Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Altered hormonal and autonomic nerve responses to hypo- and hyperglycaemia are found in overweight and insulin-resistant individuals and may contribute to the development of type 2 diabetes
Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.ORCID-id: 0000-0002-1313-0934
Visa övriga samt affilieringar
2021 (Engelska)Ingår i: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 64, nr 3, s. 641-655Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aims/hypothesis: Results from animal models and some clinical work suggest a role for the central nervous system (CNS) in glucose regulation and type 2 diabetes pathogenesis by modulation of glucoregulatory hormones and the autonomic nervous system (ANS). The aim of this study was to characterise the neuroendocrine response to various glucose concentrations in overweight and insulin-resistant individuals compared with lean individuals.

Methods: Overweight/obese (HI, n = 15, BMI ≥27.0 kg/m2) and lean (LO, n = 15, BMI <27.0 kg/m2) individuals without diabetes underwent hyperinsulinaemic euglycaemic–hypoglycaemic clamps and hyperglycaemic clamps on two separate occasions with measurements of hormones, Edinburgh Hypoglycaemic Symptom Scale (ESS) score and heart rate variability (HRV). Statistical methods included groupwise comparisons with Mann–Whitney U tests, multilinear regressions and linear mixed models between neuroendocrine responses and continuous metabolic variables.

Results: During hypoglycaemic clamps, there was an elevated cortisol response in HI vs LO (median ΔAUC 12,383 vs 4793 nmol/l × min; p = 0.050) and a significantly elevated adrenocorticotropic hormone (ACTH) response in HI vs LO (median ΔAUC 437.3 vs 162.0 nmol/l × min; p = 0.021). When adjusting for clamp glucose levels, obesity (p = 0.033) and insulin resistance (p = 0.009) were associated with elevated glucagon levels. By contrast, parasympathetic activity was less suppressed in overweight individuals at the last stage of hypoglycaemia compared with euglycaemia (high-frequency power of HRV, p = 0.024). M value was the strongest predictor for the ACTH and PHF responses, independent of BMI and other variables. There was a BMI-independent association between the cortisol response and ESS score response (p = 0.024). During hyperglycaemic clamps, overweight individuals displayed less suppression of glucagon levels (median ΔAUC −63.4% vs −73.0%; p = 0.010) and more suppression of sympathetic relative to parasympathetic activity (low-frequency/high-frequency power, p = 0.011).

Conclusions/interpretation: This study supports the hypothesis that altered responses of insulin-antagonistic hormones and the ANS to glucose fluctuations occur in overweight and insulin-resistant individuals, and that these responses are probably partly mediated by the CNS. Their potential role in development of type 2 diabetes needs to be addressed in future research.

Ort, förlag, år, upplaga, sidor
Springer, 2021. Vol. 64, nr 3, s. 641-655
Nyckelord [en]
ACTH, Central nervous system, Cortisol, Diabetes, Glucoregulatory hormones, Glucose, Insulin resistance, Obesity
Nationell ämneskategori
Endokrinologi och diabetes
Identifikatorer
URN: urn:nbn:se:umu:diva-177495DOI: 10.1007/s00125-020-05332-zISI: 000592558000001PubMedID: 33241460Scopus ID: 2-s2.0-85096588761OAI: oai:DiVA.org:umu-177495DiVA, id: diva2:1512991
Forskningsfinansiär
DiabetesförbundetStiftelsen familjen Ernfors fondNovo NordiskEXODIAB - Excellence of Diabetes Research in SwedenTillgänglig från: 2020-12-29 Skapad: 2020-12-29 Senast uppdaterad: 2023-03-24Bibliografiskt granskad

Open Access i DiVA

fulltext(1063 kB)136 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 1063 kBChecksumma SHA-512
6d47497b652b9198caa83a06912134d690de2c0a9d9f20230323ec9f34f2278a1248005c72f5f628debb36956488724465a5f9e45f331bcb6dfa2c1ce28dc1bd
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Person

Wiklund, Urban

Sök vidare i DiVA

Av författaren/redaktören
Wiklund, UrbanPereira, Maria J.Eriksson, Jan W.
Av organisationen
Radiofysik
I samma tidskrift
Diabetologia
Endokrinologi och diabetes

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 202 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 275 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf