title: Influence of physiological and supraphysiological hyperinsulinemia on skin microcirculation in healthy volunteers.
abstract: OBJECTIVE
  To examine skin perfusion in dependency on insulinemia in healthy subjects.
  
  
  METHODS
  All volunteers were informed in detail about the procedures and signed informed consent. The protocol of this study was approved by the ethical committee. In our study, a two stage hyperinsulinemic euglycemic clamp was performed, with insulinemia 100 and 250 mIU/mL and glycemia 5.0 mmol/L (3% standard deviation). Before the clamp and in steady states, microcirculation was measured by laser Doppler flowmetry and transcutaneous oximetry and energy expenditure was measured by indirect calorimetry. Results (average and standard deviation) were evaluated with paired t-test.
  
  
  RESULTS
  Physiological (50 mIU/L) insulinemia led to higher perfusion in both tests; hyperemia after heating to 44%-1848% (984-2046) vs 1599% (801-1836), P < 0.05, half time of reaching peak perfusion after occlusion release 1.2 s (0.9-2.6) vs 4.9 s (1.8-11.4), P < 0.05. Supraphysiological (150 mIU/L) insulinemia led to even higher perfusion in both tests; hyperemia after heating to 44%-1937% (1177-2488) vs 1599% (801-1836), P < 0.005, half time to reach peak perfusion after occlusion release 1.0 s (0.7-1.1) vs 4.9 s (1.8-11.4), P < 0.005. A statistically significant increase occurred in tissue oxygenation in both insulinemia. The difference in perfusion and oxygenation between physiological and supraphysiological hyperinsulinemia was not statistically significant.
  
  
  CONCLUSIONS
  The post occlusive hyperemia test in accordance with heating test showed significantly increasing skin perfusion in the course of artificial hyperinsulinemia. This effect rises non-linearly with increasing insulinemia. Dependency on the dose was not statistically significant.
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Krčma
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cechurová
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Jitka
authors.initials: J
authors.lastname: Brožová
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Jankovec
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Silvie
authors.initials: S
authors.lastname: Lacigová
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Zourek
authors.affiliation: Michal Krčma, Daniela Čechurová, Jitka Brožová, Zdeněk Jankovec, Silvie Lacigová, Michal Žourek, Zdeněk Rušavý, Diabetology Centre, 1 Department of Clinic Medicine, Teaching Hospital and Medical Faculty Charles University, 32300 Plzen, Czech Republic.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Rušavý
keywords: Diabetes; Insulin; Laser Doppler flowmetry; Microcirculation