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Department of Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California 91010
Balon, Thomas W., and Jerry L. Nadler. Evidence that
nitric oxide increases glucose transport in skeletal muscle.
J. Appl. Physiol. 82(1): 359-363, 1997.
Nitric oxide synthase (NOS) is expressed in skeletal muscle.
However, the role of nitric oxide (NO) in glucose transport in this
tissue remains unclear. To determine the role of NO in modulating
glucose transport, 2-deoxyglucose (2-DG) transport was measured in rat
extensor digitorum longus (EDL) muscles that were exposed to either a
maximally stimulating concentration of insulin or to an electrical
stimulation protocol, in the presence of
NG-monomethyl-L-arginine,
a NOS inhibitor. In addition, EDL preparations were exposed to sodium
nitroprusside (SNP), an NO donor, in the presence of submaximal and
maximally stimulating concentrations of insulin. NOS inhibition reduced
both basal and exercise-enhanced 2-DG transport but had no effect on
insulin-stimulated 2-DG transport. Furthermore, SNP increased 2-DG
transport in a dose-responsive manner. The effects of SNP and insulin
on 2-DG transport were additive when insulin was present in
physiological but not in pharmacological concentrations. Chronic
treadmill training increased protein expression of both type I and type
III NOS in soleus muscle homogenates. Our results suggest that NO may
be a potential mediator of exercise-induced glucose transport.
insulin; nitric oxide synthase isoforms; treadmill running; sodium
nitroprusside; 2-deoxyglucose transport
RECENT IMMUNOCYTOCHEMICAL STUDIES by Kobzik and
co-workers (8, 9) have noted that both the type I (neuronal) and type III (endothelial) isoforms of nitric oxide synthase (NOS) are expressed
in skeletal muscle. In conjunction with these findings, we have
observed that nitric oxide (NO) is released from incubated skeletal
muscle preparations (1). Furthermore, muscle NO release is augmented by
prior electrically induced contractions (1). Although the complete
physiological significance of NO in skeletal muscle remains to be
determined (17), a number of different researchers (8, 13-15) have
noted that NO may play a role in modulating contractile function.
A previous study (1) has demonstrated that incubation of skeletal
muscle with a NOS inhibitor decreased glucose transport (1). Both
insulin and exercise stimulate glucose transport utilization (5).
However, the potential role of NO in modulating glucose transport by
these stimuli is unknown. Accordingly, we designed experiments
utilizing both a NOS inhibitor and a NO donor to address the hypothesis
of whether NO is a potential mediator of either exercise-enhanced or
insulin-stimulated glucose transport.
Exercise protocols have been demonstrated to affect a number of
proteins within skeletal muscle (3). However, the effects of exercise
training on the expression of different NOS isoforms in skeletal muscle
have not been studied. Thus additional experiments were performed to
determine the effects of a chronic endurance-training protocol on NOS
protein expression in rat skeletal muscle.
These results indicate that NO might be a potential mediator of glucose
transport in skeletal muscle during the resting and postexercise state.
Furthermore, chronic exercise stimulates the protein expression of both
type I and type III NOS isoforms in soleus muscle.
Treatment of animals.
Male Sprague-Dawley rats (Charles River, Hollister, CA) fed ad libitum
were used for all experiments. All protocols were approved by the
Research Animal Care Committee of the City of Hope National Medical
Center and Beckman Research Institute of the City of Hope, CA. For
muscle incubation studies, rats weighing between 50 and 64 g were
anesthetized with pentobarbital sodium (5 mg/100 g body wt ip). With
the use of the exact procedures of Maizels and associates (12),
extensor digitorum longus (EDL) muscles were dissected for
incubation.
-2-ethanesulfonic acid, 1 mM EDTA, 1 mM ethylene glycol-bis(
-aminoethyl
ether)-N,N,N
,N
-tetraacetic acid, 1% Triton X-100, 0.1% sodium dodecyl sulfate (SDS), 2 mM dithiothreitol, and 1 µl/ml sodium vanadate by a polytron (Brinkmann, Westbury, NY) at a setting of 6 for 90 s. After homogenization, leupeptin (6 µl/ml), pepstatin A (1 µl/ml), and
phenylmethylsulfonyl fluoride (1 µl/ml) were added to the
homogenates, and tubes were placed on ice for 30 min. Homogenates were
centrifuged at 1,876 g for 3 min. The
resulting supernatants were assayed for protein by a dye-binding
procedure (Bio-Rad, Hercules, CA). The proteins were heated at 90°C
for 10 min in a water bath. Then 40 µg of protein from the soleus
muscles were separated by electrophoresis through a 6.5%
SDS-polyacrylamide gel. The gel was run at constant mA: 10 mA through a
stacking gel and 15 mA through the separating gel. Proteins were
transferred from the gel to polyvinylidene difluride membrane (Bio-Rad)
by using a Semiphor Semi-Dry transfer unit (Hoefer, San Francisco, CA).
