The aim of this study was to evaluate the effect of insulin on the release of vWf
in vivo during an oral glucose tolerance test (OGTT) performed in normal, glucose-intolerant
and diabetic subjects and in vitro on human endothelial cells. Twenty-eight subjects exhibiting risk factors for diabetes
underwent an OGTT: 11 subjects proved to be normal, 7 were glucose-intolerant and
10 diabetic. In each group, the vWf and PAI-1 plasmatic levels were measured at t
= 0, 30 min and 180 min after the beginning of the test. Human endothelial cells from
non-diabetic and diabetic subjects were incubated in the presence of human insulin
at various concentrations (0.25, 2.5, 25 and 250 mUI/ml). After 1, 4, and 24 hours
of incubation, the release of vWf and endothelin 1 was measured in the cell supernatant
and the intracellular amount of vWf in the cell lysate. During the OGTT, the vWf levels
in plasma were not affected despite a 4.5-, 6-, and 2.5-fold increase in insulin levels
in normal, glucose-intolerant and diabetic subjects, respectively. Although raised
in all three groups, PAI-1 plasmatic levels remained constant during the test. After
24 hours of exposure to insulin (0.25 mU/ml), the release of vWf by endothelial cells
reached 35.94 ± 23.08 % of the basal value for non-diabetic subjects, and 27.57 ±
10.05 % for diabetic patients. Similar results were observed in non-stimulated cells.
Insulin had no influence on intracellular vWf content, which remained comparable to
control values. Regardless of its concentration, insulin failed to stimulate the release
of vWf by endothelial cells of non-diabetic and diabetic subjects, while its ability
to stimulate the release of endothelin 1 was preserved. In conclusion, hyperinsulinemia
had no adverse effect on circulating vWf in normal or diabetic subjects. Neither release
nor intracellular vWf content in non-diabetic or diabetic endothelial cells was influenced
by insulin in vitro.
Key words:
Insulin - Diabetes - von Willebrand Factor - Endothelial Cell
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Dr. Laurence Kessler
Service d’Endocrinologie et de Diabétologie
Hôpital Central
1, place de l’Hôpital
67091 Strasbourg Cedex
France
Phone: 03 (88) 11 60 52
Fax: 03 (88) 11 62 63
Email: laurence.kessler@medecine.u-strasbg.fr