Forearm muscle insulin resistance during hypoglycemia: role of adrenergic mechanisms and hypoglycemia per se

1995 ◽  
Vol 268 (2) ◽  
pp. E248-E254 ◽  
Author(s):  
B. Capaldo ◽  
R. Napoli ◽  
R. Guida ◽  
P. Di Bonito ◽  
S. Antoniello ◽  
...  

The forearm perfusion technique was used 1) to quantify the muscle metabolism of glucose and gluconeogenic precursors in response to insulin-induced hypoglycemia and 2) to assess the role of catecholamines and glucose concentration, pe se. Insulin (0.5 mU.kg-1.min-1) was infused for 4 h in three groups of healthy volunteers. In group I (n = 6), blood glucose (BG) was maintained at its basal level (4.5 +/- 0.1 mmol/l). In group II (n = 7), BG was allowed to fall to approximately 3 mmol/l. Group III (n = 6) was similar to group II except that propranolol was infused also. In addition, at 240 min, hypoglycemia was locally corrected by intrabrachial glucose infusion while maintaining the systemic milieu unperturbed. In group I, forearm glucose uptake (FGU) increased from 4.7 +/- 1.3 to a mean value of 37.8 +/- 5.0 mumol.l-1.min-1, whereas in group II it remained unchanged (8.3 +/- 2.0 mumol.l-1.min-1). In group III, propranolol partially prevented the suppression of FGU that increased to 21.6 +/- 5.2 mumol.l-1.min-1 (P < 0.05 vs. group II). Local correction of hypoglycemia normalized the FGU response (36.5 +/- 8.0 mumol.l-1.min-1). Muscle release of lactate, but not of alanine, was slightly higher during hypoglycemia (P = not significant). Forearm blood flow remained unchanged in groups I and III, whereas it increased by approximately 40% in group II (P < 0.05). It is concluded that, during mild hypoglycemia 1) extreme insulin resistance develops in the skeletal muscle, mediated by beta-adrenergic stimulation and reduced glucose mass effect and 2) mobilization of gluconeogenic precursors is only weakly activated.

2021 ◽  
Vol 8 (4) ◽  
pp. 175-181
Author(s):  
Dr. Keshav Bansal ◽  
◽  
Dr. Dhaval Bhatt ◽  
Dr. Sunil Kumar Dadhich ◽  
Dr. Deep Kariya ◽  
...  

Objectives:To assess the diagnostic role of CSF C-reactive protein quantitatively in acute meningitisand to evaluate the efficacy of CSF C-reactive protein in differentiating pyogenic meningitis fromnon-pyogenic meningitis.Material and Methods: It is a prospective observational study of total 102children with suspected meningitis allocated into three groups based on initial investigations; group-I Pyogenic meningitis, group-II Non-Pyogenic meningitis and group-III No meningitis (Controlgroup). Quantitative CSF C-reactive protein was detected by the latex agglutination method. Datawere analyzed to establish the diagnostic role of CSF-CRP and to evaluate the efficacy of CSF-CRP indifferentiating pyogenic meningitis from non-pyogenic meningitis.Results: A total of 102 clinicallysuspected meningitis patients were studied. Based on CSF findings, the study population (102cases) was categorized into 3 groups. Group I was pyogenic meningitis consist 53 cases (51.96%).Group II was Non-Pyogenic meningitis consists 27 cases (26.47%). Group III was normal CSFfindings consist 22 (21.56%). 98.1% cases of pyogenic meningitis had elevated CSF-CRP level >1.1μg/ml of CSF. In the case of Non-Pyogenic meningitis, 96.2% were found to have CSF- CRP in therange of 0.05-0.10 μg/ml. The mean value of CSF-CRP in groups I,II and III were 5.57±1.48,0.09±0.042 and 0.01±0.010 respectively. Conclusion: Detection of CSF-CRP provides a newdimension to establish the diagnosis of pyogenic meningitis. It is a rapid, reliable and sensitivediagnostic test. From this study it is concluded that CSF-CRP can be used to differentiate pyogenicfrom non-pyogenic meningitis. Early, accurate and appropriate therapy can ameliorate the morbidityand mortality rates in such cases.


