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1 Endocrinology and Metabolism Section, Atlanta VA Medical Center, Decatur, Georgia, USA
2 Pulmonary and Critical Care Section, Atlanta VA Medical Center, Decatur, Georgia, USA
* To whom correspondence should be addressed. E-mail: pthule{at}emory.edu.
Hepatic insulin gene therapy (HIGT) ameliorates hyperglycemia in diabetic rodents suggesting that similar approaches may eventually provide a means to improve treatment of diabetes mellitus. However, whether the metabolic and hormonal changes produced by HIGT benefit vascular function remains unclear. The impact of HIGT on endothelium-dependent vasodilation, nitrosyl-hemoglobin content (NO-Hb), and insulin sensitivity were studied using aortic ring preparations, electron-spin resonance spectroscopy (ESR), homeostasis assessment of insulin resistance (HOMA-IR) calculations, and insulin tolerance testing (ITT). Data were correlated with selected hormone and adipocytokine concentrations. Rats made diabetic with streptozotocin were treated with subcutaneous insulin pellets dosed to sustain body weights and hyperglycemia, or with HIGT. Non-diabetic rats served as controls. Hyperglycemic rats demonstrated impaired endothelium-dependent vasodilation, reduced levels of NO-Hb, and diminished insulin, leptin and adiponectin concentrations, compared to controls. In contrast, HIGT-treatment significantly reduced blood sugars and sustained both endothelium-mediated vasodilation and NO-Hb at control levels. HOMA-IR calculations and ITT indicated enhanced insulin sensitivity among HIGT-treated rats. HIGT partially restored suppressed leptin levels in hyperglycemic rats and increased adiponectin concentrations to supra-normal levels, consistent with indicators of insulin sensitivity. Our findings indicate that the metabolic milieu produced by HIGT is sufficient to preserve vascular function in diabetic rodents. These data suggest that improved glycemia, induction of a beneficial adipocytokine profile, and enhanced insulin sensitivity combine to preserve endothelium dependent vascular function in HIGT treated diabetic rats. Consequently, HIGT may represent a novel and efficacious approach to reduce diabetes associated vascular dysfunction.
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