Skip to main content
Erschienen in: Diabetologia 7/2015

01.07.2015 | Article

Dysregulation of muscle glycogen synthase in recovery from exercise in type 2 diabetes

verfasst von: Andreas J. T. Pedersen, Janne R. Hingst, Martin Friedrichsen, Jonas M. Kristensen, Kurt Højlund, Jørgen F. P. Wojtaszewski

Erschienen in: Diabetologia | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

Aims/hypothesis

Insulin and exercise stimulate skeletal muscle glycogen synthase (GS) activity by dephosphorylation and changes in kinetic properties. The aim of this study was to investigate the effects of insulin, exercise and post-exercise insulin stimulation on GS phosphorylation, activity and substrate affinity in obesity and type 2 diabetes.

Methods

Obese men with type 2 diabetes (n = 13) and weight-matched controls (n = 14) underwent euglycaemic–hyperinsulinaemic clamps in the rested state and 3 h after 60 min of cycling (70% maximal pulmonary oxygen uptake [\( \overset{.}{V}{\mathrm{O}}_{2 \max } \)]). Biopsies from vastus lateralis muscle were obtained before and after clamps, and before and immediately after exercise.

Results

Insulin-stimulated glucose uptake was lower in diabetic patients vs obese controls with or without prior exercise. Post exercise, glucose partitioning shifted away from oxidation and towards storage in both groups. Insulin and, more potently, exercise increased GS activity (fractional velocity [FV]) and substrate affinity in both groups. Both stimuli caused dephosphorylation of GS at sites 3a + 3b, with exercise additionally decreasing phosphorylation at sites 2 + 2a. In both groups, changes in GS activity, substrate affinity and dephosphorylation at sites 3a + 3b by exercise were sustained 3 h post exercise and further enhanced by insulin. Post exercise, reduced GS activity and substrate affinity as well as increased phosphorylation at sites 2 + 2a were found in diabetic patients vs obese controls.

