Int J Sports Med 2005; 26(7): 558-562
DOI: 10.1055/s-2004-830333
Physiology & Biochemistry

© Georg Thieme Verlag KG Stuttgart · New York

Effect of Chronic Aerobic Exercise on Cutaneous Microcirculatory Flow Response to Insulin Iontophoresis and to Ischemia in Elderly Males

M. Rossi1 , G. Santoro1 , R. Ricco1 , F. Pentimone1 , A. Carpi2
  • 1Department of Internal Medicine, University of Pisa, Italy
  • 2Department of Reproduction and Ageing, University of Pisa, Italy
Further Information

Publication History

Accepted after revision: July 30, 2004

Publication Date:
26 November 2004 (online)

Abstract

The aim of this study was to assess whether chronic aerobic exercise can favourably influence the vascular activity of insulin in elderly subjects. We measured in arbitrary units (A. U.) the cutaneous blood flow basally and in response to iontophoresis of insulin, by the means of a Laser Doppler flowmeter, on the right arm of 10 elderly athletes (10 males, aged 65 ± 6 years) and of 10 sex- and age-matched sedentary subjects. The cutaneous blood flow response to ischemia was also explored in the right leg of the same subjects by means of the same instrument. No significant differences in cutaneous arm and leg blood flow were observed basally between athletes and sedentary subjects (7.25 ± 2.65 A. U. versus 6.35 ± 4.04 A. U. and 9.74 ± 5.11 A. U. versus 9.41 ± 6.40 A. U., respectively). Cathodal iontophoresis (six poulses of 0.1 mA each for 20 s, with 40-s interval between stimulations) of regular insulin (0.1 ml Humulin R 100 IU/ml diluted 1/10 with 0.9 % saline) induced a significant increase of cutaneous blood flow in both groups (p < 0.01 in athletes, p < 0.01 in sedentary subjects). However the maximal cutaneous blood flow response to insulin was higher in athletes than in sedentary subjects (24.69 ± 13.34 A. U. versus 14.33 ± 7.73 A. U., respectively, p < 0.05) as well as the curve of the net blood flux response to insulin iontophoresis (% change from baseline in response to insulin minus % change from baseline in response to saline iontophoresis) (p < 0.001 ANOVA for repeated measures). After ischemia there was a significant increase of leg cutaneous blood flow in both groups (p < 0.001 in athletes and in sedentary subjects) with higher blood flow response in athletes than in sedentary subjects (38.18 ± 17.08 A. U. versus 26.01 ± 6.39 A. U., respectively, p < 0.05). The time reached from the release of ischemia to peak-flow was significantly longer in sedentary subjects than in athletes (43.5 ± 28.5 s versus 20.0 ± 9.3 s, p < 0.05, respectively). These results suggest that chronic aerobic exercise increases insulin vasodilatory activity and improves endothelial function in elderly subjects.

