Microcirculation and Insulin Resistance

Is Defective Microcirculation Responsible for Insulin Resistance? PART 1: Microvascular Dysfunction and Insulin Resistance are Linked: Evidences from Clinical Observations

Author(s): Nicolas Wiernsperger

Pp: 119-139 (21)

DOI: 10.2174/978160805057410901010119

* (Excluding Mailing and Handling)

Abstract

This chapter describes the arguments supporting our concept that microcirculatory defects may underlie insulin resistance (IR). Vascular (patho) physiology and metabolism are vast areas subjected to many confounding factors detailed here, which are cardinal to sort the many existing contradictory reports. A thorough analysis of the epidemiological and clinical literature clearly establishes that microvascular dysfunction and IR are linked and observable very early in life, well before metabolic syndrome and cardiometabolic diseases develop. In part 2 the thermodynamic, particularly microvascular effects of insulin itself are detailed and analyzed in terms of their physiological pertinence. Part 3 deals with underlying mechanisms, based on selected clinical situations. These reveal puzzling commonalities: together with cell physiology, they suggest that primary (inherited, early acquired) or secondary defects in sensing exaggerated physical forces of blood flow by the microvascular endothelial surface may be responsible. Glycocalyx and mainly caveolae, which are linked to vasomotor reactions and to insulin signalling and transport, are tentatively designed as the culprit.


Keywords: Endothelial dysfunction, insulin resistance, metabolic syndrome, microcirculation.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 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 <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1740496334 and j.to_date >= 1740496334 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1928) 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 <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1740496334 and j.to_date >= 1740496334 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1928) 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 <= 309791667 and j.to_ip >=309791667 )) and ((j.from_date <= 1740496334 and j.to_date >= 1740496334 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1928)
      650μsalphaeurekaselec_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` <= 1740496334 and `b`.`banner_to_date` >= 1740496334 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.08msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 924
      • 3: 1740496334
      • 4: 1740496334
      • 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='e524730ac4d6f2848b66635ef0654ee0'
      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
        S9tYQcYkQ4HbNY2rvOvnG7lOC7w6q2gCn5yuBoNj
        uc_cart_id
        e524730ac4d6f2848b66635ef0654ee0
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1928" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/1928
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
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        response_headers
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        ClearShow all
        Date ↕MethodURLData
        #12025-02-25 15:12:14GET/chapter/1928112196