digoxin and Glucose-Intolerance

Topics: Aged; Aged, 80 and over; Blood Glucose; Cardiotonic Agents; Diabetes Mellitus, Type 2; Digoxin; Fatal Outcome; Female; Glucose Intolerance; Glyburide; Humans; Hypoglycemic Agents; Male; Metformin

Digoxin-like immunoactivity (DLIA) reflects the presence of endogenous substances which are close to cardiac glycosides. These substances via inhibition of Na(+)-K(+)-ATPase increase intracellular calcium stores (Ca2+i) and may modulate various Ca(2+)-dependent mechanisms. Although DLIA are known primarily as hypertension and natriuresis promoting factors, several recent works have suggested that DLIA relates also to diabetes mellitus. The main stimulus for DLIA secretion represents volume-expansion.. To assess relation of DLIA to glucose tolerance and insulin levels in pregnant women (PW).. 1) 67 PW (DLIA measured by RIA-kit HUMA-LAB Kosice), 2) 53 PW (DLIA measured by RIA-kit ORION). PW were subdivided according to the glucose tolerance and insulin concentrations.. 1. DLIA in hyperinsulinemic PW were significantly higher than in those with normal insulin levels. 2. DLIA significantly correlated with insulin levels as well as with insulinogenic index. 3. The increase in plasma glucose and insulinemia during OGTT was accompanied by a decrease in DLIA. These findings were independent of other measured parameters (age, body mass index, pregnancy induced weight gain, blood pressure and steroid hormones).. These findings suggest that DLIA does not respond only to changes regarding sodium-retention and volume-expansion, but also to changes in glucose and insulin metabolism. Thus, DLIA could represent one of the markers of "specific" neurohumoral activation. However, the question of whether an elevation in DLIA may consequently modulate mechanisms of insulin secretion, insulin sensitivity, vascular reactivity and other Ca2+i-dependent mechanisms remains speculative. (Tab. 4, Fig. 4, Ref. 41).

Topics: Blood Glucose; Cardenolides; Diabetes, Gestational; Digoxin; Enzyme Inhibitors; Female; Glucose Intolerance; Glucose Tolerance Test; Humans; Insulin; Pregnancy; Pregnancy Complications; Radioimmunoassay; Saponins; Sodium-Potassium-Exchanging ATPase

The role of endogenous digitalis-like factors in the pathogenesis of the hypertension associated with impaired glucose tolerance was investigated by measuring plasma digoxin-like immunoreactivity (DLI). Mean blood pressure correlated significantly with the obesity index, serum insulin-like immunoreactivity (IRI), and plasma DLI concentrations in subjects with impaired glucose tolerance (IGT). Plasma DLI concentrations also correlated significantly with the obesity index and serum IRI concentrations. Because increased insulin has been proposed to promote sodium reabsorption, sodium retention in turn has presumably caused an increase of natriuretic, digitalis-like factors reflected by the increased plasma DLI concentrations in patients with IGT. Consequently, increased DLI may contribute to the elevated arterial pressure in patients with hyperinsulinemia.

Topics: Adult; Aged; Blood Pressure; Blood Proteins; Cardenolides; Digoxin; Glucose Intolerance; Glucose Tolerance Test; Humans; Hypertension; Insulin; Middle Aged; Obesity; Regression Analysis; Saponins; Sodium-Potassium-Exchanging ATPase

The changes of serum digoxin-like immunoactivity (DLIA) during 75g oral glucose tolerance test (OGTT), were investigated in 25 pregnant women with various glucose tolerance. 13 women had a normal glucose tolerance (NGT), 12 women had an impaired glucose tolerance (IGT) or gestational diabetes mellitus (GDM). Test was performed after 25 week of pregnancy. The results were compared with 9 nonpregnant healthy volunteers (NHV). After an oral glucose challenge, there was observed a significant decrease in serum DLIA (p < 0.01 in 1st hour), in both groups of the pregnant women. In the group of NHV these findings were not found. Our findings suggest a possible relationships between DLIA and glucose tolerance in pregnant women. However, it needs further investigation. (Tab. 1, Fig. 1, Ref. 24.)

Topics: Adult; Blood Proteins; Cardenolides; Diabetes, Gestational; Digoxin; Female; Glucose Intolerance; Glucose Tolerance Test; Humans; Pregnancy; Pregnancy Complications; Saponins; Sodium-Potassium-Exchanging ATPase