The effects of hypoglycaemia during hyperinsulinaemia, occurring under various pathophysiological conditions, on the cardiovascular regulatory system and vasculature are largely unknown. The aim of the present study was to investigate regulatory and haemodynamic responses to acute hyperinsulinaemia and consequent hypoglycaemia in 18 healthy subjects. Blood sampling and 5 min ECG and blood pressure recordings were performed at baseline and during the euglycaemic and hypoglycaemic phases of a hyperinsulinaemic clamp. Heart rate variability (HRV) and blood pressure variability (BPV) were assessed by using power spectral analysis, and baroreflex sensitivity (BRS) was assessed using the cross-spectral method. Stroke volume was assessed from the non-invasive blood pressure signal by the arterial pulse contour method. Euglycaemic hyperinsulinaemia did not change plasma catecholamine concentrations, HRV, BPV, BRS, heart rate, blood pressure, stroke volume, cardiac output or peripheral resistance. However, hyperinsulinaemic hypoglycaemia resulted in an 11.7-fold increase in the plasma adrenaline concentration (from 0.19±0.03 to 1.68±0.32 nmol/l; P<0.001), and a modest 1.3-fold increase in the plasma noradrenaline concentration (from 1.74±0.22 to 2.02±0.19 nmol/l; P<0.05) compared with baseline. Furthermore, we observed significant decreases in diastolic blood pressure (from 68±3 to 60±3 mmHg; P<0.05) and peripheral resistance (from 24.1±1.2 to 18.5±1.1 mmHg·min-1·l-1; P<0.01). Stroke volume and cardiac output increased markedly from the euglycaemic to the hypoglycaemic period only (P<0.01 for both). Hypoglycaemia did not influence HRV, BPV or BRS. Our findings indicate that hyperinsulinaemic hypoglycaemia is characterized by a significant increase in the plasma adrenaline concentration and by decreases in peripheral resistance and blood pressure. Counter-regulation during hyperinsulinaemic hypoglycaemia involves selective adrenomedullary sympathetic activation, and does not influence cardiac parasympathetic regulation or baroreflex control of heart rate.
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Research Article|
September 01 2003
Effects of euglycaemic and hypoglycaemic hyperinsulinaemia on sympathetic and parasympathetic regulation of haemodynamics in healthy subjects
Tomi LAITINEN;
*Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
Correspondence: Dr Tomi Laitinen, Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland (e-mail [email protected]).
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Hanna HUOPIO;
Hanna HUOPIO
†Department of Paediatrics, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Ilkka VAUHKONEN;
Ilkka VAUHKONEN
‡Department of Medicine, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Cyril CAMARO;
Cyril CAMARO
§University Medical Centre, University of Nijmegen, P.O. Box 9102, 6500 HC Nijmegen, The Netherlands
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Juha HARTIKAINEN;
Juha HARTIKAINEN
‡Department of Medicine, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Markku LAAKSO;
Markku LAAKSO
‡Department of Medicine, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Leo NISKANEN
Leo NISKANEN
‡Department of Medicine, Kuopio University Hospital and University of Kuopio, P.O. Box 1777, FIN-70211, Kuopio, Finland
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Publisher: Portland Press Ltd
Received:
February 27 2003
Revision Received:
May 02 2003
Accepted:
May 29 2003
Accepted Manuscript online:
May 29 2003
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2003 The Biochemical Society
2003
Clin Sci (Lond) (2003) 105 (3): 315–322.
Article history
Received:
February 27 2003
Revision Received:
May 02 2003
Accepted:
May 29 2003
Accepted Manuscript online:
May 29 2003
Citation
Tomi LAITINEN, Hanna HUOPIO, Ilkka VAUHKONEN, Cyril CAMARO, Juha HARTIKAINEN, Markku LAAKSO, Leo NISKANEN; Effects of euglycaemic and hypoglycaemic hyperinsulinaemia on sympathetic and parasympathetic regulation of haemodynamics in healthy subjects. Clin Sci (Lond) 1 September 2003; 105 (3): 315–322. doi: https://doi.org/10.1042/CS20030079
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