Regulation of glucose uptake in heart muscle from normal and alloxan-diabetic rats: the effects of insulin, growth hormone, cortisone, and anoxia

Metabolic and morphological changes of the heart in Chinese hamsters (CHAD strain) with spontaneous long-term diabetes

We studied the effect of spontaneous long-term (9-10 months) diabetes on the heart of Chinese hamsters (CHAD strain) to elucidate the relationship between diabetes mellitus and cardiomyopathy. The diabetic hamsters, aged approximately 11 months, showed body weight loss, hyperglycemia (mean fasting plasma glucose 402 mg/dl), hypoinsulinemia, hyperlipidemia and ketonemia. The diabetic hamsters showed reduced activities of cytoplasmic glycolytic key enzymes; hexokinase, pyruvate kinase and phosphofructokinase, increases in cardiac glycogen and glucose-6-phosphate contents and a 40% decrease in cardiac ATP content, indicating decreased energy production. An accumulation of myocardial triglyceride and cholesterol was found in the diabetic hamsters. In addition, the cardiac norepinephrine content was increased in the diabetic hamsters, suggesting the presence of autonomic nervous disorder. Increased heart weight and thickening of the septum and both ventricular walls were found in the diabetic hamsters. Light-microscopic analysis revealed that 42.9% of the diabetic hamsters had myocardial degeneration without any vascular lesion of extramural large and intramural small vessels, whereas the non-diabetic controls had no myocardial or vascular lesions. These data suggest that the diabetic Chinese hamsters had cardiomyopathy, which is possibly caused by extravascular factors such as metabolic or autonomic nervous disorder although conclusive evidence is lacking.

Autophosphorylation and kinase activity of insulin receptor in diabetic rats

Insulin resistance is observed in insulin-deficient diabetic states in spite of an increase in insulin binding to its target cells. To characterize this type of insulin resistance, autophosphorylation and kinase activity of the insulin receptor on liver was studied with streptozotocin (STZ)-induced and BB diabetic rats. Insulin binding capacity was increased in proportion to the severity of the diabetic state in the STZ rat. In the diabetic BB rat, the insulin binding capacity was also increased, and this was partially normalized by insulin treatment. By contrast, insulin-stimulated autophosphorylation of the beta-subunit of the insulin receptor was decreased in proportion to the severity of the diabetic state in the STZ rat. Peptide mapping by reverse-phase high-performance liquid chromatography revealed a decrease in labeling at all sites of autophosphorylation. Kinase activity of the insulin receptor to exogenous substrates was also decreased in proportion to the diabetic state. In the BB rat, autophosphorylation and kinase activity of the insulin receptor were both decreased in the diabetic state and partially normalized by insulin treatment. In addition to the beta-subunit of insulin receptor, a 170 kdalton phosphotyrosine-containing protein was also identified in the glycoprotein fraction of liver. Although the phosphorylation of this protein was not insulin dependent, it was decreased markedly in the diabetic state. This protein is immunologically distinct from the insulin receptor, but is rich in phosphotyrosine. Based on its size and phosphotyrosine content, this protein may be the epidermal growth factor receptor.(ABSTRACT TRUNCATED AT 250 WORDS)

Anoxemia as the cause of death in shock

The case is presented that both hemorrhagic and septic shock are due to an inadequate oxygen supply to mitochondria of vascular muscle cells in peripheral circulatory beds. Mitochondria disintegrate in the presence of severe hypoxia; this is a normal response which does not, per se, indicate generalized cell damage. Irreversible shock follows when appreciable numbers of the muscle mitochondria become non-functional. The ATP available from glycolysis is inadequate to resynthesize the mitochondrial apparatus and oxygen cannot be used by the damaged mitochondria to produce the needed ATP through oxidative phosphorylation. In the absence of adequate ATP, the tone of these peripheral vessels must fall, leading to irreversible systemic hypotension and death. In hemorrhagic shock, mitochondrial hypoxia of smooth muscle cells is produced by decreased perfusion of the vasa vasorum in the constricted peripheral vessels; in septic shock there is direct competition for oxygen between bacterial cytochromes and muscle mitochondria.