References

  • 1 Baron A D, Tarshoby M, Hook G, Lazaridis E N, Cronin J, Johonson A, Steinberg H O. Interaction between insulin sensitivity and muscle perfusion on glucose uptake in human skeletal muscle: evidence of capillary recruitment.  Diabetes. 2002;  49 768-774
  • 2 Binggeli C, Spieker L E, Corti R, Sudano I, Stojanovic V, Hayoz D, Luscher T F, Noll G. Statins enhance postischemic hyperemia in the skin circulation of hypercholesterolemic patients. E monitoring test of endothelial dysfunction for clinical practise.  JACC. 2003;  42 71-77
  • 3 Buchfuhrer M J, Hansen J E, Robinson T E. et al . Optimizing the exercise protocol for cardiopulmonary assessment.  J Appl Physiol. 1983;  55 1550-1564
  • 4 Chen Y L, Messina E J. Dilation of isolated skeletal muscle arterioles by insulin is endothelium dependent and nitric oxide mediated.  Am J Physiol. 1996;  270 2120-2124
  • 5 Cleland S, Petrie J R, Ueda S, Elliott H L, Connell J M. Insulin-mediated vasodilation and glucose uptake are functionally linked in humans.  Hypertension. 1999;  33 554-558
  • 6 Clevenger C M, Parker Jones P, Tanaka H, Seals D R, DeSouza C A. Decline in insulin action with age in endurance-trained humans.  J Appl Physiol. 2002;  93 2105-2111
  • 7 Cupisti A, Rossi M, Fabbri A, Placidi A, Morelli E, Vagheggini G, Meola M, Barsotti G. Responses of skin microcirculation to acetylcholine in patients with essential hypertension and in normotensive patients with chronic renal failure.  Nephron. 2000;  85 114-119
  • 8 Fujimoto T, Kemppainem J, Kalliokoski K K, Nuutila P, Ito M, Knuuti J. Skeletal muscle glucose uptake response to exercise in trained and untrained men.  Med Sci Sport Exerc. 2003;  35 777-783
  • 9 Harris M I, Eastman R C, Cowie C C, Flegal K M, Eberhardt M S. Comparison of diabetes diagnostic categories in the U. S. population according to the 1997 American Diabetes Association and 1980 - 1985 World Health Organisation diagnostic criteria.  Diabetes Care. 1997;  20 1859-1863
  • 10 Hughes V A, Fiatarone M A, Fielding R A, Kahn B B, Ferrara C M, Shepherd P, Fisher E C, Wolfe R R, Elahi D, Evans W. Exercise increases muscle GLUT-4 levels and insulin action in subjects with impaired glucose tolerance.  Am J Physiol. 1993;  264 855-862
  • 11 Kvernmo K, Slagsvold C E, Gjolberg T. Laser Doppler flux reappearance time (FRT) in patients with lower limb atherosclerosis and healthy controls.  Eur J Vasc Surg. 1998;  2 171-176
  • 12 Mather K, Anderson T J, Verma S. Insulin action in the vasculature: Physiology and pathophysiology.  J Vasc Res. 2001;  38 415-422
  • 13 Morris S J, Shore A C, Tooke J E. Responses of the skin microcirculation to acetylcholine and sodium nitroprusside in patients with NIDDM.  Diabetologia. 1995;  38 1337-1344
  • 14 Perry C G, Spiers A, Cleland S J, Lowe G D, Petrie J R, Connell J M. Glucocorticoids and insulin sensitivity: Dissociation of insulin's metabolic and vascular actions.  J Clin Endocrinol Metab. 2003;  88 6008-6014
  • 15 Rossi M, Cupisti A, Mariani S, Santoro G, Pentimone F. Endothelium-dependent and endothelium-independent skin vasoreactivity in the elderly.  Aging Clin Exp Res. 2002;  14 343-346
  • 16 Rossi M, Cupisti A, Ricco R, Santoro G, Pentimone F, Carpi A. Skin vasoreactivity to insulin iontophoresis is reduced in elderly subjects and is absent in treated non insulin dependent diabetes patients.  Biomed Pharmacother. 2004;  10 in press
  • 17 Sage B H. Insulin iontophoresis.  Pharm Biotechnol. 1997;  10 319-341
  • 18 Serné E H, Gans R O, Maaten J C, Wee P M, Donker A J, Stehouver C D. Capillary recruitment is impaired in essential hypertension and relates to insulin's metabolic and vascular actions.  Cardiovasc Res. 2001;  49 181-168
  • 19 Serné E H, Ijezerman R G, Gans R O, Nijveldt R, De Vries G, Evertz R, Donker J M, Stehouwer C D. Direct evidence for insulin-induced capillary recruitment in skin of healthy subjects during physiological hyperinsulinemia.  Diabetes. 2002;  51 1515-1522
  • 20 Steinberg H O, Brechtel G, Johnson A, Fineberg N, Baron A D. Insulin-mediated skeletal muscle vasodilation is nitric oxide dependent. A novel action of insulin to increase nitric oxide release.  J Clin Invest. 1994;  94 1172-1179
  • 21 Sundell J, Laine H, Nuutila P, Ronnemaa T, Luotolahti M, Raitakari O, Knuuti J. The effects of insulin and short-term hyperglycaemia on myocardial blood flow in young men with uncomplicated Type I diabetes.  Diabetologia. 2002;  45 775-782
  • 22 Taddei S, Galetta F, Virdis A, Ghiadoni L, Salvetti G, Franzoni F, Giusti C, Salvetti A. Physical activity prevents age-related impairment in nitric oxide availability in elderly athletes.  Circulation. 2000;  101 2896-2901
  • 23 Vassalle C, Lubrano V, Domenici C, L'Abbate A. Influence of chronic aerobic exercise on microcirculatory flow and nitric oxide in humans.  Int J Sport Med. 2003;  24 30-35
  • 24 Wahlberg E, Olofson P, Takolander R, Swedenborg J. Postocclusive reactive hyperemia estimating peripheral vascular resistance: a non invasive method to predict outcome of infrainguinal vascular reconstructions.  J Cardiovasc Surg. 1996;  37 545-552
  • 25 Yim S, Choi S M, Choi Y, Lee N, Chung J, Park H. Insulin and hypoxia share common target genes but not hypoxia-inducible factor-1 alpha.  J Biol Chem. 2003;  278 38260-38268

Dott. M. Rossi

Dipartimento di Medicina Interna, Università degli Studi di Pisa

Via Roma 67

56100 Pisa

Italy

Phone: + 50993207

Fax: + 50 55 34 14

Email: mrossi@int.med.unipi.it

    >