Microcirculation and Insulin Resistance

Microvascular Dysfunction in Insulin Resistance

Author(s): Jefferson C. Frisbee and Robert W. Brock

Pp: 31-40 (10)

DOI: 10.2174/978160805057410901010031

* (Excluding Mailing and Handling)

Abstract

The increasing incidence and prevalence of insulin resistance and its associated co-morbidities represents a growing concern to public health policy across developed economies world wide. While the economic and psycho-social implications of insulin resistance and the ultimate development of type II diabetes mellitus are profound, much of this is associated with the increased probability of afflicted individuals for the development of peripheral vascular disease; with the hallmark characteristics of impaired matching of skeletal muscle perfusion with elevated metabolic demand. Two models of insulin resistance are highlighted in this chapter: the fructose-fed rodent model (which develops insulin resistance in the absence of obesity) and the obese Zucker rat (which develops insulin resistance subsequent to a chronic hyperphagia). While this chapter provides an overview of some of the skeletal muscle perfusion impairments associated with insulin resistance and its satellite co-morbidities, it also provides a discussion of key contributing elements to this relative ischemic condition. Specifically, this chapter will discuss the contributions of altered vascular reactivity from the perspective of both dilator and constrictor responses, the impact of insulin resistance on potassium channel function, structural alterations to microvascular networks (microvascular rarefaction), and the impact of insulin resistance on patterns of capillary recruitment. What rapidly becomes apparent is that the profound impact of pathological states such as insulin resistance on skeletal muscle perfusion represents a spatially and temporally distributed outcome with many contributors resulting in an integrated negative outcome.


Keywords: Vascular reactivity, vasculopathy, impaired glycemic control, skeletal muscle perfusion.

