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The characteristics of the dose response of insulin on the glucose turnover rate and erythrocyte insulin binding parameters were determined in five normal men before and during experimentally induced hyperthyroidism [L-T4 (2 micrograms kg-1 day-1) for 4 weeks with additional L-T3 (1 microgram kg-1 day-1) for the following 3 weeks]. Hyperthyroidism was characterized by significant rises in T3 from 1.92 +/- 0.17 (+/- SEM) to 3.66 +/- 0.17 nmol/liter (P less than 0.01) and resting metabolic rate from 39 +/- 0.7 to 48 +/- 1 watt/m2 (P less than 0.001). While the subjects received a diet adapted to the metabolic rate, blood glucose rose from 3.8 +/- 0.07 to 4.46 +/- 0.11 mmol/liter (P less than 0.05) without a significant change in plasma insulin. During the insulin dose-response study, glucose infusion rates were unaltered by hyperthyroidism, and neither the maximum effect nor the sensitivity to insulin was altered. Glucose turnover rate, measured using [6,6-2H2]glucose as tracer, was determined in the basal state and during the 0.4 mU kg-1 min-1 insulin infusion. In the basal state, it was significantly increased by hyperthyroidism (control, 2.3 +/- 0.1; hyperthyroidism, 3.7 +/- 0.1 mg kg-1 min-1). During the insulin infusion, hepatic glucose production was totally suppressed before T4 and T3 treatment, but was 0.96 +/- 0.39 mg kg-1 min-1 during T4 and T3 treatment. A marked decrease in the insulin binding affinity to erythrocytes was found without a change in the insulin receptor number. In conclusion, glucose metabolism in experimental hyperthyroidism is characterized by 1) increases in basal glucose production and utilization; 2) antagonism between the effect of insulin and hyperthyroidism at the hepatic level; and 3) lack of peripheral insulin resistance in spite of marked alteration in erythrocyte insulin binding affinity.
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PMID:Glucose metabolism in experimental hyperthyroidism: intact in vivo sensitivity to insulin with abnormal binding and increased glucose turnover. 637 13

Adipocytes from old rats (greater than 450 g) were separated into 2 populations with mean cell volumes of 201 +/- 14 and 813 +/- 41 pl (mean +/- SEM, 20 observations) by filtering through nylon mesh (64 microns diameter) and compared with adipocytes from young rats (less than 150 g) with a mean adipocyte volume of 154 +/- 20 pl (14 observations). Large adipocytes had more insulin receptors per cell but less per unit of surface area. They internalized greater amounts of insulin than small cells in the presence or absence of bacitracin and chloroquine, although the proportion of bound hormone which was internalized was similar in all 3 groups. Down-regulation of the insulin receptor was evident in large and small adipocytes after incubation in the presence of 10(-7)M insulin. Large cells degraded insulin (extracellularly and intracellularly) at significantly greater rates than small cells whether expressed per cell or per unit of surface area. Small cells from old rats had essentially identical properties to small cells from young rats in all parameters examined. The results suggest that the decreased surface density of insulin receptors observed in large adipocytes from old rats is due to size rather than age and that the decreased insulin sensitivity of large adipocytes is not due to an inability to internalize insulin or down-regulate its receptors but may be due to increased rates of insulin degradation.
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PMID:Effects of cell volume on insulin binding, internalization and degradation in rat adipocytes. 638 Nov 72

We have investigated changes in insulin binding to erythrocytes in response to the oral administration of 500 mg of L-Dopa in ten healthy subjects. L-Dopa administration increases insulin binding from 5.18 +/- 0.14% (mean +/- SEM) to 6.18 +/- 0.34% (P less than 0.05) with concomitant increase in basal plasma growth hormone from 1.3 +/- 0.1 ng/ml to 14.4 +/- 4.8 ng/ml (P less than 0.05). The increase in insulin binding is due to increase in affinity of insulin receptor without changes in the number of insulin receptors. The plasma insulin and glucose did not show significant changes after L-Dopa administration. Direct incubation of L-Dopa with erythrocytes did not affect insulin binding to the cells. These results suggest that growth hormone may directly or indirectly induce acute alteration in affinity of insulin receptors on erythrocytes.
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PMID:Effect of L-dopa administration on insulin binding: possible role of growth hormone in regulation of insulin receptor affinity. 674 30

