. M., Johnston G. D., McDermott B. J., McGrath L. T., Henry W. R., Andrews J. W., Hayes J. R. Impaired endothelium-dependent and independent vasodilation in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1992 Aug;35(8):771–776. doi: 10.1007/BF00429099. [DOI] [PubMed] [Google Scholar]
  25. Miller V. M., Aarhus L. L., Vanhoutte P. M. Modulation of endothelium-dependent responses by chronic alterations of blood flow. Am J Physiol. 1986 Sep;251(3 Pt 2):H520–H527. doi: 10.1152/ajpheart.1986.251.3.H520. [DOI] [PubMed] [Google Scholar]
  26. Miller V. M., Burnett J. C., Jr Modulation of NO and endothelin by chronic increases in blood flow in canine femoral arteries. Am J Physiol. 1992 Jul;263(1 Pt 2):H103–H108. doi: 10.1152/ajpheart.1992.263.1.H103. [DOI] [PubMed] [Google Scholar]
  27. Miller V. M., Vanhoutte P. M. Enhanced release of endothelium-derived factor(s) by chronic increases in blood flow. Am J Physiol. 1988 Sep;255(3 Pt 2):H446–H451. doi: 10.1152/ajpheart.1988.255.3.H446. [DOI] [PubMed] [Google Scholar]
  28. Moncada S., Rees D. D., Schulz R., Palmer R. M. Development and mechanism of a specific supersensitivity to nitrovasodilators after inhibition of vascular nitric oxide synthesis in vivo. Proc Natl Acad Sci U S A. 1991 Mar 15;88(6):2166–2170. doi: 10.1073/pnas.88.6.2166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Neahring J. M., Stepniakowski K., Greene A. S., Egan B. M. Insulin does not reduce forearm alpha-vasoreactivity in obese hypertensive or lean normotensive men. Hypertension. 1993 Oct;22(4):584–590. doi: 10.1161/01.hyp.22.4.584. [DOI] [PubMed] [Google Scholar]
  30. Palmer R. M., Ferrige A. G., Moncada S. Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor. Nature. 1987 Jun 11;327(6122):524–526. doi: 10.1038/327524a0. [DOI] [PubMed] [Google Scholar]
  31. Palmer R. M., Rees D. D., Ashton D. S., Moncada S. L-arginine is the physiological precursor for the formation of nitric oxide in endothelium-dependent relaxation. Biochem Biophys Res Commun. 1988 Jun 30;153(3):1251–1256. doi: 10.1016/s0006-291x(88)81362-7. [DOI] [PubMed] [Google Scholar]
  32. Panza J. A., Quyyumi A. A., Brush J. E., Jr, Epstein S. E. Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med. 1990 Jul 5;323(1):22–27. doi: 10.1056/NEJM199007053230105. [DOI] [PubMed] [Google Scholar]
  33. Rees D. D., Palmer R. M., Moncada S. Role of endothelium-derived nitric oxide in the regulation of blood pressure. Proc Natl Acad Sci U S A. 1989 May;86(9):3375–3378. doi: 10.1073/pnas.86.9.3375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Shimizu K., Muramatsu M., Kakegawa Y., Asano H., Toki Y., Miyazaki Y., Okumura K., Hashimoto H., Ito T. Role of prostaglandin H2 as an endothelium-derived contracting factor in diabetic state. Diabetes. 1993 Sep;42(9):1246–1252. doi: 10.2337/diab.42.9.1246. [DOI] [PubMed] [Google Scholar]
  35. Uvnäs B. Cholinergic vasodilator nerves. Fed Proc. 1966 Nov-Dec;25(6):1618–1622. [PubMed] [Google Scholar]
  36. Vallance P., Collier J., Moncada S. Effects of endothelium-derived nitric oxide on peripheral arteriolar tone in man. Lancet. 1989 Oct 28;2(8670):997–1000. doi: 10.1016/s0140-6736(89)91013-1. [DOI] [PubMed] [Google Scholar]
  37. Vollenweider P., Tappy L., Randin D., Schneiter P., Jéquier E., Nicod P., Scherrer U. Differential effects of hyperinsulinemia and carbohydrate metabolism on sympathetic nerve activity and muscle blood flow in humans. J Clin Invest. 1993 Jul;92(1):147–154. doi: 10.1172/JCI116542. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Zemel M. B., Johnson B. A., Ambrozy S. A. Insulin-stimulated vascular relaxation. Role of Ca(2+)-ATPase. Am J Hypertens. 1992 Sep;5(9):637–641. doi: 10.1093/ajh/5.9.637. [DOI] [PubMed] [Google Scholar]

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