Conclusions/interpretation

Exercise-induced activation of muscle GS in obesity and type 2 diabetes involves dephosphorylation of GS at sites 3a + 3b and 2 + 2a and enhanced substrate affinity, which is likely to facilitate glucose partitioning towards storage. Lower GS activity and increased phosphorylation at sites 2 + 2a in type 2 diabetes in the recovery period imply an impaired response to exercise.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat DeFronzo RA, Tripathy D (2009) Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes Care 32(Suppl 2):157–163CrossRef DeFronzo RA, Tripathy D (2009) Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes Care 32(Suppl 2):157–163CrossRef
2.
Zurück zum Zitat Højlund K (2014) Metabolism and insulin signaling in common metabolic disorders and inherited insulin resistance. Dan Med J 61:B4890PubMed Højlund K (2014) Metabolism and insulin signaling in common metabolic disorders and inherited insulin resistance. Dan Med J 61:B4890PubMed
3.
Zurück zum Zitat Shulman GI, Rothman DL, Jue T, Stein P, DeFronzo RA, Shulman RG (1990) Quantitation of muscle glycogen synthesis in normal subjects and subjects with non-insulin-dependent diabetes by 13C nuclear magnetic resonance spectroscopy. N Engl J Med 322:223–228PubMedCrossRef Shulman GI, Rothman DL, Jue T, Stein P, DeFronzo RA, Shulman RG (1990) Quantitation of muscle glycogen synthesis in normal subjects and subjects with non-insulin-dependent diabetes by 13C nuclear magnetic resonance spectroscopy. N Engl J Med 322:223–228PubMedCrossRef
4.
Zurück zum Zitat Højlund K, Staehr P, Hansen BF et al (2003) Increased phosphorylation of skeletal muscle glycogen synthase at NH2-terminal sites during physiological hyperinsulinemia in type 2 diabetes. Diabetes 52:1393–1402PubMedCrossRef Højlund K, Staehr P, Hansen BF et al (2003) Increased phosphorylation of skeletal muscle glycogen synthase at NH2-terminal sites during physiological hyperinsulinemia in type 2 diabetes. Diabetes 52:1393–1402PubMedCrossRef
5.
Zurück zum Zitat Vind BF, Pehmoller C, Treebak JT et al (2011) Impaired insulin-induced site-specific phosphorylation of TBC1 domain family, member 4 (TBC1D4) in skeletal muscle of type 2 diabetes patients is restored by endurance exercise-training. Diabetologia 54:157–167PubMedCrossRef Vind BF, Pehmoller C, Treebak JT et al (2011) Impaired insulin-induced site-specific phosphorylation of TBC1 domain family, member 4 (TBC1D4) in skeletal muscle of type 2 diabetes patients is restored by endurance exercise-training. Diabetologia 54:157–167PubMedCrossRef
6.
Zurück zum Zitat Højlund K, Birk JB, Klein DK et al (2009) Dysregulation of glycogen synthase COOH- and NH2-terminal phosphorylation by insulin in obesity and type 2 diabetes mellitus. J Clin Endocrinol Metab 94:4547–4556PubMedCrossRef Højlund K, Birk JB, Klein DK et al (2009) Dysregulation of glycogen synthase COOH- and NH2-terminal phosphorylation by insulin in obesity and type 2 diabetes mellitus. J Clin Endocrinol Metab 94:4547–4556PubMedCrossRef
7.
Zurück zum Zitat Cusi K, Maezono K, Osman A et al (2000) Insulin resistance differentially affects the PI 3-kinase- and MAP kinase-mediated signaling in human muscle. J Clin Invest 105:311–320PubMedCentralPubMedCrossRef Cusi K, Maezono K, Osman A et al (2000) Insulin resistance differentially affects the PI 3-kinase- and MAP kinase-mediated signaling in human muscle. J Clin Invest 105:311–320PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325:147–152PubMedCrossRef Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr (1991) Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 325:147–152PubMedCrossRef
10.
