Low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients.
Fourteen hypertensive (174.3/98.3 mmHg) non-diabetic patients were given a euglyceamic glucose clamp along with infusion of 0.9% NaCl and the prostacyclin (PGI2) analogue Iloprost (0.7 ng x kg x min(-1)). Substrate oxidation was also determined by indirect calorimetry. Over the last 60 min of the clamp, Iloprost vs saline improved whole body glucose disposal (WBGD) (35 vs 28.3 micromol x kg(-1) LBM) and non-oxidative glucose metabolism (24.7 vs 18.1 micromol x kg(-1) LBM x min(-1). Iloprost delivery was associated with a significant decrease in membrane microviscosity (0.253 vs 0.205), but did not affect arterial blood pressure and heart rate. In nine patients, skeletal muscle blood flow (SMBF) and insulin-stimulated glucose uptake (GU) were also studied. At the end of the study, despite a similar SMBF (37 vs 38 ml x min(-1) x kg(-1)), GU (0.55 vs 0.46 mmol x l(-1)) was significantly increased by Iloprost infusion. Percentage decrease in membrane microviscosity was correlated with percentage increase in WBGD (r = 0.65) and non-oxidative glucose metabolism (r = 0.68). In conclusion, low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients.
Paolisso
G
G
Dipartimento di Geriatria e Malattie del Metabolismo, I Policlinico, Naples, Italy.
Gambardella
A
A
Saccomanno
F
F
Varricchio
G
G
D'Amore
A
A
Varricchio
M
M
D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D002462:Cell Membrane / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D011464:Epoprostenol / Q000096:biosynthesis / Q000097:blood; D005260:Female; D005947:Glucose / Q000493:pharmacokinetics; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D016285:Iloprost / Q000009:adverse effects / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007328:Insulin / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply; D010084:Oxidation-Reduction; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*; D014783:Viscosity
D001786:Blood Glucose; D007328:Insulin; D014665:Vasodilator Agents; D011464:Epoprostenol; D005947:Glucose; D016285:Iloprost