2004 ◽  
Vol 23 (8) ◽  
pp. 413-419 ◽  
Author(s):  
Cetin Kaymak ◽  
Ela Kadioglu ◽  
Hulya Basar ◽  
Semra Sardas

In this study, genotoxic effects of repeated sevoflurane anaesthesia were investigated in rabbits with or without antioxidant supplementation. Twenty-one New Zealand male rabbits were included in the study and randomized into three groups as: placebo treated (Group I), vitamin E supplemented (Group II) and selenium supplemented (Group III). Vitamin E and selenium were given intraperitoneally for 15 days before anaesthesia treatment. Anaesthesia was administered using 3% sevoflurane in 4 L/min oxygen for a 3-hour period and continued for 3 days. Blood samples were collected before anaesthesia (Sample 1), after the first, second and third days of sevoflurane administration (Sample 2, Sample 3 and Sample 4 respectively) and the last samples were taken 5 days after the last sevoflurane administration (Sample 5). Genotoxic damage was examined using the comet assay. The degree of damage is assessed by grading the cells into three categories of no migration (NM), low migration (LM) and high migration (HM) depending on the fraction of DNA pulled out into the tail under the influence of the electric field. The number of comets in each sample was calculated (1 × number of comets in category NM + 2 × number of comets in category LM + 3 ×number of comets in category HM) and expressed as the total comet score (TCS), which summarizes the damage frequencies. In Group I, a significant increase in the mean TCSs was observed for Samples 3 and 4 as compared with Sample 1. However, there were no significant differences between Samples 1, 2 and 5. The mean TCS of Sample 4 was significantly higher than Sample 1, 2 and 3 in Group II. Group III demonstrated no significant mean TCSs for any experimental conditions. Statistical differences were also observed between the groups with significant P values. This experimental study points out the presence of DNA damage with repeated sevoflurane anaesthesia and the genoprotective role of antioxidant supplementation on DNA damage in mononuclear leukocytes of rabbits by highly sensitive comet assay.


1991 ◽  
Vol 261 (2) ◽  
pp. H443-H450 ◽  
Author(s):  
H. Toga ◽  
J. Usha Raj ◽  
R. Hillyard ◽  
B. Ku ◽  
J. Anderson

We have determined the sites of action of endothelin-1 (ET) in the lamb pulmonary circulation. The influence of cyclooxygenase inhibition and baseline vasomotor tone on ET effects was also studied. Lungs of 14 lambs (6-9 wk of age, 12.1 +/- 0.6 kg body wt) were isolated and perfused with blood. Group I lungs (n = 5) were untreated, group II lungs (n = 5) were treated with indomethacin to inhibit cyclooxygenase, and group III lungs (n = 4) were treated with indomethacin and a thromboxane A2 analogue, U-46619, to elevate vasomotor tone. All lungs were perfused with constant flow in zone 3, with left atrial and airway pressures being 8 and 6 cmH2O, respectively. We measured pulmonary arterial pressure and, by the micropuncture servo-null method, pressures in 20- to 50-microns diameter subpleural venules, both before and after each dose of ET was infused (50, 100, 250, and 500 ng/kg). Group I lungs, with high baseline vasomotor tone, exhibited a biphasic response to ET; 50-100 ng/kg of ET dilated both arteries and veins, whereas 500 ng/kg of ET constricted both arteries and veins. In group II lungs with low vasomotor tone, all doses of ET caused constriction of arteries only. In group III lungs (indomethacin treated with elevated vasomotor tone), 50-100 ng/kg of ET caused dilation of arteries and veins, whereas 500 ng/kg of ET induced constriction, this time only in arteries. We conclude that ET has both dilator and constrictor effects in arteries and veins of isolated, perfused lamb lungs. ET-induced arterial and venous dilation is dependent on initial vasomotor tone but not on cyclooxygenase metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)


2021 ◽  
Author(s):  
Shivkumar Gopalakrishnan ◽  
sangeetha kandasamy ◽  
S.Malini ◽  
S.Peer Mohamed ◽  
k.velmurugan

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.


2021 ◽  
Vol 17 (4) ◽  
pp. 346-356
Author(s):  
I. S. Lipatov ◽  
Yu. V. Tezikov ◽  
A. R. Azamatov

Background: An in-depth study of dismetabolic mechanisms in the genesis of pre-eclampsia (PE) has been updated because pregnancy is considered as a natural model of metabolic syndrome (MS), as well as the metabolic disorders are important in development of essential hypertension.Aims: to reveal clinical and laboratory parallels in pregnancy complicated by PE without MS and pregnancy proceeding on the background of MS to assess the role of metabolic disturbances in the development of PE.Materials and methods: 82 women with MS were examined in the dynamics of pregnancy and were divided into 2 groups depending on the implementation of PE: group I consisted of 50 women with PE on the background of MS, group II 32 women with MS without PE. We formed group III consisting of 44 pregnant women with PE without accompanying diseases to assess the pathogenetic value of metabolic disorders in the development of PE. The IV (control) group consisted of 30 healthy women with physiological pregnancy. Metabolic, hematological parameters, hormones, markers of the proinflammatory state, endothelial hemostasiological dysfunction, decidualization and placental angiogenesis, accumulation dynamics and distribution loci of adipose tissue were determined in all pregnant women.Results: In the groups of pregnant women with PE, changes similar to MS were revealed: pronounced diabetic and atherogenic disorders with the development of pathological insulin resistance, hyperinsulinemia and leptinemia, endothelial-platelet link hyperactivation, thrombotic and inflammatory status, visceral type of fat deposition, hyperuricemia, hypersympathicotonia. It is proved that in the hierarchy of mechanisms of PE formation, placental dysfunction is a secondary alteration factor, which additionally potentiates the insulin resistance increase and the effects of structural and functional destabilization of the vascular endothelium.Conclusions: The direction of metabolic changes during pregnancy, the common development of PE and MS indicate the important role of dismetabolic mechanisms in the formation of PE.


