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Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia—Implications for Obesity and Insulin Resistance

  • Obesity (KM Gadde and P Singh, Section Editors)
  • Published:
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Abstract

Purpose of Review

Herein, we summarize recent advances which provide new insights into the role of the autonomic nervous system in the control of blood flow and blood pressure during hyperinsulinemia. We also highlight remaining gaps in knowledge as it pertains to the translation of findings to relevant human chronic conditions such as obesity, insulin resistance, and type 2 diabetes.

Recent Findings

Our findings in insulin-sensitive adults show that increases in muscle sympathetic nerve activity with hyperinsulinemia do not result in greater sympathetically mediated vasoconstriction in the peripheral circulation. Both an attenuation of α-adrenergic-receptor vasoconstriction and augmented β-adrenergic vasodilation in the setting of high insulin likely explain these findings. In the absence of an increase in sympathetically mediated restraint of peripheral vasodilation during hyperinsulinemia, blood pressure is supported by increases in cardiac output in insulin-sensitive individuals.

Summary

We highlight a dynamic interplay between central and peripheral mechanisms during hyperinsulinemia to increase sympathetic nervous system activity and maintain blood pressure in insulin-sensitive adults. Whether these results translate to the insulin-resistant condition and implications for long-term cardiovascular regulation warrants further exploration.

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Funding

The work summarized herein was largely supported by the National Heart, Lung, and Blood Institute grants R00 HL130339 (J.K.L.), R01 HL153523 (J.K.L.), and R01 HL137769 (J.P.), as well as AHA15SDG25080095 (JKL).

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Authors and Affiliations

  1. Department of Nutrition and Exercise Physiology, University of Missouri, 204 Gwynn Hall, Columbia, MO, 65211, USA

    Jacqueline K. Limberg & Jaume Padilla

  2. Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, USA

    Jacqueline K. Limberg, Rogerio N. Soares & Jaume Padilla

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  1. Jacqueline K. Limberg
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  2. Rogerio N. Soares
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  3. Jaume Padilla
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Correspondence to Jacqueline K. Limberg.

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Limberg, J.K., Soares, R.N. & Padilla, J. Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia—Implications for Obesity and Insulin Resistance. Curr Diab Rep 22, 169–175 (2022). https://doi.org/10.1007/s11892-022-01456-1

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