AJP - Endocrinology and Metabolism, Vol 268, Issue 6 E1167-E1173, Copyright © 1995 by American Physiological Society

ARTICLES

Glutathione reverses systemic hemodynamic changes induced by acute hyperglycemia in healthy subjects

R. Marfella, G. Verrazzo, R. Acampora, C. La Marca, R. Giunta, C. Lucarelli, G. Paolisso, A. Ceriello and D. Giugliano
Department of Geriatrics and Metabolic Diseases, Second University of Naples, Italy.

The present study aimed at evaluating whether acute elevations of plasma glucose concentrations could influence systemic hemodynamic parameters and baroreflex activity in humans. Plasma glucose concentrations were acutely raised to 15 mmol/l in 12 healthy male volunteers. During hyperglycemia, there were significant increments of systolic [from 118 +/- 9 to 138 +/- 12 (SD) mmHg, P < 0.01] and diastolic (from 71 +/- 5 to 85 +/- 6 mmHg, P < 0.001) blood pressure, as well as heart rate (from 76 +/- 7 to 85 +/- 10 beats/min, P < 0.01) and plasma catecholamine levels. Both maximal and steady-state mean arterial pressure after squatting were higher during hyperglycemia (27 +/- 8 and 16 +/- 6 mmHg, respectively) compared with levels obtained during euglycemia (18 +/- 5 and 2 +/- 0.6 mmHg, respectively, P < 0.001). The infusion of the somatostatin analogue octreotide (25 micrograms as i.v. bolus followed by a 0.5 microgram/min infusion), to avoid the possible confounding vascular actions of insulin, did not influence the hemodynamic effects of hyperglycemia except for a lesser increase of both heart rate and plasma catecholamines. Glutathione (600 mg as an iv bolus followed by a 5 mg/min infusion) completely prevented the vascular effects of hyperglycemia. This study shows that acute hyperglycemia, similar to that observed in poorly controlled diabetic patients, produces relevant systemic hemodynamic changes and also alters baroreflex activity via a glutathione-sensitive presumably free radical-mediated pathway.

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