Ability of circulating insulin to chronically regulate the cellular glucose transport system

We have tested the idea that the circulating plasma insulin level plays an important role in the long-term regulation, or maintenance, of the cellular glucose transport system, distinct from insulin's ability to acutely accelerate glucose transport. To study this hypothesis, groups of rats were made either hyperinsulinemic or hypoinsulinemic by daily insulin injections or Streptozotocin treatment, respectively. Different levels of hypoinsulinemia were produced by using different doses of Streptozotocin (40 and 55 mg/kg). Isolated adipocytes were prepared from each animal and glucose transport was assessed by measuring the initial rates of uptake of the nonmetabolyzable hexose 2-deoxy glucose. In cells from control animals, the Vmax of in vitro adipocyte glucose transport was 7.1 +/- 0.7 nmole/min/10(6) cells in the basal state and 22.9 +/- 0.9 nmole/min/10(6) cells in the presence of a maximally effective insulin concentration (25 ng/ml) in the buffer. In cells from the experimentally hyperinsulinemic animals, these Vmax values were increased to 11.7 +/- 0.8 and 44.2 +/- 1.1 nmole/min/10(6) cells. Using adipocytes from both groups of Streptozotocin treated (high dose, 55 mg/kg, low dose, 40 mg/kg) insulin deficient diabetic animals, Vmax values were found to be progressively decreased. Thus, in the low dose group, basal and insulin stimulated Vmax values were 1.6 +/- 0.5 and 5.7 +/- 0.7 nmole/min/10(6) cells, as compared to values of 0.9 +/- 0.2 and 1.7 +/- 0.6 in the high dose group. Furthermore, when hyperinsulinemia was induced by feeding rats high carbohydrate diets for 10 days, adipocyte glucose transport Vmax increased 50%. In contrast, when hypoinsulinemia was achieved by fasting rats for 72 hr, transport Vmax decreased by 50%. The apparent Km for 2-deoxy glucose uptake was the same under all conditions. In conclusion, assuming that the Vmax of transport is some function of the number of glucose transport carriers per cell, then these results support the hypothesis that in addition to acute acceleration of glucose transport, insulin is also an important long-term regulator of the number of available adipocyte glucose transport carriers.

Long-term regulation of adipocyte glucose transport capacity by circulating insulin in rats

We have tested the idea that the circulating plasma insulin level plays an important role in the long-term regulation, or maintenance, of the cellular glucose transport system, distinct from insulin's ability to acutely accelerate glucose transport. To study this hypothesis, groups of rats were made either hyperinsulinemic or hypoinsulinemic by daily insulin injections, or streptozotocin treatment, respectively. Different levels of hypoinsulinemia were produced by using different doses of streptozotocin (40 and 55 mg/kg). The mean (+/-SE) 9 a.m. plasma insulin level for each experimental group was: hyperinsulinemic animals, 65+/-5 muU/ml; controls, 32+/-3 muU/ml; low dose streptozotocin group, 18+/-3 muU/ml; and high dose streptozotocin group 5+/-2 muU/ml. Isolated adipocytes were prepared from each animal and glucose transport was assessed by measuring the initial rates of uptake of the nonmetabolyzable hexose 2-deoxy glucose. The V(max) and K(m) values for adipocyte glucose transport were calculated from the 2-deoxy glucose uptake data. The results demonstrated that in cells from control animals the V(max) of in vitro adipocyte glucose transport was 7.1+/-0.7 nmol/min per 10(6) cells in the basal state and 22.9+/-0.9 nmol/min per 10(6) cells in the presence of a maximally effective insulin concentration (25 ng/ml) in the buffer. In cells from the experimentally hyperinsulinemic animals these V(max) values were increased to 11.7+/-0.8 and 44.2+/-1.1 nmol/min per 10(6) cells. Using adipocytes from both groups of streptozotocin-treated (high dose, 55 mg/kg; low dose, 40 mg/kg) insulin-deficient diabetic animals, V(max) values were found to be progressively decreased. Thus, in the low dose group, basal-and insulin-stimulated V(max) values were 1.6+/-0.5 and 5.7+/-0.7 nmol/min per 10(6) cells, as compared to values of 0.9+/-0.2 and 1.7+/-0.6 in the high dose group. Thus, when considered as group data a positive relationship was found between circulating plasma insulin levels and adipocyte glucose transport V(max), with increased V(max) values in hyperinsulinemic rats and decreased V(max) values in hypoinsulinemic rats. Furthermore, when the individual data were analyzed, highly significant correlation coefficients were found between the height of the plasma insulin level and both the basal (r = 0.82, P < 0.001) and insulin-stimulated (r = 0.93, P < 0.001) V(max) values. The apparent K(m) for 2-deoxy glucose uptake was the same under all conditions. In conclusion, assuming that the V(max) of transport is some function of the number of glucose transport carriers per cell, then these results support the hypothesis that in addition to acute acceleration of glucose transport, insulin is also an important long-term regulator of the number of available adipocyte glucose transport carriers.

