Introduction: Muscle sympathetic nervous activity (MSNA) may play a role in insulin resistance in humans. However, the direction and nature of the relationships between MSNA and peripheral or hepatic insulin resistance in obesity remain unclear.
Methods: Forty-five non-diabetic obese subjects (22 men, 23 women) aged 51±11 years were studied. Two-step (low-dose [15] and high-dose [80] mU/m2/min) hyperinsulinaemic-euglycaemic clamps were performed using deuterated glucose to determine liver and muscle insulin sensitivity. Subjects in the top tertile of endogenous glucose production (EGP) suppression were deemed Liversen; those in the bottom two tertiles were deemed Liverres. Subjects in the top tertile of glucose infusion rate (GIR) during the high-dose insulin clamp were deemed Musclesen; the bottom two tertiles were deemed Muscleres. Clinical and metabolic parameters were assessed. MSNA was measured by microneurography and abdominal fat distribution and liver lipid by magnetic resonance imaging.
Results: MSNA did not differ between insulin-sensitive and insulin-resistantgroups stratified by either liver or muscle insulin sensitivity. However, insulin-sensitive men had lower MSNA burst frequency compared with their insulin-resistant counterparts (27±14 vs. 38±7 bursts per minute; P=0.03, Liversen and Liverres,respectively; and 24±9 vs. 38±9 burst per minute; P=0.004, Musclesen and Muscleres, respectively). No differences in MSNA were observed in women. In men, MSNA burst frequency correlated inversely with liver insulin sensitivity (r=-0.53, P=0.02) and fibroblast growth factor (FGF)-19 (r=-0.47, P=0.03) and positively with C-reactive protein (CRP) (r=0.57, P=0.006).
Conclusions: Basal sympathetic nerve activity is related to liver insulin sensitivity in men. MSNA is significantly associated with circulating hepatokines, suggesting a potential hepato-endocrine-autonomic axis. Future studies are needed to clarify the influence of sympathetic nervous activity on liver insulin sensitivity in men.