Hepatic glucose production and metabolic clearance rate of glucose were measured using (3-3H) glucose at steady state, basally and during two sequential 2 h insulin (25 and 40 mU . kg -1 . h -1)/glucose (2 and 3 mg. kg -1 . min -1) infusion periods. Eight diabetic subjects were studied before and after 1 week of twice daily insulin therapy; six control subjects matched for age, weight and degree of obesity were also studied. In the diabetic patients, pre-treatment hepatic glucose production was 20.0 +/- 2.2, 9.9 +/- 2.9, and 1.4 +/- 0.8 mu mol . kg -1 . min -1 respectively (+/- SEM) for each of the three periods, and fell significantly with treatment to 12.8 +/- 1.7, 4.0 +/- 1.5 and 1.9 +/- 1.0 mu mol . kg -1 . min -1. Hepatic glucose production in normal subjects was 13.2 +/- 0.6, 2.2 +/- 0.8 and less than 1 mu mol . kg -1 . min -1. The pre-treatment metabolic clearance rate in all diabetic studies with insulin levels greater than or equal to 30 mU/l was 1.10 +/- 0.14 ml . kg -1 . min -1 and remained virtually unchanged following insulin therapy; this was significantly lower than in the control subjects (6.83 +/- 1.02, p less than 0.001). Basal non-esterified fatty acid levels were higher (p less than 0.02) in the pre-treated diabetic patients compared to post-treated diabetic patients and control subjects. Non-esterified fatty acids in each group fell to similar levels during the insulin infusions, but the rate of fall was slower in the pre-treated diabetic patients. Insulin receptor binding to erythrocytes was normal in the diabetic subjects and unchanged by treatment. Therefore, following insulin treatment of uncontrolled Type 2 (non-insulin-dependent) diabetes, the initially increased basal hepatic glucose production, and decreased hepatic sensitivity, return towards normal. However, the glucose clearance remains low, despite good diabetic control, and appears to be a major factor in the continuing glucose intolerance. As insulin receptor binding is normal, the defect of glucose clearance in Type 2 diabetes appears compatible with a post-receptor defect of glucose metabolism.
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PMID:Differential effects of insulin therapy on hepatic and peripheral insulin sensitivity in Type 2 (non-insulin-dependent) diabetes. 675 16

Insulin insensitivity of uncertain etiology often exists in myotonic muscular dystrophy, a multitissue, autosomal dominant disorder hypothesized to be a hereditary membrane disease. The present studies show that monocytes from patients with myotonic dystrophy fail to demonstrate the normally observed qualitative increase in insulin-binding affinity after oral glucose loading. Monocytes from 10 normal volunteers developed a significantly increased insulin-binding affinity by 2 hr after glucose ingestion (mean +/- SEM, 11.7 +/- 2.7 ng/ml compared to basal 50% insulin displacement value of 23.3 +/- 2.2 ng/ml, P less than 0.005). This increase was maintained at 5 hr (13.5 +/- 2.7 ng/ml, P less than 0.05). In contrast, no significant increase in monocyte insulin-binding affinity occurred in cells from nine myotonic dystrophy patients at 2 and 5 hr after glucose loading (50% insulin displacement values: basal, 14.2 +/- 2.8 ng/ml; 2 hr, 16.7 +/- 1.7 ng/ml; 5 hr, 10.8 +/- 2.1 ng/ml). These alterations document the presence of abnormalities in the insulin receptor or receptor-associated processes that modulate insulin binding. A hereditary plasma membrane defect may underlie these findings. This abnormality may have an etiologic role in the decreased insulin sensitivity that frequently afflicts patients with myotonic dystrophy.
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PMID:Abnormal regulation of monocyte insulin-binding affinity after glucose ingestion in patients with myotonic dystrophy. 701 35

The insulin receptor in isolated rat liver plasma membranes was covalently labeled with the photoreactive insulin analogue NB-29-[(4-azido-2-nitrophenyl)acetyl]insulin and solubilized with the nondenaturing detergent Triton X-100. The resulting protein-detergent complex was characterized by gel filtration on Sepharose 6B, sedimentation rate determination in linear sucrose gradients, and equilibrium isopycnic centrifugation in NaBr and CsCl. The labeled insulin receptor was found in two forms. The Strokes radii and s20,w's of the two receptor-detergent complexes (R1 and R2) were (mean +/- SEM) 7.08 +/- 0.04 and 3.62 +/- 0.05 nm and 10.45 +/- 0.04 and 6.54 +/- 0.15 S, respectively. The two forms appeared to have the same buoyant density, 1.285 +/- 0.002 g cm-3. The dissociation of R2 from R1, or its reaggregation, either with itself or with other unlabeled proteins, to give R1 proceeded without chemical modification. Mild reduction of disulfide bonds (1 mM 1,4-dithiothreitol) increased the dissociation of R2 from R1. These results indicate that the solubilized receptor binds significant amounts of detergents, that the insulin binding component of the receptor binds to other receptor components by hydrophobic interactions, and that one or more components of the insulin receptor contain intrachain disulfide bonds.
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PMID:Hydrodynamic characterization of the photoaffinity-labeled insulin receptor solubilized in Triton X-100. 702 91

