Influence of the sympathetic nervous system on insulin sensitivity and adipose tissue metabolism: A study in spinal cord—injured subjects

• Published in: Metabolism, clinical and experimental clinical and experimental, 1995, Vol.44 (1), p.52-58
• Main Authors: Karlsson, Ann-Katrin, Attvall, Stig, Jansson, Per-Anders, Sullivan, Lars, Lännroth, Peter
• Format: Article
• Language: English
• Subjects: Adipose Tissue - metabolism; Adipose Tissue - pathology; Administration, Oral; Adult; Biological and medical sciences; Female; Glucose Tolerance Test; Glycerol - blood; Glycerol - metabolism; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Insulin - pharmacology; Lactates - blood; Lactates - metabolism; Lactic Acid; Male; Medical sciences; Middle Aged; Spinal Cord Injuries - pathology; Spinal Cord Injuries - physiopathology; Sympathetic Nervous System - physiopathology; Traumas. Diseases due to physical agents
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/0026-0495(95)90289-9

To evaluate insulin sensitivity and adipose tissue metabolism, seven spinal cord—injured (SCI) subjects (age, 43 ± 6 years; body mass index, 22.8 ± 1.4; mean ± SE) and their seven siblings (age, 45 ± 6 years; body mass index, 24.8 ± 0.8) were studied using oral glucose (100-g) tolerance tests (OGTTs), euglycemic insulin clamps (insulin infusion, 1 mU/kg · min), and microdialysis of the subcutaneous tissue. Blood glucose and insulin after oral glucose were significantly increased in SCI subjects as compared with their siblings. During insulin clamping, plasma adrenaline increased significantly in controls, but not in SCI subjects. However, the rates of glucose production (2.02 ± 0.36 v 1.59 ± 0.09 mg/kg · min) and utilization (5.13 ± 0.71 v 5.78 ± 0.34) were similar in the two groups. Furthermore, interstitial subcutaneous glycerol and lactate concentrations before and after oral glucose were similar in the two groups, even in neurally decentralized tissue with broken connection between the central nervous system and peripheral sympathetic nerves. The data suggest that (1) well-mobilized SCI subjects show minor insulin resistance, and (2) sympathetic nervous activity has a minor influence on adipose tissue metabolism in the postabsorptive state, but may affect insulin sensitivity during euglycemic clamping.