Vasomotor dysfunction and alterations of adipokines in metabolic syndrome patients with insulin resistance
Peteris Tretjakovs1,2, Antra Jurka1,2, Inga Bormane1,2, Dace Reihmane1, Indra Mikelsone1, Liga Balode1, Juris Aivars1 & Valdis Pirags1,2
Aim: To evaluate relationships between adipokines (adiponectin, resistin, leptin, interleukin-6, tumor necrosis factor-alpha), insulin resistance and cutaneous vasomotor responses in metabolic syndrome (MS) patients with insulin resistance. MS patients with insulin resistance were divided into two groups: 18 patients with type-2 diabetes mellitus (without insulin therapy and pronounced diabetic complications) (DM) and 18 patients without DM. Of 18 healthy subjects were selected as controls (C). The study groups were matched for age and sex. Insulin resistance was measured by HOMA-IR method (IMx Abbott analyzer) and adipokines were measured by xMAP technology (Luminex-200 analyzer). We recorded changes in laser Doppler flux (LDF; PeriFlux 4001, Perimed) in the foot. The following variables were measured: basal LDF (b-LDF), postocclusive hyperemia (m1-LDF), vasoconstrictor response (v-LDF) to deep inspiration on the pulp of the toe; and heat (+44°C; PeriTemp 4005) induced hyperemia (m2-LDF) on the dorsum of the foot.
Results: Only the patient group with diabetes demonstrated a significant diminution in v-LDF compared to the group of healthy subjects (P<0.05). m1-LDF was decreased in both patient groups in comparison with the group of controls (P<0.05), but only in diabetics the decrease of m2-LDF was significant (P<0.05). Adipokines levels were changed (P<0.05) in diabetic patient group. Our findings show that MS patients with insulin resistance have significant cutaneous vasomotor dysfunction but diabetics (with insulin resistance and MS) have also changed adipokines levels.