Evidence mapPaperPMID 2189893Full record

ArticleThe Journal of clinical investigation1990

Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. A novel mechanism for insulin resistance.

M Laakso, S V Edelman, G Brechtel, A D Baron

4 registry-linked trialsOpen access · bronzeAbstract read
In one paragraph

Article in The Journal of clinical investigation, 1990. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 209 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
209citing papers in PubMed, 2 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02633488 nacompletedstarted 2014, after this paper: background citation

Effect of Metformin on Insulin Sensitivity and Pan-Arterial Vascular Function in Adults With Metabolic Syndrome

Ran2014Enrolled19Registered outcomes1Posted comparisons1ConditionsInsulin Sensitivity, Metabolic SyndromeArmsMetformin, Placebos
Open the trial in the graph
NCT04133922 early_phase1withdrawnstarted 2019, after this paper: background citation

Effect of GLP-1 on Microvascular Insulin Responses in Type 1 Diabetes

Ran2019Enrolled0Registered outcomes5Posted comparisons0ConditionsInsulin Sensitivity/Resistance, Type 1 DiabetesArmsDextrose 20 % in Water, GLP-1, Insulin
Open the trial in the graph
NCT02490124 completednot on this mapstarted 2014, after this paper: background citation

The Effect of Type 1 Diabetes on Pan-Arterial Vascular Function and Insulin Sensitivity in Humans

TypeobservationalSponsorUniversity of VirginiaRan2014 to 2015Enrolled7ConditionsDiabetes Type 1
NCT03174288 nacompletednot on this mapstarted 2015, after this paper: background citation

The Impact of Fitness and Mineralocorticoid Receptor Blockade on Vascular Dysfunction in Adults With Type 1 Diabetes

TypeinterventionalSponsorUniversity of VirginiaRan2015 to 2019Enrolled32ConditionsType 1 DiabetesArmsExercise, Spironolactone
3 · Its place in the literature

Who cites it

209 citing papers in PubMed, 2 syntheses or guidelines pooled it, 931 citations in OpenAlex.

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  13. Hyperinsulinemia fails to augment ET-1 action in the skeletal muscle vascular bed in vivo in humans.American journal of physiology. Endocrinology and metabolism · 2008
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  18. A carbohydrate meal attenuates the forearm vasoconstrictor response to lower body subatmospheric pressure in healthy young adults.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 1997
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149 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

M LaaksoDepartment of Medicine, Veterans Administration Medical Center, San Diego, California 92161.
S V Edelman
G Brechtel
A D Baron
University Medical Center · USIndiana University – Purdue University Indianapolis · USUniversity of California, San Diego · US

Funding

ZOVIRAX CREAM TO TREAT HERPES LABIALIS IN ADOLESCENTSM01RR000827 · UNIVERSITY OF CALIFORNIA SAN DIEGO · 1985 to 2005
$47.5M
INSULIN RESISTANCE IN NON-INSULIN-DEPENDENT DIABETESF05TW003969 · UNIVERSITY OF CALIFORNIA SAN DIEGO · 1987 to 1988
FIC NIH HHS TW 03969-01NCRR NIH HHS MO1 RR-00827
6 · The paper itself

Abstract

Obesity is characterized by decreased rates of skeletal muscle insulin-mediated glucose uptake (IMGU). Since IMGU equals the product of the arteriovenous glucose difference (AVGd) across muscle and blood flow into muscle, reduced blood flow and/or tissue activity (AVGd) can lead to decreased IMGU. To examine this issue, we studied six lean (weight 68 +/- 3 kg, mean +/- SEM) and six obese (94 +/- 3 kg) men. The insulin dose-response curves for whole body and leg IMGU were constructed using the euglycemic clamp and leg balance techniques over a large range of serum insulin concentrations. In lean and obese subjects, whole body IMGU, AVGd, blood flow, and leg IMGU increased in a dose dependent fashion and maximal rates of all parameters were reduced in obese subjects compared to lean subjects. The dose-response curves for whole body IMGU, leg IMGU, and AVGd were right-shifted in obese subjects with an ED50 two- to threefold higher than that of lean subjects for each parameter. Leg blood flow increased approximately twofold from basal 2.7 +/- 0.2 to 4.4 +/- 0.2 dl/min in lean, P less than 0.01, and from 2.5 +/- 0.3 to 4.4 +/- 0.4 dl/min in obese subjects, P less than 0.01. The ED50 for insulin's effect to increase leg blood flow was about fourfold higher for obese (957 pmol/liter) than lean subjects (266 pmol/liter), P less than 0.01. Therefore, decreased insulin sensitivity in human obesity is not only due to lower glucose extraction in insulin-sensitive tissues but also to lower blood flow to these tissues. Thus, in vivo insulin resistance can be due to a defect in insulin action at the tissue level and/or a defect in insulin's hemodynamic action to increase blood flow to insulin sensitive tissues.

Indexed as

Insulin ResistanceAdultBiological TransportFatty Acids, NonesterifiedGlucoseHumansInsulinLactatesLegMusclesObesityRegional Blood FlowRegression AnalysisFatty Acids, NonesterifiedGlucoseInsulinLactates

Identifiers

PMID2189893
PMCPMC296649
OpenAlexW2164471793

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.