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      • 11. app/Models/ContentAccess.php:647
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51638174 and j.to_ip >=51638174 )) and ((j.from_date <= 1740516577 and j.to_date >= 1740516577 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1905) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51638174 and j.to_ip >=51638174 )) and ((j.from_date <= 1740516577 and j.to_date >= 1740516577 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1905) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51638174 and j.to_ip >=51638174 )) and ((j.from_date <= 1740516577 and j.to_date >= 1740516577 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1905)
      520μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 924 and `b`.`banner_from_date` <= 1740516577 and `b`.`banner_to_date` >= 1740516577 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.02msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 924
      • 3: 1740516577
      • 4: 1740516577
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='7c6c82f0e6ed4cf1649c53c71ab00a72'
      200μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    4Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        n1sWyg4g0evjngivizXVmR3GyZtZjG0zgfuQ6u48
        uc_cart_id
        7c6c82f0e6ed4cf1649c53c71ab00a72
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1905" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/1905
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6ImFzUW5KWXJDdFgrU0grb2EwY212ZEE9PSIsInZhbHVlIjoiZ2ZwN1pLSFgzOHE1QkRWV2xvNno3K1U5akpBOHlaTm5oN0NmY2Q1UlNtMD0iLCJtYWMiOiIyZGVjZmRhOGU0YTNiZDZkZWEyZjI1ZjY1YjhlNjlhZjRiYWM1ZWQ2NjBiY2U0NGQzYWQ4YWNiYjYzYmY0MDBiIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6ImFzUW5KWXJDdFgrU0grb2EwY212ZEE9PSIsInZhbHVlIjoiZ2ZwN1pLSFgzOHE1QkRWV2xvNno3K1U5akpBOHlaTm5oN0NmY2Q1UlNtMD0iLCJtYWMiOiIyZGVjZmRhOGU0YTNi" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Tue, 25 Feb 2025 20:49:37 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkJnZGs1NkFrcmNNbEx3dFF3MTNqZnc9PSIsInZhbHVlIjoiZy8veElBVWZLR3V2Rm02UGduUkxFdWtKL2hYejZYYTFLZTFxS1FuaUIxNjRXNUNtSzViaE11dU5HV1o1OFZMWE1hWFEzSWNEQnc3L2RtOHV5Y3p0b09FT0J2Z1hraGRVOVBLY3R1T1YyVEFEdmpBZlVTeHBXNndrMDBCdUZsVCsiLCJtYWMiOiI4MzM1MzViYzYyNWVjOWI2Y2MyYTU3YWE5OTYxNmNkMWE0MGM5NTIyZmFiOTVjYjJhZDFlMTZiNmE5NDkxMTkyIiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 08:49:37 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkJnZGs1NkFrcmNNbEx3dFF3MTNqZnc9PSIsInZhbHVlIjoiZy8veElBVWZLR3V2Rm02UGduUkxFdWtKL2hYejZYYTFLZTFxS1FuaUIxNjRXNUNtSzViaE11dU5HV1o1OFZMWE1hWFEzS" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjJ1V2FQQ1hCUjBlNFJ5bTBJZnZ2TXc9PSIsInZhbHVlIjoiWmJacGRIVmRnOGJUemQxOXVsWnVVTnNoRVpSaFoyZjRtaExlbjlIcW5qWVhYZ09sZ0IwMTZDblJkbExHdkhST0N5NVpXTVh3dlVrcnNxL2FERzA0ZGpORjl3MVpjdkVtelh1VnJ3STFMUlRqWldBa1R6RlMzUTg2SS81TVFoU2siLCJtYWMiOiJiZjM3MzRkNjE0OGMxMmM3NzdiMWYyNzU1OGVkNDMxYmRmYTdjODg2ODM5MDJmOWQ2MzU1NGM4YmIyZWZkM2VlIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IjJ1V2FQQ1hCUjBlNFJ5bTBJZnZ2TXc9PSIsInZhbHVlIjoiWmJacGRIVmRnOGJUemQxOXVsWnVVTnNoRVpSaFoyZjRtaExlbjlIcW5qWVhYZ09sZ0IwMTZDblJ" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkJnZGs1NkFrcmNNbEx3dFF3MTNqZnc9PSIsInZhbHVlIjoiZy8veElBVWZLR3V2Rm02UGduUkxFdWtKL2hYejZYYTFLZTFxS1FuaUIxNjRXNUNtSzViaE11dU5HV1o1OFZMWE1hWFEzSWNEQnc3L2RtOHV5Y3p0b09FT0J2Z1hraGRVOVBLY3R1T1YyVEFEdmpBZlVTeHBXNndrMDBCdUZsVCsiLCJtYWMiOiI4MzM1MzViYzYyNWVjOWI2Y2MyYTU3YWE5OTYxNmNkMWE0MGM5NTIyZmFiOTVjYjJhZDFlMTZiNmE5NDkxMTkyIiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 08:49:37 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkJnZGs1NkFrcmNNbEx3dFF3MTNqZnc9PSIsInZhbHVlIjoiZy8veElBVWZLR3V2Rm02UGduUkxFdWtKL2hYejZYYTFLZTFxS1FuaUIxNjRXNUNtSzViaE11dU5HV1o1OFZMWE1hWFEzS" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjJ1V2FQQ1hCUjBlNFJ5bTBJZnZ2TXc9PSIsInZhbHVlIjoiWmJacGRIVmRnOGJUemQxOXVsWnVVTnNoRVpSaFoyZjRtaExlbjlIcW5qWVhYZ09sZ0IwMTZDblJkbExHdkhST0N5NVpXTVh3dlVrcnNxL2FERzA0ZGpORjl3MVpjdkVtelh1VnJ3STFMUlRqWldBa1R6RlMzUTg2SS81TVFoU2siLCJtYWMiOiJiZjM3MzRkNjE0OGMxMmM3NzdiMWYyNzU1OGVkNDMxYmRmYTdjODg2ODM5MDJmOWQ2MzU1NGM4YmIyZWZkM2VlIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IjJ1V2FQQ1hCUjBlNFJ5bTBJZnZ2TXc9PSIsInZhbHVlIjoiWmJacGRIVmRnOGJUemQxOXVsWnVVTnNoRVpSaFoyZjRtaExlbjlIcW5qWVhYZ09sZ0IwMTZDblJ" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "n1sWyg4g0evjngivizXVmR3GyZtZjG0zgfuQ6u48" "uc_cart_id" => "7c6c82f0e6ed4cf1649c53c71ab00a72" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1905" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-25 20:49:37GET/chapter/1905112196