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Insulin resistance and autonomic function in traumatic lower limb amputees
E Peles1, S Akselrod, D S Goldstein
1Department of Clinical Epidemiology, Sheba Medical Centre, Tel Hashomer, Israel.
Summary
Male lower limb amputees exhibit insulin resistance due to heightened sympathoneural activity and impaired adrenomedullary response during glucose challenges, impacting glucose metabolism.
Area of Science:
- Endocrinology
- Autonomic Neuroscience
- Metabolic Physiology
Background:
- Insulin resistance is a significant metabolic disorder.
- Autonomic nervous system (ANS) activity influences glucose homeostasis.
- Lower limb amputation may affect metabolic and autonomic function.
Purpose of the Study:
- To investigate plasma insulin response to oral glucose load.
- To assess autonomic nervous system activity in male lower limb amputees.
- To compare these parameters with matched controls.
Main Methods:
- Oral glucose tolerance test (OGTT) was administered.
- Heart rate variability (HRV) was analyzed for low- and high-frequency power.
- Plasma levels of norepinephrine (NE) and epinephrine (EPI) were measured.
Main Results:
- Amputees showed higher fasting and post-OGTT insulin levels, indicating insulin resistance.
- No baseline differences in HRV or catecholamines were observed.
- Amputees exhibited increased low-frequency HRV power and plasma NE during OGTT.
- Plasma EPI levels were higher in amputees post-glucose challenge.
Conclusions:
- Lower limb amputees demonstrate insulin resistance.
- Amputees display enhanced sympathoneural responsiveness during glucose challenge.
- Attenuated suppression of adrenomedullary secretion contributes to insulin resistance in amputees.