We have investigated the effects on carbohydrate metabolism of human GH produced by recombinant DNA technology (methionyl-hGH) compared with pituitary hGH. Twelve normal adult male subjects received four daily im injections of either methionyl-hGH or pituitary hGH in a double blind, crossover study. Oral glucose tolerance tests and assays of insulin binding to peripheral monocytes were performed before th initial administration and 12 h after the fourth injection of both hGH preparations. Both methionyl-hGH and pituitary hGH resulted in significant carbohydrate intolerance, with a rise in fasting plasma glucose from 96.6 +/- 2.9 to 105.9 +/- 3.0 mg/ml (mean +/- SEM) after pituitary hGH and from 96.2 +/- 1.5 to 107.5 +/- 3.3 mg/dl after methionyl-hGH (P less than 0.01). The area under the glucose tolerance curve increased by 34% after pituitary hGH and by 37% after methionyl-hGH. With both hGH preparations, carbohydrate intolerance was associated with marked hyperinsulinemia, with a rise in fasting plasma insulin levels from 9.4 +/- 1.2 to 33.2 +/- 7.8 microU/ml after pituitary hGH and from 7.4 +/- 1.1 to 45.8 +/- 11.1 microU/ml after methionyl-hGH (P less than 0.01). The integrated plasma insulin levels during the oral glucose tolerance test tripled after both hGH preparations. The pronounced insulin resistance could not be attributed to an alteration in insulin receptor concentrations. Both hGH preparations were associated with small reductions in insulin binding to monocytes at tracer concentrations, but the decline in binding was not statistically significant. The calculated binding sites per cell and Ke were not significantly altered by hGH administration. We conclude that methionyl-hGH and pituitary hGH are indistinguishable in their ability to induce insulin-resistant carbohydrate intolerance. This decrease in insulin sensitivity cannot be attributed to an alteration in insulin binding, and presumably represents a postreceptor defect in insulin action.
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PMID:Both human pituitary growth hormone and recombinant DNA-derived human growth hormone cause insulin resistance at a postreceptor site. 703 19

Insulin binding has been reported to be decreased in non-insulin-dependent diabetes mellitus (NIDDM). Although elevated basal insulin concentrations have been correlated with decreased insulin binding in obesity, this relationship has not been found in NIDDM. To determine the potential cause(s) of the decrease, we measured 125I-insulin binding to circulating monocytes isolated from 31 non-insulin-treated patients with NIDDM who had a fasting plasma glucose (FPG) concentration greater than 7.8 mmol/L and 13 control subjects. We examined the influence of obesity, insulin concentration, glycemic control, and treatment with oral hypoglycemic agents on insulin binding in a cross-sectional study. Insulin binding was significantly decreased in the entire NIDDM group (mean +/- SEM, %/10(7) monocytes: 4.65 +/- 0.33) as compared with controls (6.45 +/- .70, P < .02). Subgroups defined by obesity (relative body weight > 1.2) and poor glycemic control (FPG > 11.1 mmol/L) and those not taking oral hypoglycemic agents had significantly lower insulin binding (P < .02). However, neither relative body weight nor insulin concentrations (basal or stimulated) correlated with insulin binding. Stepwise linear regression analysis showed that only FPG significantly correlated with insulin binding (r = -.45, P = .002) even when oral hypoglycemic agent-treated patients were removed from the analysis (r = -.50, P = .003). There was no significant contribution to explain insulin binding by the other variables, including diagnosis of diabetes, obesity, insulin concentration, or treatment with oral hypoglycemic agents. We conclude that poor metabolic control is associated with an alteration in insulin receptor regulation in NIDDM.
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PMID:Insulin binding in non-insulin-dependent diabetes mellitus (NIDDM) is correlated with glycemic control: clinical evidence for abnormal receptor regulation in NIDDM. 772 74

