Insulin sensitivity is preserved despite disrupted endothelial function

Sudha S. Shankar, Robert Considine, J. Christopher Gorski, Helmut O. Steinberg

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

It is well established that endothelial dysfunction and insulin resistance go hand in hand. However, it is unclear whether endothelial dysfunction per se is sufficient to impair insulin-mediated glucose uptake. We have previously reported that 4 wk of administration of the human immunodeficiency virus (HIV)-1 protease inhibitor indinavir to HIV-negative subjects induces endothelial dysfunction. Hence, we hypothesized that indinavir-induced endothelial dysfunction was associated with impaired insulin-mediated glucose disposal. We measured insulin-mediated glucose disposal at the level of the whole body, skeletal muscle, and vasculature by performing hyperinsulinemic euglycemic clamp, and vascular function studies, in a separate group of HIV-negative healthy nonobese subjects (n = 13) before and after 4 wk of daily oral indinavir. Four weeks of indinavir resulted in a 113 ± 29% (P < 0.01) reduction of endothelium-dependent vasodilation, consistent with our earlier findings. In addition, there was a significant impairment of insulin-mediated vasodilation (101 ± 14% before indinavir vs. 35 ± 15% after indinavir; P < 0.05). However, there was no significant change in insulin-mediated glucose disposal at the level of the whole body (8.9 ± 0.5 before indinavir vs. 8.5 ± 0.6 mg·kg -1·min-1 after indinavir; P = 0.4), or skeletal muscle. Furthermore, in a separate group of four HIV-negative healthy nonobese subjects, we found that 4 wk of indinavir has no sustained effect on insulin-stimulated glucose uptake in adipose tissue. Thus our findings indicate that 1) endothelial dysfunction alone is insufficient to impair insulin-mediated glucose disposal, and 2) indinavir-induced endothelial dysfunction is likely due to a direct effect of the drug on the endothelium and is not coupled to the induction of insulin resistance.

Original languageEnglish
JournalAmerican Journal of Physiology - Endocrinology and Metabolism
Volume291
Issue number4
DOIs
StatePublished - 2006

Fingerprint

Indinavir
Insulin Resistance
Insulin
Viruses
Glucose
HIV
Vasodilation
Endothelium
Muscle
Healthy Volunteers
Skeletal Muscle
Glucose Clamp Technique
Clamping devices
Protease Inhibitors
Blood Vessels
Adipose Tissue
HIV-1
Tissue

Keywords

  • Endothelium
  • Glucose disposal
  • Protease inhibitor
  • Vascular function

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Biochemistry

Cite this

Insulin sensitivity is preserved despite disrupted endothelial function. / Shankar, Sudha S.; Considine, Robert; Gorski, J. Christopher; Steinberg, Helmut O.

In: American Journal of Physiology - Endocrinology and Metabolism, Vol. 291, No. 4, 2006.

Research output: Contribution to journalArticle

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