The effect of chronic heart failure and type 2 diabetes on insulin-stimulated endothelial function is similar and additive

Britt Falskov, Thomas Steffen Hermann, Christian Rask-Madsen, Atheline Major-Pedersen, Buris Christiansen, Jakob Raunsø, Lars Køber, Christian Torp-Pedersen, Helena Dominguez

Research output: Contribution to journalJournal articleResearchpeer-review

7 Citations (Scopus)

Abstract

AIM: Chronic heart failure is associated with endothelial dysfunction and insulin resistance. The aim of this investigation was to study insulin-stimulated endothelial function and glucose uptake in skeletal muscles in patients with heart failure in comparison to patients with type 2 diabetes.

METHODS: Twenty-three patients with systolic heart failure and no history of diabetes, seven patients with both systolic heart failure and type 2 diabetes, 19 patients with type 2 diabetes, and ten healthy controls were included in the study. Endothelial function was studied by venous occlusion plethysmography. Insulin-stimulated endothelial function was assessed after intra-arterial infusion of insulin followed by co-infusion with serotonin in three different dosages. Forearm glucose uptake was measured during the insulin infusion.

RESULTS: Patients with systolic heart failure had impaired insulin-stimulated endothelial function. The percentage increase in blood flow during co-infusion with insulin and serotonin dose response study was 24.74% ± 6.16%, 23.50% ± 8.32%, and 22.29% ± 10.77% at the three doses respectively, compared to the healthy control group 45.96% ± 11.56%, 67.40% ± 18.11% and 84.57% ± 25.73% (P = 0.01). Insulin-stimulated endothelial function was similar in heart failure patients and patients with type 2 diabetes, while it was further deteriorated in patients suffering from both heart failure and diabetes with a percentage increase in blood flow of 19.15% ± 7.81%, -2.35% ± 11.76%, and 5.82% ± 17.70% at the three doses of serotonin, respectively. Forearm glucose uptake was impaired in patients with heart failure compared to healthy controls (P = 0.03) and tended to be further impaired by co-existence of diabetes (P = 0.08).

CONCLUSION: Systolic heart failure and type 2 diabetes result in similar vascular insulin resistance and reduced muscular insulin-stimulated glucose uptake. The effects of systolic heart failure and type 2 diabetes appear to be additive.

Original languageEnglish
JournalVascular Health and Risk Management (Online)
Volume7
Pages (from-to)771-6
Number of pages6
ISSN1178-2048
DOIs
Publication statusPublished - 2011

Keywords

  • Aged
  • Diabetes Mellitus, Type 2
  • Endothelium, Vascular
  • Female
  • Forearm
  • Glucose
  • Heart Failure
  • Humans
  • Hypoglycemic Agents
  • Infusions, Intra-Arterial
  • Insulin
  • Insulin Resistance
  • Male
  • Middle Aged
  • Muscle, Skeletal
  • Plethysmography
  • Regional Blood Flow
  • Serotonin
  • Serotonin Receptor Agonists
  • Vasodilation

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