Effects of burn injury on insulin secretion and on sensitivity to insulin in the rat in vivo

Both insulin resistance and impairment of insulin secretion are know to occur in man after injury. The relative importance of these effects was studied in rats 2 h after a non-lethal 20 percent dorsal scald. No impairment of insulin secretion was found after this injury. Concentrations of both blood glucose and plasma insulin were elevated in scalded rats. Scalded rats responded to intravenous glucose injection (1-0 g/kg) with a further rise in plasma insulin concentration, which remained normal for the prevailing blood glucose concentration. However, marked impairment of glucose tolerance was observed, indicating the presence of insulin resistance. After intravenous insulin injection (1-0 U/kg) the initial rate coefficient for fall of blood glucose concentration was significantly lower (p less than 0-02) in scalded (mean 3-9 percent min.(-1) than in control rats (mean 6-3 percent min.(-1). The minimum in blood glucose concentration after insulin injection was reached at 10 min. in control rats, but not until 60 min. after injection in scalded rats. This difference was due to a delay in compensation for the hypoglycaemia in the scalded rats, since the rate of disappearance of insulin measured by injection of a tracer of 125I-labelled bovine insulin was not decreased after this injury. It was concluded that the impairment of glucose utilization in scalded rats (Heath and Corney, 1973) is due to decreased sensitivity to insulin rather than to suppression of insulin release.

Comparison of the effects of anoxia and whole heart ischemia on carbohydrate utilization in isolated working rat hearts

The rates of utilization of glycogen and exogenous glucose by hearts perfused at low coronary flows and high perfusate oxygen tension (ischemia) and by hearts perfused at high coronary flows and low perfusate oxygen tension (anoxia) were studied in the isolated, working rat heart. Ischemic tissue had a glycolytic rate that was 25% of the anoxic rate and 50% of the control rate. Inhibition of carbohydrate utilization during ischemia was due to a lower flux through the glycolytic pathway and not to a lower rate of glucose transport or substrate availability. Insulin and elevated perfusate glucose increased glucose transport and caused accumulation of free intracellular glucose, but ischemia still inhibited glucose utilization. Insulin failed to maintain tissue levels of high-energy phosphates or to prevent mechanical failure in ischemic hearts. In the absence of insulin, tissue lactate increased tenfold during 20 minutes of ischemia, although it increased only threefold in anoxic tissue. The increased tissue lactate in ischemic hearts corresponded to the inhibition of glycolysis and to the failure of mechanical performance. Insulin caused a further increase in tissue lactate during ischemia. These findings illustrate several important differences between anoxia and ischemia and suggest that insulin may be more harmful than it is beneficial in severely ischemic tissue.

Metabolic response during impending myocardial infarction. I. Relevance of studies of glucose and fatty acid metabolism in animals

Both glucose and free fatty acids (FFA) are major fuels for the normally oxygenated heart with the dominant contribution being derived from glucose in the resting, fed state and FFA in the resting, fasted state. In anoxia, all energy must be produced anaerobically from glycogen or glucose. Anoxia by itself accelerates glycolysis, but further increases may follow an increased circulating glucose concentration and the addition of insulin. Even maximal rates of anaerobic glycolysis, achieved at high coronary flow rates, can only sustain the energy needs of the K + -arrested heart but not of the working heart. FFA cannot be utilized for energy in anoxia and may accumulate intracellularly as triglyceride or FFA. From these and other animal data have grown the concepts that glucose is "good" for the survival of the ischemic heart, and that FFA is "bad." However, glucose-fatty acid interaction has not been well studied in the infarcting, ischemic myocardium. While a "toxic" effect of FFA has been shown in many experimental models, there are other reports of increased FFA concentrations having no harmful effect or even a beneficial effect on the infarcting myocardium. The possible benefits of administration of glucose (with insulin) to patients with acute myocardial infarction could only be assessed by a controlled therapeutic trial.

Effects of polypeptide and protein hormones on lipid monolayers. I. Effect of insulin and parathyroid hormone on monomolecular films of monooctadecyl phosphate and stearic acid

Insulin in low concentrations inhibits the uptake of Ca(++) by the monooctadecyl (stearyl) phosphate monolayer (at air-water interface) and facilitates the release of Ca(++) adsorbed to the monolayer. These effects of insulin are more pronounced at higher insulin concentrations. Evidence is presented that a relatively intact insulin molecule competes with Ca(++) for the free phosphate group of the monolayer. Albumin has a slight inhibitory action on calcium uptake and parathyroid hormone has no observable action on calcium uptake or release.