Antioxidant therapy potentiates antihypertensive action of insulin in diabetic rats.
BACKGROUND
Poorly controlled longstanding diabetes frequently results in sustained hypertension (HTN) which plays a major role in the pathogenesis of diabetic nephropathy. In addition, hyperglycemia, per se, causes a reversible rise in blood pressure (BP) and increases production of reactive oxygen species (ROS). Increased ROS activity may raise BP by promoting inactivation of nitric oxide (NO) and/or nonenzymatic generation of vasoconstrictive prostaglandins from peroxidation of arachidonic acid. Therefore, we hypothesized that antioxidant therapy may enhance the BP-lowering effect of glycemia control with insulin replacement in diabetes.


METHODS
Male Sprague-Dawley rats were rendered diabetic by streptozotocin administration and randomized to untreated, antioxidant-treated (vitamin E-fortified food, tocopherol 5000 U/kg chow and vitamin C-fortified H2O, 1000 mg/L), insulin-treated and insulin plus antioxidant-treated groups. Normal rats fed a regular diet or antioxidant-fortified diet served as controls and monitored for 4 weeks.


RESULTS
The diabetic animals showed marked hyperglycemia, HTN, proteinuria, depressed tissue glutathione level and elevated plasma lipid peroxidation product, malondialdehyde (MDA) denoting increased ROS activity. Insulin therapy alone resulted in significant, but incomplete reduction in BP and plasma MDA but not proteinuria. Antioxidant therapy alone had no effect on the measured parameters in either the diabetic or control animals. However, combined insulin and antioxidant therapies normalized BP, plasma MDA and urinary protein in the diabetic animals. As expected, uncontrolled diabetes resulted in glomerular hyperfiltration which was partially reversed by insulin therapy, but was unaffected by antioxidant therapy.


CONCLUSIONS
Uncontrolled hyperglycemia in the early phase of diabetes was associated with elevated plasma MDA, HTN and proteinuria. Insulin therapy alone resulted in significant but incomplete reduction of plasma MDA and BP. Antioxidant therapy which was ineffective when given alone, normalized plasma MDA, BP and reduced urinary protein excretion when combined with insulin treatment.
Department of Medicine, University of California-Irvine, 92697, USA.
Ja-Ryong
JR
Koo
Zhenmin
Z
Ni
Fariba
F
Oviesi
Nosratola D
ND
Vaziri
D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D001786:Blood Glucose; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight; D003404:Creatinine / Q000378:metabolism; D003921:Diabetes Mellitus, Experimental / Q000188:drug therapy* / Q000378:metabolism; D004357:Drug Synergism; D005978:Glutathione / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006943:Hyperglycemia / Q000188:drug therapy / Q000378:metabolism; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007328:Insulin / Q000494:pharmacology*; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D009569:Nitric Oxide / Q000378:metabolism; D018384:Oxidative Stress / Q000187:drug effects; D011507:Proteinuria / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D024505:Tocopherols / Q000494:pharmacology*
D000975:Antioxidants; D001786:Blood Glucose; D003404:Creatinine; D005978:Glutathione; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008315:Malondialdehyde; D009569:Nitric Oxide; D024505:Tocopherols