title: Angiotensin II enhances insulin sensitivity in healthy volunteers under euglycemic conditions.
abstract: OBJECTIVE
  It has been postulated that vasoconstrictors cause insulin resistance. This effect has been documented for epinephrine but not for angiotensin II (Ang II). The aim of this study was to investigate the effect of the latter on insulin sensitivity.
  
  
  METHODS
  In order to study the influence of subpressor doses of Ang II on insulin-mediated glucose uptake under euglycemic conditions, eight healthy volunteers were allocated in random order to sham infusion or infusion of Ang II (first 0.75 ng/kg per min and subsequently 1.5 ng/kg per min). In addition, in seven of the subjects Ang II was infused after 3 days of indomethacin pretreatment (150 mg/day).
  
  
  METHODS
  Insulin-mediated glucose uptake (expressed as M value) was measured with the euglycemic clamp technique. Insulin levels were measured enzymatically, plasma renin activity, Ang II, aldosterone and C-peptide levels by radioimmunoassay, blood pressure by Dinamap and muscle blood flow by plethysmography.
  
  
  RESULTS
  The M value after sham infusion was 7.81 +/- 1.52 mg/kg per min and after 1.5 ng/kg Ang II per min was 9.76 +/- 1.26 mg/kg per min (P < 0.001). Indomethacin pretreatment did not abolish the Ang II-induced rise in the M value. Mean arterial blood pressure during the euglycemic clamp was unchanged with sham infusion and the low dose of Ang II. It increased slightly with the higher dose of Ang II. Inferior limb muscle perfusion was higher after infusion of Ang II than after sham infusion; this effect was not obliterated by indomethacin pretreatment.
  
  
  CONCLUSIONS
  Ang II increases insulin-mediated glucose uptake: that is, it enhances insulin sensitivity by mechanisms independent of prostaglandins. The observations are of potential relevance to the changes in insulin sensitivity in some forms of hypertension.
authors.affiliation: Department of Internal Medicine, Ruperto-Carola University Heidelberg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Fliser
authors.forename: U
authors.initials: U
authors.lastname: Arnold
authors.forename: B
authors.initials: B
authors.lastname: Kohl
authors.forename: R
authors.initials: R
authors.lastname: Hartung
authors.forename: E
authors.initials: E
authors.lastname: Ritz
mesh_terms: D000328:Adult; D000804:Angiotensin II / Q000494:pharmacology*; D004357:Drug Synergism; D004837:Epinephrine / Q000494:pharmacology; D005947:Glucose / Q000378:metabolism; D015309:Glucose Clamp Technique; D006801:Humans; D007213:Indomethacin / Q000494:pharmacology; D007328:Insulin / Q000494:pharmacology*; D008297:Male; D009132:Muscles / Q000098:blood supply; D012039:Regional Blood Flow / Q000187:drug effects
chemical_list: D007328:Insulin; D000804:Angiotensin II; D005947:Glucose; D007213:Indomethacin; D004837:Epinephrine