2013 ◽  
Vol 5 (2) ◽  
pp. 101 ◽  
Author(s):  
Ritawaty Ritawaty ◽  
Indriyanti Rafi Sukmawati ◽  
Ilhamjaya Patellongi ◽  
Ferry Sandra

BACKGROUND: Gamma glutamyltransferase (GGT) was reported recently to be associated with inflammation, oxidative stress and increased amino acid. However, role of GGT in insulin resistance pathomechanism is not exactly known. Therefore correlation of GGT with inflammation, oxidative stress and elevated amino acid, in men with central obesity need to be confirmed.METHODS: A cross-sectional study was designed. Men with central obesity were recruited and selected. Anthropometric parameters, creatinine, hs-CRP, fasting glucose, fasting insulin, glutathione peroxidase (GPx) activity, GGT, plasma total cysteine (tCys) and fatty liver were measured. Subjects were then divided in 4 groups based on waist circumference (WC) and fatty liver: Group I: WC ≤100 cm, without fatty liver; Group II: WC ≤100 cm, with fatty liver; Group III: WC >100 cm, without fatty liver; Group IV: WC >100 cm, with fatty liver. All biochemical characteristics in each group were then statistically analyzed.RESULTS: Seventy-two men with central obesity were selected. Numbers of subjects in each group were: Group I: n=33; Group II: n=5; Group III: n=17; Group IV: n=17. We found significant difference of HOMA-IR between Group I and IV, significant correlation between GGT and HOMAIR, and significant negative correlation between tCys with HOMA-IR in Group IV.CONCLUSION: GGT was significantly correlated with HOMA-IR in men with WC >100 cm and fatty liver. Further investigation with more subjects is necessary to determine clear GGT cut-off to distinguish subjects with fatty liver and insulin resistance.KEYWORDS: GGT, hs-CRP, GPx, tCys, HOMA-IR, insulin resistance


1995 ◽  
Vol 268 (4) ◽  
pp. H1510-H1520 ◽  
Author(s):  
C. van Hardeveld ◽  
V. J. Schouten ◽  
A. Muller ◽  
E. T. van der Meulen ◽  
G. Elzinga

The beneficial effect of low pH during cardiac ischemia on reperfusion injury has often been attributed to its energy-saving effect due to inhibition of contraction. The role of low pH on Ca2+ accumulation and muscle tension was assessed in energy-depleted tissue by changing the pH of the medium from 7.4 to 6.2 at onset of rigor development during metabolic inhibition (MI), i.e., in the energy-depleted phase. Cytosolic free Ca2+ ([Ca2+]i) and intracellular H+ (pHi) were measured in rat trabeculae at 20 degrees C with fura 2 and 2',7'-bis(carboxyethyl)-5(6)-carboxyfluorescein, respectively, and tension was recorded. The preparations were energy depleted by stimulation at 1 Hz in glucose-free Tyrode solution with 2 mM NaCN. Rigor developed within 20 min, indicating energy depletion. Resting [Ca2+]i was followed during 50 min (group I) or 100 min (group II) of rigor, and recovery was followed for 60 min in glucose-containing Tyrode solution at 0.2-Hz stimulation. Resting [Ca2+]i rose within 50 min (group I) but stabilized in the 50- to 100-min period (group II). All preparations from group I (n = 5) resumed contraction in the recovery period but in group II (n = 10) 70% failed to recover, and [Ca2+]i remained elevated compared with those that recovered. An extracellular pH of 6.2, resulting in similar pHi, from onset of rigor development (group III) led to only a modest rise in [Ca2+]i during the 100-min rigor period, and all preparations resumed contraction after approximately 3 min in normal medium. ATP was very low in all groups at the end of MI but was still significantly lower in group II than in groups I and III. A beneficial energy-sparing effect of low pH during the rigor phase can therefore not be excluded. We conclude that 1) the capacity of trabeculae to recover from MI depends on the time period and magnitude of the [Ca2+]i rise in the energy-depleted phase and 2) low pH in energy-depleted trabeculae protects against Ca overload, improving recovery after normalization of perfusion conditions.


Author(s):  
Shyamala Nayak ◽  
Arun Kumar Nayanatara ◽  
Anupama Hegde ◽  
Rekha D Kini ◽  
Vandana Blossom ◽  
...  

