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Heni, M. ; Wagner, R. ; Willmann, C. ; Jaghutriz, B.A. ; Vosseler, A. ; Kübler, C. ; Hund, V.* ; Scheffler, K.* ; Peter, A. ; Häring, H.-U. ; Preissl, H. ; Kullmann, S. ; Fritsche, A.

Insulin action in the hypothalamus increases second phase insulin secretion in humans.

Neuroendocrinology 110, 929-937 (2020)
Publ. Version/Full Text Postprint DOI PMC
Open Access Green
Background:Animal studies and initial correlative data in humans indicate that insulin action in the brain may affect pancreatic insulin secretion. An important brain region for this process is the hypothalamus, an area that can develop insulin resistance.Methods:Fifteen young, healthy men (27 +/- 3 years) with a wide BMI spectrum (20-30 kg/m(2)) underwent 2 hyperglycemic clamps (target blood glucose: 10 mmol/L). In this double-blind study, subjects received 160 U of insulin or placebo as a nasal spray on 2 days in randomized order. On another day, insulin sensitivity of the hypothalamus was determined by functional magnetic resonance imaging.Results:Glucose levels were comparable on both study days. In the whole group, C-peptide levels were not significantly different between conditions. Though, there was a significant interaction between insulin sensitivity of the hypothalamus x nasal spray x time on C-peptide levels (p= 10(-6)). The group was therefore divided according to median hypothalamic insulin sensitivity. C-peptide concentrations were higher after intranasal insulin compared to placebo spray in the group with a strong hypothalamic insulin response (p< 0.0001, beta = 6.00 +/- 1.24) and lower in the brain insulin-resistant group (p= 0.005, beta = -2.68 +/- 0.95). Neither somatostatin nor glucagon kinetics was altered by the nasal spray.Conclusions:In participants with high hypothalamic insulin sensitivity, insulin action in the brain enhanced second-phase insulin secretion from pancreatic beta cells. This reaction could, for example, contribute to late postprandial glucose regulation by suppressing hepatic glucose production by portal venous insulin.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Hypothalamus ; Imaging ; Insulin Resistance ; Insulin Secretion ; Pancreas; Ventromedial Hypothalamus; Glucose; Obesity; Hyperinsulinemia; Overweight; Resistance; Glucagon; Sensitivity; System
ISSN (print) / ISBN 0028-3835
e-ISSN 1423-0194
Journal Neuroendocrinology
Quellenangaben Volume: 110, Issue: 11-12, Pages: 929-937 Article Number: , Supplement: ,
Publisher Karger
Publishing Place Allschwilerstrasse 10, Ch-4009 Basel, Switzerland
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants German Federal Ministry of Education and Research (BMBF)