Effects of hyperinsulinemia on sympathetic responses to mental stress.
Effects of hyperinsulinemia on sympathetic responses to mental stress.
复制标题
高胰岛素血症对精神压力交感神经反应的影响。
DOI：
10.1016/s0895-7061(99)00146-6
复制
发表时间：
2000
影响因子：
3.2
通讯作者：
Kjeldsen,SE
中科院分区：
文献类型：
--
作者：
Høieggen,A;Fossum,E;Moan,A;Rostrup,M;Eide,IK;Kjeldsen,SE
在最近的一项研究中，我们无法找到证据支持胰岛素在高胰岛素葡萄糖钳夹过程中激活交感神经系统（SNS）的假设。然而，精神压力测试（MST）可用于检测基线或静息状态下不存在的血压和SNS活动的差异。在本研究中，为探讨葡萄糖钳夹过程中高胰岛素血症对血压和交感神经对精神应激反应的影响，对18名21岁男性高血压患者进行了5分钟的心算应激试验（MST-1），然后进行了120分钟的异糖基-高胰岛素葡萄糖钳夹试验（MST-2）。葡萄糖和胰岛素的输注速率保持恒定。胰岛素浓度从119 ± 10 pmol/L增加至752 ± 65 pmol/L。我们观察到MST引起血压和心率显著升高，但胰岛素和生理盐水输注均不影响这些反应。在MST-1期间，去甲肾上腺素增加461 ± 165 pmol/L（平均值± SEM），肾上腺素增加218 ± 76 pmol/L。在MST-2期间，变化分别为372 ± 112 pmol/L和187 ± 60 pmol/L。去甲肾上腺素（P= 0.8）和肾上腺素（P= 0.7）反应未受胰岛素影响。因此，尽管输注胰岛素，动脉化静脉血中的血压、心率和血浆儿茶酚胺浓度对MST的反应也相似。一个可能的时间效应被排除，包括一个盐水溶液对照组（n = 7），表现出几乎相同的结果。我们的研究结果表明，急性高胰岛素血症在异糖基化葡萄糖钳夹不干扰心血管或交感神经对精神压力的反应。Am J Hypertens 2000;13：21-28 © 2000 American Journal of Hypertension，Ltd.
In a recent study, we could not find evidence to support the hypothesis that insulin activates the sympathetic nervous system (SNS) during a hyperinsulinemic glucose clamp procedure. Mental stress tests (MST), however, may be used to detect differences in blood pressure and SNS activity that are not present during baseline or resting conditions. In this study, we aimed to investigate the effects of hyperinsulinemia during glucose clamp on blood pressure and sympathetic responses to mental stress.Borderline hypertensive but otherwise healthy 21-year-old men (n = 18) underwent 5 min of mental arithmetic stress testing (MST-1) before and at the end of 120 min of isoglycemic hyperinsulinemic glucose clamp (MST-2) with infusion rates of glucose and insulin kept constant. Insulin concentration increased from 119 ± 10 pmol/L to 752 ± 65 pmol/L. We observed highly significant increases in blood pressure and heart rate in response to MST, but neither insulin nor saline solution infusions affected these responses. During MST-1, norepinephrine increased by 461 ± 165 pmol/L (mean ± SEM) and epinephrine by 218 ± 76 pmol/L. During MST-2 the changes were 372 ± 112 pmol/L and 187 ± 60 pmol/L, respectively. The norepinephrine (P= .8) and epinephrine (P= .7) responses were unchanged by insulin. Thus, there were similar increases in blood pressure, heart rate, and plasma catecholamine concentrations in arterialized venous blood in response to MST despite the infusion of insulin. A possible time effect was excluded by including a saline solution control group (n = 7) that showed almost identical results.Our results suggest that acute hyperinsulinemia during isoglycemic glucose clamp does not interfere with cardiovascular or sympathetic responses to mental stress. Am J Hypertens 2000;13:21–28 © 2000 American Journal of Hypertension, Ltd.