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The effect of antecedent hypoglycaemia on ß2-adrenergic sensitivity in healthy participants with the Arg16Gly polymorphism of the ß2-adrenergic receptor.
Schouwenberg, B J J W; Smits, P; Tack, C J; de Galan, B E.
Afiliação
  • Schouwenberg BJ; Department of Pharmacology-Toxicology 149, Radboud University Nijmegen Medical Centre, Geert Grooteplein 21, PO Box 9101, 6500HB Nijmegen, the Netherlands. b.schouwenberg@pharmtox.umcn.nl
Diabetologia ; 54(5): 1212-8, 2011 May.
Article em En | MEDLINE | ID: mdl-21298412
ABSTRACT
AIMS/

HYPOTHESIS:

Homozygosity for glycine at codon 16 (GlyGly) of the ß(2)-adrenergic receptor may alter receptor sensitivity upon chronic stimulation and has been implicated in the pathogenesis of hypoglycaemia unawareness. We compared the effect of antecedent hypoglycaemia on ß(2)-adrenergic receptor sensitivity between GlyGly participants and those with arginine 16 homozygosity (ArgArg) for the ß(2)-adrenergic receptor.

METHODS:

We enrolled 16 healthy participants, who were either GlyGly (n = 8) or ArgArg (n = 8). They participated randomly in two 2 day experiments. Day 1 consisted of two 2-h hyperinsulinaemic hypoglycaemic (2.8 mmol/l) or euglycaemic (4.8 mmol/l) glucose clamps. On day 2, we measured the forearm vasodilator response to the ß(2)-adrenergic receptor agonist salbutamol and the dose of isoprenaline required to increase the heart rate by 25 bpm (IC(25)).

RESULTS:

The vasodilator response to salbutamol tended to be greater after antecedent hypoglycaemia than after euglycaemia (p = 0.078), consistent with increased ß(2)-adrenergic receptor sensitivity. This effect was driven by a significant increase in ß(2)-adrenergic receptor sensitivity following hypoglycaemia compared with euglycaemia in ArgArg participants (p = 0.019), whereas no such effect was observed in the GlyGly participants. Antecedent hypoglycaemia tended to decrease the IC(25) in ArgArg participants, whereas the reverse occurred in the GlyGly participants (GlyGly vs ArgArg group p = 0.047). CONCLUSION/

INTERPRETATION:

Antecedent hypoglycaemia did not affect ß(2)-adrenergic receptor sensitivity in healthy GlyGly participants, but increased it in ArgArg participants. If these results also hold for participants with type 1 diabetes, such an increase in ß(2)-adrenergic receptor sensitivity may potentially reduce the risk of repeated hypoglycaemia and the subsequent development of hypoglycaemia unawareness in ArgArg diabetic participants. TRIAL REGISTRATION ClinicalTrials.gov NCT00160056.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimorfismo Genético / Receptores Adrenérgicos beta 2 / Hipoglicemia Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Diabetologia Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Polimorfismo Genético / Receptores Adrenérgicos beta 2 / Hipoglicemia Tipo de estudo: Clinical_trials / Diagnostic_studies Limite: Adult / Female / Humans / Male Idioma: En Revista: Diabetologia Ano de publicação: 2011 Tipo de documento: Article País de afiliação: Holanda