Zurück zum Zitat Martin IK, Katz A, Wahren J (1995) Splanchnic and muscle metabolism during exercise in NIDDM patients. Am J Physiol 269:583–590 Martin IK, Katz A, Wahren J (1995) Splanchnic and muscle metabolism during exercise in NIDDM patients. Am J Physiol 269:583–590
11.
Zurück zum Zitat Mikines KJ, Sonne B, Farrell PA, Tronier B, Galbo H (1988) Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol 254:248–259 Mikines KJ, Sonne B, Farrell PA, Tronier B, Galbo H (1988) Effect of physical exercise on sensitivity and responsiveness to insulin in humans. Am J Physiol 254:248–259
12.
Zurück zum Zitat Bogardus C, Thuillez P, Ravussin E, Vasquez B, Narimiga M, Azhar S (1983) Effect of muscle glycogen depletion on in vivo insulin action in man. J Clin Invest 72:1605–1610PubMedCentralPubMedCrossRef Bogardus C, Thuillez P, Ravussin E, Vasquez B, Narimiga M, Azhar S (1983) Effect of muscle glycogen depletion on in vivo insulin action in man. J Clin Invest 72:1605–1610PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Devlin JT, Hirshman M, Horton ED, Horton ES (1987) Enhanced peripheral and splanchnic insulin sensitivity in NIDDM men after single bout of exercise. Diabetes 36:434–439PubMedCrossRef Devlin JT, Hirshman M, Horton ED, Horton ES (1987) Enhanced peripheral and splanchnic insulin sensitivity in NIDDM men after single bout of exercise. Diabetes 36:434–439PubMedCrossRef
14.
Zurück zum Zitat Wojtaszewski JF, Hansen BF, Kiens B, Richter EA (1997) Insulin signaling in human skeletal muscle: time course and effect of exercise. Diabetes 46:1775–1781PubMedCrossRef Wojtaszewski JF, Hansen BF, Kiens B, Richter EA (1997) Insulin signaling in human skeletal muscle: time course and effect of exercise. Diabetes 46:1775–1781PubMedCrossRef
15.
Zurück zum Zitat Prats C, Helge JW, Nordby P et al (2009) Dual regulation of muscle glycogen synthase during exercise by activation and compartmentalization. J Biol Chem 284:15692–15700PubMedCentralPubMedCrossRef Prats C, Helge JW, Nordby P et al (2009) Dual regulation of muscle glycogen synthase during exercise by activation and compartmentalization. J Biol Chem 284:15692–15700PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Jensen J, Tantiwong P, Stuenaes JT et al (2012) Effect of acute exercise on glycogen synthase in muscle from obese and diabetic subjects. Am J Physiol Endocrinol Metab 303:82–89CrossRef Jensen J, Tantiwong P, Stuenaes JT et al (2012) Effect of acute exercise on glycogen synthase in muscle from obese and diabetic subjects. Am J Physiol Endocrinol Metab 303:82–89CrossRef
17.
Zurück zum Zitat Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W, Berria R, Belfort R, Mandarino LJ (2003) Increased insulin receptor signaling and glycogen synthase activity contribute to the synergistic effect of exercise on insulin action. J Appl Physiol 95:2519–2529PubMedCrossRef Christ-Roberts CY, Pratipanawatr T, Pratipanawatr W, Berria R, Belfort R, Mandarino LJ (2003) Increased insulin receptor signaling and glycogen synthase activity contribute to the synergistic effect of exercise on insulin action. J Appl Physiol 95:2519–2529PubMedCrossRef
18.
Zurück zum Zitat Skurat AV, Roach PJ (1995) Phosphorylation of sites 3a and 3b (Ser640 and Ser644) in the control of rabbit muscle glycogen synthase. J Biol Chem 270:12491–12497PubMedCrossRef Skurat AV, Roach PJ (1995) Phosphorylation of sites 3a and 3b (Ser640 and Ser644) in the control of rabbit muscle glycogen synthase. J Biol Chem 270:12491–12497PubMedCrossRef
19.
Zurück zum Zitat Skurat AV, Dietrich AD, Roach PJ (2000) Glycogen synthase sensitivity to insulin and glucose-6-phosphate is mediated by both NH2- and COOH-terminal phosphorylation sites. Diabetes 49:1096–1100PubMedCrossRef Skurat AV, Dietrich AD, Roach PJ (2000) Glycogen synthase sensitivity to insulin and glucose-6-phosphate is mediated by both NH2- and COOH-terminal phosphorylation sites. Diabetes 49:1096–1100PubMedCrossRef