Natural products are gaining much importance in light of the serious side effects posed by drugs of chemical origin. High intake of foods rich in antioxidants reduces the risk of neurodegenerative disorders. Traditionally, Allium sativum L.(garlic) and Allium cepa. L (onion) has received considerable attention for their therapeutic benefits around the globe. The present study assesses the free radical scavenging role of Allium sativum and Allium cepa in cerebral cortex, striatum, and hippocampus. Adult wistar rats of either sex were grouped as control group (Group I) treated with normal saline and the two experimental group were treated with the aqueous bulbous extracts of dehydrated Allium sativum (Group II) and Allium cepa (Group III) was considered as treated groups. Homogenates of hippocampus, striatum and cerebral cortex were analyzed for biochemical and neuronal analysis. LD50 value of these extracts in rats was found at a dose of 500 mg/kg BW. A Significant decline (P<0.05) in the MDA level was observed in the hippocampus, striatum and cerebral cortex in group II when compared to group III. Total antioxidant level, GSH, SOD level was significantly high (P<0.001) in the treated groups. Neuronal increase was significant in Group II (P < 0.01) when compared to Group III. Allium sativum and Allium cepa was found to have a challenging role in hampering oxidative stress in Hippocampus, striatum and cerebral cortex, the target regions in neurological disorders. However, ample number of studies are required to establish their mechanism of action as a progression to clinical approach.


1980 ◽  
Vol 53 (5) ◽  
pp. 642-651 ◽  
Author(s):  
Richard Leblanc ◽  
Augustin M. O'Gorman

✓ Forty-six neonates with intracranial hemorrhage were classified into three groups on the basis of the major computerized tomography (CT) scan findings: Group I consisted of 24 cases of subarachnoid hemorrhage, Group II 20 cases of intracerebral and/or intraventricular hemorrhage, and Group III two cases of subdural hemorrhage. The initial scans in Group I showed blood in the interhemispheric fissure and the supratentorial recess. Sixty percent had an associated hypodensity in the frontal and/or parietal areas, thought to be an indication of ischemia. Changes in the configuration of the ventricular system were infrequent. Initial scans in Group II showed hematomas as follows: one in the brain stem, five in the basal ganglia, 10 in the temporal lobes, and 11 in the ventricles. In 70% of these cases, changes in the configuration of the ventricular system were seen, including compression of a lateral ventricle by mass effect, ventricular dilatation with blood, and obstructive hydrocephalus. Subarachnoid blood was an associated finding in 55% of cases, and focal and diffuse cerebral edema in 40%. Scans in both Group III patients initially showed a mass effect from a subdural clot. In all, 30 patients had one or more follow-up CT scans, and 13 of these were scanned at regular intervals. None of the Group I patients developed hydrocephalus, but 85% of Group II patients with intraventricular blood extending from an intracerebral hemorrhage had this complication. A seizure disorder occurred in 31% of Group I patients and 20% of Group II patients, where it was seen exclusively in those with an intralobar hematoma. A major motor disturbance occurred in 16% of patients; their CT scans showed evidence of brain destruction involving enlargement of a lateral ventricle, porencephaly, or focal atrophy. Computerized tomography is a useful adjunct to the diagnosis, management, and follow-up study of neonatal intracranial hemorrhage, and correlates well with the clinical findings.


Author(s):  
Arul Daniel J ◽  
Susmita Das ◽  
Neethu Jayan ◽  
Asha Devi S

Objectives: Various clinically available drugs along with the beneficial action also have drastic side effects due to chronic exposure. In liver, these resulting side effects can be over production of reactive oxygen species, which will further lead to oxidative stress and hepatotoxicity. Therefore, as a preventive measure, the protective role of herbal extracts is being evaluated because of its high success rate and low toxic effects. The primary aim of this study was to evaluate the efficiency of the protective role of Asparagus racemosus is evaluated and studied against methotrexate (MTX)-induced hepatic damage in male Wistar albino rats.Methods: The course of the study was for 14 days. During this experimental study, the animals were categorized into four groups with six rats per group. Group I (positive control) which was treated with normal saline, Group II (negative control) with MTX 20 mg/kg of body weight on 12th day, Group III with A. racemosus 300 mg/kg of body weight + MTX 20 mg/kg on 12th day, and Group IV with A. racemosus 100 mg/kg of body weight + MTX 20 mg/kg on 12th day. On 14th day, the animals were sacrificed, and histopathological as well as antioxidant assays were performed.Results and Conclusion: Assays revealed high lipid peroxidation level and low antioxidant levels in Group II. Meanwhile, in Group III and IV, the levels were restored near to control, which supported the protective role of A. racemosus against MTX-induced hepatic damage. Histopathology evaluation also supported the above-mentioned findings.


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