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1 Department of Clinical Pharmacology, 2 Institute of Medical Physics, and 3 Division of Endocrinology and Metabolism, Department of Internal Medicine III, University of Vienna, A-1090 Vienna, Austria
Elevated plasma free fatty acids (FFA) induce skeletal
muscle insulin resistance and impair endothelial function. The aim of
this study was to characterize the acute hemodynamic effects of FFA in
the eye and skin. A triglyceride (Intralipid 20%, 1.5 ml/min)/heparin
(bolus: 200 IU; constant infusion rate: 0.2 IU · kg
1 · min
1) emulsion
or placebo was administered to 10 healthy subjects. Measurements of
pulsatile choroidal blood flow with laser interferometry, retinal blood
flow with the blue field entoptic technique, peak systolic and end
diastolic blood velocity (PSV, EDV) in the ophthalmic artery with
Doppler sonography, and subcutaneous blood flow with laser Doppler
flowmetry were performed during an euglycemic somatostatin-insulin clamp over 405 min. Plasma FFA/triglyceride elevation induced a rise in
pulsatile choroidal blood flow by 25 ± 3% (P < 0.001) and in retinal blood flow by 60 ± 23% (P = 0.0125). PSV increased by 27 ± 8% (P = 0.001),
whereas EDV was not affected. Skin blood flow increased by 149 ± 38% (P = 0.001). Mean blood pressure and pulse rate
remained unchanged, whereas pulse pressure amplitude increased by
17 ± 5% (P = 0.019). Infusion of heparin alone
had no hemodynamic effect in the eye or skin. In conclusion,
FFA/triglyceride elevation increases subcutaneous and ocular blood flow
with a more pronounced effect in the retina than in the choroid, which may play a role for early changes of ocular perfusion in the insulin resistance syndrome.
hyperlipidemia; blood flow; blood pressure; retina; choroidea
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