1. Recent molecular genetic studies have implicated the low-density-lipoprotein receptor gene locus (LDLR, at chromosome 19p13.2) in obesity in essential hypertensive patients and in the atherogenic lipoprotein phenotype. The present study examined genotypes for the obesity-associated ApaLI restriction fragment length polymorphism of LDLR, and genotypes for a hypertension-associated RsaI restriction fragment length polymorphism at the insulin receptor gene (INSR) locus, which is linked to LDLR, in relation to plasma lipids, body mass index and blood pressure in 27 obese and 57 non-obese Caucasians with severe essential hypertension, selected on the basis of having parents who were both hypertensive, and in 25 obese and 45 non-obese normotensive subjects selected on the basis of having parents who were both normotensive after the age of 50 years. 2. Plasma triacylglycerol and low-density-lipoprotein-cholesterol were elevated in hypertensive patients, but did not differ between the obese and non-obese hypertensive groups. Significant positive correlations were seen between body mass index and triacylglycerol and low-density-lipoprotein-cholesterol in the obese and non-obese hypertensive patients, respectively. In addition, obese hypertensive patients had significantly higher diastolic blood pressure than non-obese hypertensive patients. 3. The eight obese hypertensive patients who were homozygous for the obesity-associated 6.6 kb allele of the ApaLI restriction fragment length polymorphism of LDLR ('6.6. kb homozygotes') had a significantly higher body mass index [34 +/- 6.0 (SD) kg/m2] than the 18 heterozygotes (29 +/- 2.7 kg/m2) and the single subject who was homozygous for the 9.4 kb allele (29 kg/m2) (P = 0.012 by one-way analysis of variance). The body mass index of the eight hypertensive 6.6 kb homozygotes was also greater than the body mass index of 29 +/- 2.4 kg/m2 observed for the eight obese normotensive 6.6 kb homozygotes. In addition, the eight obese hypertensive 6.6 kb homozygotes had a higher plasma triacylglycerol [4.2 +/- 0.77 (SEM) mmol/l] than the 18 obese hypertensive heterozygotes (2.4 +/- 0.33 mmol/l; P = 0.045). Non-obese hypertensive patients showed no significant genotypic differences in relation to the LDLR restriction fragment length polymorphism. 4. In the normotensive group, however, the frequency of the 6.6 kb allele of the LDLR ApaLI restriction fragment length polymorphism in obese subjects (0.54) was not significantly greater than in non-obese subjects (0.48) [cf. the significantly (P = 0.004( different values of 0.63 and 0.39, respectively, in obese and non-obese hypertensive patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Significant relationships of plasma lipids and body mass index with polymorphisms at the linked low-density-lipoprotein receptor gene and insulin receptor gene loci (19p13.2) in essential hypertensive patients. 803 1

Adipose tissue was used to characterize the metabolic abnormality of insulin resistance in polycystic ovary syndrome (PCOS). Nine patients with PCOS were studied during a period of amenorrhea and confirmed to be chronically anovulatory by vaginal ultrasound and plasma progesterone measurements. These were compared with six age- and body mass index (BMI)-matched controls (BMI, 27.2 +/- 2.2 in PCOS and 24.7 +/- 2.3 in control subjects). Insulin receptor binding was measured and insulin action was assessed by measuring initial rates of 3-O-methylglucose uptake and by inhibition of lipolysis. The maximum specific insulin receptor binding was 0.62% +/- 0.12% and 1.78% +/- 0.18% per 10-cm2 cell surface (mean +/- SEM) in PCOS and control subjects, respectively (P < .001). Maximum rates of glucose transport were also impaired as compared with controls, with 3-O-methylglucose transport being 0.90 +/- 0.15 versus 1.57 +/- 0.28 pmol/10 cm2/5 s, respectively (P < .05). The concentration of insulin required for half-maximal stimulation of glucose uptake was 165 +/- 36 versus 32 +/- 10 pmol in PCOS and control subjects, respectively (P < .05). The maximum percentage lipolysis inhibition (mean +/- SEM) was 9.5% +/- 1.6% in PCOS and 28.3% +/- 7.2% in control patients, respectively (P < .01). These data demonstrate that there are both insulin binding and postreceptor defects in adipocytes from amenorrheic PCOS subjects. The degree of defect in adipocyte insulin action is greater than would have been anticipated from in vivo data.
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PMID:Severe impairment of insulin action in adipocytes from amenorrheic subjects with polycystic ovary syndrome. 799 Jul 8


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