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Insulin- and glucagon-like peptide-1-induced changes in heart rate and vagosympathetic activity: why they matter

P Valensi1, S Chiheb, M Fysekidis

  • 1Department of Endocrinology-Diabetology-Nutrition, AP-HP, Jean Verdier Hospital, Paris-Nord University, CRNH-IdF, Avenue du 14 juillet, 93143 Bondy Cedex, France. paul.valensi@jvr.aphp.fr

Diabetologia
|April 16, 2013
PubMed

Insights

Insulin sensitivity and body mass index (BMI), not insulin levels, influence heart rate and cardiac vagal control in healthy individuals. Glucagon-like-peptide-1 (GLP-1) affects heart rate and blood pressure but not vagal control.

Area of Science:

  • Cardiovascular Physiology
  • Autonomic Nervous System Function
  • Metabolic Regulation

Background:

  • Heart rate (HR) is a predictor of cardiovascular morbidity and mortality, particularly in individuals with diabetes.
  • Cardiac autonomic neuropathy, characterized by vagal depression and sympathetic predominance, is a significant risk marker in type 2 diabetic patients.
  • Understanding the autonomic nervous system's regulation of cardiovascular parameters is crucial for managing metabolic and cardiovascular diseases.

Purpose of the Study:

  • To investigate the impact of euglycemic and hyperglycemic clamp conditions, with and without glucagon-like-peptide-1 (GLP-1) and arginine, on cardiac vagal control in healthy subjects.
  • To determine the influence of insulin levels, insulin sensitivity, and body mass index (BMI) on heart rate and cardiac vagal control.
  • To assess the acute effects of GLP-1 infusion on heart rate, blood pressure, and cardiac autonomic activity.

Main Methods:

  • Utilized euglycemic and hyperglycemic clamp techniques in a cohort of healthy subjects.
  • Administered glucagon-like-peptide-1 (GLP-1) and arginine during clamp procedures.
  • Measured heart rate (HR), blood pressure (BP), and various indices of cardiac vagal control.

Main Results:

  • After adjusting for age, BMI, and insulin sensitivity, the association between insulin levels and HR was partially maintained, while its link to vagal control was abolished.
  • BMI and insulin sensitivity emerged as primary determinants of cardiac vagal control, independent of insulin levels.
  • GLP-1 infusion during hyperglycemia led to a statistically significant increase in HR and BP, with a non-significant trend towards decreased cardiac vagal control.

Conclusions:

  • Insulin sensitivity and BMI are key modulators of cardiac vagal control in healthy individuals.
  • Acute GLP-1 administration influences hemodynamic parameters (HR, BP) but has a limited, non-significant impact on cardiac vagal control in this context.
  • Further research is required to elucidate the long-term effects of GLP-1 on autonomic activity and hemodynamics in diabetic and obese populations to understand its cardiovascular implications.

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