title: Effect of needle biopsy from the vastus lateralis muscle on insulin-stimulated glucose metabolism in humans.
abstract: To examine the cellular mechanisms behind conditions characterized by insulin resistance, the clamp technique is often combined with muscle biopsies. To test whether the trauma of a needle biopsy from the vastus lateralis muscle per se may influence insulin-stimulated glucose uptake, eight healthy subjects underwent two randomly sequenced hyperinsulinemic (insulin infusion rate: 0.6 mU.kg-1.min-1 for 150 min) euglycemic clamps with an interval of 4-6 wk. In one study (study B) a muscle biopsy (approximately 250 mg, i.e., larger than normal standard) was taken in the basal state just before the clamp procedure, whereas the other was a control study (study C). Insulin-stimulated glucose uptake was significantly reduced in study B (5.36 +/- 0.96 mg.kg-1.min-1) compared with study C (6.06 +/- 0.68 mg.kg-1.min-1; P < 0.05). Nonoxidative glucose disposal (indirect calorimetry) was decreased (2.81 +/- 1.08 vs. 3.64 +/- 1.34 mg.kg-1.min-1; P < 0.05), whereas glucose oxidation was unaltered. Likewise, endogenous glucose output ([3-3H]glucose) was identically suppressed during hyperinsulinemia. Circulating levels of epinephrine, glucagon, and growth hormone did not differ significantly in studies B and C. In contrast, plasma norepinephrine, serum cortisol, and free fatty acid rose after biopsy (P < 0.05). In conclusion, performance of a muscle biopsy may diminish insulin sensitivity by affecting nonoxidative glucose metabolism. This should be considered when assessing whole body insulin sensitivity after a percutaneous needle muscle biopsy.
authors.affiliation: Department of Medicine M (Endocrinology and Diabetes), Kommunehospitalet, Aarhus, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Holck
authors.forename: N
authors.initials: N
authors.lastname: Pørksen
authors.forename: M F
authors.initials: MF
authors.lastname: Nielsen
authors.forename: B
authors.initials: B
authors.lastname: Nyholm
authors.forename: J F
authors.initials: JF
authors.lastname: Bak
authors.forename: F
authors.initials: F
authors.lastname: Andreasen
authors.forename: N
authors.initials: N
authors.lastname: Møller
authors.forename: O
authors.initials: O
authors.lastname: Schmitz
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism*; D015309:Glucose Clamp Technique; D006728:Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000494:pharmacology*; D007866:Leg; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology*
chemical_list: D005230:Fatty Acids, Nonesterified; D006728:Hormones; D007328:Insulin; D005947:Glucose