20.
Zurück zum Zitat Beck-Nielsen H (2012) The role of glycogen synthase in the development of hyperglycemia in type 2 diabetes: 'To store or not to store glucose, that's the question'. Diabetes Metab Res Rev 28:635–644PubMedCrossRef Beck-Nielsen H (2012) The role of glycogen synthase in the development of hyperglycemia in type 2 diabetes: 'To store or not to store glucose, that's the question'. Diabetes Metab Res Rev 28:635–644PubMedCrossRef
21.
Zurück zum Zitat Friedrichsen M, Birk JB, Richter EA et al (2013) Akt2 influences glycogen synthase activity in human skeletal muscle through regulation of NH2-terminal (sites 2 + 2a) phosphorylation. Am J Physiol Endocrinol Metab 304:631–639CrossRef Friedrichsen M, Birk JB, Richter EA et al (2013) Akt2 influences glycogen synthase activity in human skeletal muscle through regulation of NH2-terminal (sites 2 + 2a) phosphorylation. Am J Physiol Endocrinol Metab 304:631–639CrossRef
22.
Zurück zum Zitat Poulsen P, Wojtaszewski JF, Petersen I et al (2005) Impact of genetic versus environmental factors on the control of muscle glycogen synthase activation in twins. Diabetes 54:1289–1296PubMedCrossRef Poulsen P, Wojtaszewski JF, Petersen I et al (2005) Impact of genetic versus environmental factors on the control of muscle glycogen synthase activation in twins. Diabetes 54:1289–1296PubMedCrossRef
23.
Zurück zum Zitat Jensen J, Lai YC (2009) Regulation of muscle glycogen synthase phosphorylation and kinetic properties by insulin, exercise, adrenaline and role in insulin resistance. Arch Physiol Biochem 115:13–21PubMedCrossRef Jensen J, Lai YC (2009) Regulation of muscle glycogen synthase phosphorylation and kinetic properties by insulin, exercise, adrenaline and role in insulin resistance. Arch Physiol Biochem 115:13–21PubMedCrossRef
24.
Zurück zum Zitat Astrand I (1960) Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand (Suppl 49):1–92 Astrand I (1960) Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand (Suppl 49):1–92
25.
Zurück zum Zitat Vind BF, Birk JB, Vienberg SG et al (2012) Hyperglycaemia normalises insulin action on glucose metabolism but not the impaired activation of AKT and glycogen synthase in the skeletal muscle of patients with type 2 diabetes. Diabetologia 55:1435–1445PubMedCrossRef Vind BF, Birk JB, Vienberg SG et al (2012) Hyperglycaemia normalises insulin action on glucose metabolism but not the impaired activation of AKT and glycogen synthase in the skeletal muscle of patients with type 2 diabetes. Diabetologia 55:1435–1445PubMedCrossRef
26.
Zurück zum Zitat Lowry O, Passanneau JV (1972) A flexible system of enzyme analysis. Academic, London, pp 1–291 Lowry O, Passanneau JV (1972) A flexible system of enzyme analysis. Academic, London, pp 1–291
27.
Zurück zum Zitat Cohen P, Alessi DR, Cross DA (1997) PDK1, one of the missing links in insulin signal transduction? FEBS Lett 410:3–10PubMedCrossRef Cohen P, Alessi DR, Cross DA (1997) PDK1, one of the missing links in insulin signal transduction? FEBS Lett 410:3–10PubMedCrossRef
28.
Zurück zum Zitat Jørgensen SB, Nielsen JN, Birk JB et al (2004) The alpha2-5'AMP-activated protein kinase is a site 2 glycogen synthase kinase in skeletal muscle and is responsive to glucose loading. Diabetes 53:3074–3081PubMedCrossRef Jørgensen SB, Nielsen JN, Birk JB et al (2004) The alpha2-5'AMP-activated protein kinase is a site 2 glycogen synthase kinase in skeletal muscle and is responsive to glucose loading. Diabetes 53:3074–3081PubMedCrossRef
29.
