title: Antecedent hypoglycaemia attenuates vascular endothelial growth factor response to subsequent hypoglycaemia in healthy men.
abstract: OBJECTIVE
  The plasma concentration of vascular endothelial growth factor (VEGF) has recently been shown to increase sharply in response to hypoglycaemia and, thus, has been proposed as having a role in hypoglycaemia counter-regulation. Many counter-regulatory hormones show a reduced response after antecedent hypoglycaemia. We therefore investigated whether this decrease in responsiveness with repetitive hypoglycaemia also pertains to VEGF.
  
  
  METHODS
  Three hypoglycaemic clamp experiments were performed on two consecutive days in 15 healthy men. VEGF response was assessed during the first and last hypoglycaemic period.
  
  
  RESULTS
  As expected, plasma VEGF concentrations rose markedly during the clamps (P < 0.001). The increase was distinctly blunted during the third (+13 +/- 8 pg/ml) as compared with the first (+54 +/- 18 pg/ml) hypoglycaemic clamp (P = 0.046).
  
  
  CONCLUSIONS
  This data confirms that circulating VEGF concentrations increase acutely during hypoglycaemia. Like the counter-regulatory hormones, the hypoglycaemia-induced rise in VEGF is attenuated after antecedent hypoglycaemia. The origin of increased systemic VEGF concentration during hypoglycaemia and its physiological role remains to be defined.
authors.affiliation: Department of Internal Medicine I, University of Leubeck, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Merl
authors.forename: A
authors.initials: A
authors.lastname: Peters
authors.forename: K M
authors.initials: KM
authors.lastname: Oltmanns
authors.forename: W
authors.initials: W
authors.lastname: Kern
authors.forename: C
authors.initials: C
authors.lastname: Hubold
authors.forename: H L
authors.initials: HL
authors.lastname: Fehm
authors.forename: J
authors.initials: J
authors.lastname: Born
authors.forename: B
authors.initials: B
authors.lastname: Schultes
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003071:Cognition; D004837:Epinephrine / Q000097:blood; D006801:Humans; D007003:Hypoglycemia / Q000097:blood*; D008297:Male; D008570:Memory, Short-Term; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D001786:Blood Glucose; D042461:Vascular Endothelial Growth Factor A; D004837:Epinephrine