Low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients

Fourteen hypertensive (174.3/98.3 mmHg) non-diabetic patients were given a euglyceamic glucose clamp along with infusion of 0.9% NaCl and the prostacyclin (PGI₂) analogue Iloporst (0.7 ng · kg · min^–1). Substrate oxidation was also determined by indirect calorimetry. Over the last 60 min of the clamp, Iloprost vs saline improved whole body glucose disposal (WBGD) (35 vs 28.3 mol · kg^–1 LBM) and non-oxidative glucose metabolism (24.7 vs 18.1 mol · kg^–1 LBM · min^–1). Iloprost delivery was associated with a significant decrease in membrane microviscosity (0.253 vs 0.205), but did not affect arterial blood pressure and heart rate. In nine patients, skeletal muscle blood flow (SMBF) and insulin-stimulated glucose uptake (GU) were also studied. At the end of the study, despite a similar SMBF (37 vs 38 ml · min^–1 · kg^–1), GU (0.55 vs 0.46 mmol · 1^–1) was significantly increased by Iloprost infusion. Percentage decrease in membrane microviscosity was correlated with percentage increase in WBGD (r=0.65) and non-oxidative glucose metabolism (r=0.68). In conclusion, low-dose Iloprost infusion improves insulin action and non-oxidative glucose metabolism in hypertensive patients.