Zurück zum Zitat Glintborg D, Højlund K, Andersen NR, Hansen BF, Beck-Nielsen H, Wojtaszewski JF (2008) Impaired insulin activation and dephosphorylation of glycogen synthase in skeletal muscle of women with polycystic ovary syndrome is reversed by pioglitazone treatment. J Clin Endocrinol Metab 93:3618–3626PubMedCrossRef Glintborg D, Højlund K, Andersen NR, Hansen BF, Beck-Nielsen H, Wojtaszewski JF (2008) Impaired insulin activation and dephosphorylation of glycogen synthase in skeletal muscle of women with polycystic ovary syndrome is reversed by pioglitazone treatment. J Clin Endocrinol Metab 93:3618–3626PubMedCrossRef
30.
Zurück zum Zitat Danforth WH (1965) Glycogen synthetase activity in skeletal muscle. Interconversion of two forms and control of glycogen synthesis. J Biol Chem 240:588–593PubMed Danforth WH (1965) Glycogen synthetase activity in skeletal muscle. Interconversion of two forms and control of glycogen synthesis. J Biol Chem 240:588–593PubMed
31.
Zurück zum Zitat Jensen J, Jebens E, Brennesvik EO et al (2006) Muscle glycogen inharmoniously regulates glycogen synthase activity, glucose uptake, and proximal insulin signaling. Am J Physiol Endocrinol Metab 290:154–162CrossRef Jensen J, Jebens E, Brennesvik EO et al (2006) Muscle glycogen inharmoniously regulates glycogen synthase activity, glucose uptake, and proximal insulin signaling. Am J Physiol Endocrinol Metab 290:154–162CrossRef
32.
Zurück zum Zitat Wojtaszewski JF, Nielsen JN, Richter EA (2002) Invited review: effect of acute exercise on insulin signaling and action in humans. J Appl Physiol 93:384–392PubMedCrossRef Wojtaszewski JF, Nielsen JN, Richter EA (2002) Invited review: effect of acute exercise on insulin signaling and action in humans. J Appl Physiol 93:384–392PubMedCrossRef
33.
Zurück zum Zitat Lai YC, Stuenaes JT, Kuo CH, Jensen J (2007) Glycogen content and contraction regulate glycogen synthase phosphorylation and affinity for UDP-glucose in rat skeletal muscles. Am J Physiol Endocrinol Metab 293:1622–1629CrossRef Lai YC, Stuenaes JT, Kuo CH, Jensen J (2007) Glycogen content and contraction regulate glycogen synthase phosphorylation and affinity for UDP-glucose in rat skeletal muscles. Am J Physiol Endocrinol Metab 293:1622–1629CrossRef
34.
Zurück zum Zitat Lin FC, Bolling A, Stuenaes JT et al (2012) Effect of insulin and contraction on glycogen synthase phosphorylation and kinetic properties in epitrochlearis muscles from lean and obese Zucker rats. Am J Physiol Cell Physiol 302:1539–1547CrossRef Lin FC, Bolling A, Stuenaes JT et al (2012) Effect of insulin and contraction on glycogen synthase phosphorylation and kinetic properties in epitrochlearis muscles from lean and obese Zucker rats. Am J Physiol Cell Physiol 302:1539–1547CrossRef
35.
Zurück zum Zitat Richter EA, Mikines KJ, Galbo H, Kiens B (1989) Effect of exercise on insulin action in human skeletal muscle. J Appl Physiol 66:876–885PubMed Richter EA, Mikines KJ, Galbo H, Kiens B (1989) Effect of exercise on insulin action in human skeletal muscle. J Appl Physiol 66:876–885PubMed
36.
Zurück zum Zitat Kjaer M, Hollenbeck CB, Frey-Hewitt B, Galbo H, Haskell W, Reaven GM (1990) Glucoregulation and hormonal responses to maximal exercise in non-insulin-dependent diabetes. J Appl Physiol 68:2067–2074PubMed Kjaer M, Hollenbeck CB, Frey-Hewitt B, Galbo H, Haskell W, Reaven GM (1990) Glucoregulation and hormonal responses to maximal exercise in non-insulin-dependent diabetes. J Appl Physiol 68:2067–2074PubMed
37.
Zurück zum Zitat Burstein R, Epstein Y, Shapiro Y, Charuzi I, Karnieli E (1990) Effect of an acute bout of exercise on glucose disposal in human obesity. J Appl Physiol 69:299–304PubMed Burstein R, Epstein Y, Shapiro Y, Charuzi I, Karnieli E (1990) Effect of an acute bout of exercise on glucose disposal in human obesity. J Appl Physiol 69:299–304PubMed
38.
Zurück zum Zitat Bahr R, Høstmark AT, Newsholme EA, Grønnerød O, Sejersted OM (1991) Effect of exercise on recovery changes in plasma levels of FFA, glycerol, glucose and catecholamines. Acta Physiol Scand 143:105–115PubMedCrossRef Bahr R, Høstmark AT, Newsholme EA, Grønnerød O, Sejersted OM (1991) Effect of exercise on recovery changes in plasma levels of FFA, glycerol, glucose and catecholamines. Acta Physiol Scand 143:105–115PubMedCrossRef
39.
Zurück zum Zitat Boden G (2002) Interaction between free fatty acids and glucose metabolism. Curr Opin Clin Nutr Metab Care 5:545–549PubMedCrossRef Boden G (2002) Interaction between free fatty acids and glucose metabolism. Curr Opin Clin Nutr Metab Care 5:545–549PubMedCrossRef
40.
Zurück zum Zitat Szendroedi J, Yoshimura T, Phielix E et al (2014) Role of diacylglycerol activation of PKCθ in lipid-induced muscle insulin resistance in humans. Proc Natl Acad Sci U S A 111:9597–9602PubMedCentralPubMedCrossRef Szendroedi J, Yoshimura T, Phielix E et al (2014) Role of diacylglycerol activation of PKCθ in lipid-induced muscle insulin resistance in humans. Proc Natl Acad Sci U S A 111:9597–9602PubMedCentralPubMedCrossRef
41.
Zurück zum Zitat Høeg LD, Sjøberg KA, Jeppesen J et al (2011) Lipid-induced insulin resistance affects women less than men and is not accompanied by inflammation or impaired proximal insulin signaling. Diabetes 60:64–73PubMedCentralPubMedCrossRef Høeg LD, Sjøberg KA, Jeppesen J et al (2011) Lipid-induced insulin resistance affects women less than men and is not accompanied by inflammation or impaired proximal insulin signaling. Diabetes 60:64–73PubMedCentralPubMedCrossRef
42.
Zurück zum Zitat Pehmøller C, Brandt N, Birk JB et al (2012) Exercise alleviates lipid-induced insulin resistance in human skeletal muscle-signaling interaction at the level of TBC1 domain family member 4. Diabetes 61:2743–2752 Pehmøller C, Brandt N, Birk JB et al (2012) Exercise alleviates lipid-induced insulin resistance in human skeletal muscle-signaling interaction at the level of TBC1 domain family member 4. Diabetes 61:2743–2752
43.
Zurück zum Zitat Bienso RS, Ringholm S, Kiilerich K et al (2012) GLUT4 and glycogen synthase are key players in bed rest-induced insulin resistance. Diabetes 61:1090–1099PubMedCentralPubMedCrossRef Bienso RS, Ringholm S, Kiilerich K et al (2012) GLUT4 and glycogen synthase are key players in bed rest-induced insulin resistance. Diabetes 61:1090–1099PubMedCentralPubMedCrossRef
44.
Zurück zum Zitat Damsbo P, Vaag A, Hother-Nielsen O, Beck-Nielsen H (1991) Reduced glycogen synthase activity in skeletal muscle from obese patients with and without type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 34:239–245PubMedCrossRef Damsbo P, Vaag A, Hother-Nielsen O, Beck-Nielsen H (1991) Reduced glycogen synthase activity in skeletal muscle from obese patients with and without type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 34:239–245PubMedCrossRef
45.
Zurück zum Zitat Ghanassia E, Brun JF, Fedou C, Raynaud E, Mercier J (2006) Substrate oxidation during exercise: type 2 diabetes is associated with a decrease in lipid oxidation and an earlier shift towards carbohydrate utilization. Diabetes Metab 32:604–610PubMedCrossRef Ghanassia E, Brun JF, Fedou C, Raynaud E, Mercier J (2006) Substrate oxidation during exercise: type 2 diabetes is associated with a decrease in lipid oxidation and an earlier shift towards carbohydrate utilization. Diabetes Metab 32:604–610PubMedCrossRef
Metadaten
Titel
Dysregulation of muscle glycogen synthase in recovery from exercise in type 2 diabetes
verfasst von
Andreas J. T. Pedersen
Janne R. Hingst
Martin Friedrichsen
Jonas M. Kristensen
Kurt Højlund
Jørgen F. P. Wojtaszewski
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Diabetologia / Ausgabe 7/2015
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-015-3582-z

Weitere Artikel der Ausgabe 7/2015

Diabetologia 7/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.