The membranes were then washed with tris(hydroxymethyl)aminomethane
(Tris)-buffered saline-Tween 20 (TBST), consisting of 10 mM Tris (pH
7.5) with 100 mM NaCl and 0.1% Tween 20, for 5 min and were placed
into fresh TBST and allowed to incubate overnight at 4°C. A
Western-Light Chemiluminescent Detection System (Tropix, Bedford, MA)
was used in conjunction with primary antibodies for type I and type III
NOS isoforms (Transduction Laboratories, Lexington, KY). Rat brain and
human endothelial cell lysates were used as positive controls for type
I and type III NOS isoforms, respectively. After exposure to film,
densitometry was used for quantification.
Statistics.
All data are expressed as means ± SE. When two means were compared,
analysis was performed by an unpaired
t-test, except when the muscles were
taken from the contralateral leg for comparison with the opposite leg.
In this case, the paired t-test was
employed. When multiple means were compared, analyses were performed by an analysis of variance. If a significant
F ratio was found, further analysis
was performed by a Tukey's post hoc comparison.
P < 0.05 was selected for acceptance
of statistical significance.
2 M, SNP
significantly (P <0.01) decreased
2-DG transport to rate that was 75 ± 5% of that observed
in control incubations, which contained no SNP or insulin. SNP at a
concentration of 5 × 10
2 M resulted in an even
larger (50 ± 16%) reduction in 2-DG transport.
Figure 2 shows the effects of insulin and SNP alone and in combination with one another on 2-DG transport. Each agent, when used alone at the listed concentrations, has a significant (P < 0.05) submaximal effect on stimulating 2-DG transport. However, when used in combination at these submaximal stimulating concentrations with one another, there is an additive effect on the stimulation of 2-DG transport. When the muscles are exposed to a maximal stimulating concentration of insulin (20,000 µU/ml), SNP has no additional effect on the stimulation of 2-DG transport.
Effects of SNP on high-energy phosphate concentrations of skeletal muscle. SNP, when used at a concentration equal to or <10
2 M, did not alter
either ATP or CP concentrations of previously incubated EDL muscle
(results not shown). However, there was a significant decrease in ATP
(2.45 ± 0.21 vs. 5.26 ± 1.12 µmol/g) and CP (1.50 ± 0.22 vs. 14.51 ± 0.72 µmol/g) concentrations (both
n = 5;
P < 0.05) after incubation with 2 × 10
2 M SNP,
demonstrating that an incubation with a high concentration of SNP
compromises metabolic integrity of the muscle.
Effects of NOS inhibition on 2-DG transport.
Incubation with L-NMMA decreases
basal 2-DG by ~30% (Table 1, Fig.
3). In marked contrast,
L-NMMA has no effect on
insulin-stimulated 2-DG transport at either physiological (Fig. 3) or
pharmacological concentrations (Table 1). However, contraction-enhanced
2-DG transport is nearly completely abolished by NOS inhibition (Table 1).
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Effect of exercise training on NOS protein expression. Type I NOS protein is barely detectable in soleus muscle homogenates of sedentary rats (Fig. 4). However, soleus muscle obtained from trained rats shows a marked fourfold increase (P < 0.01) in type I NOS protein expression (4.09 ± 0.18 arbitrary units; n = 6) compared with their sedentary counterparts (1.00 ± 0.15 arbitrary units; n = 6). Type III NOS protein expression is also increased (P < 0.05) in soleus muscle samples obtained from trained rats (1.98 ± 0.40 arbitrary units; n = 6) compared with sedentary counterparts [1.00 ± 0.15 arbitrary units (n = 6)].
The major finding of the current studies is our observation that NOS inhibition selectively inhibits exercise enhanced 2-DG transport. Although it has been observed by ourselves (7, 21) and others (4, 5) that different factors activate glucose uptake in skeletal muscle, the signaling molecules or mechanisms remain obscure. Although further investigation is needed, we hypothesize that exercise activates glucose transport through a NO-mediated pathway, whereas insulin increases glucose-transport through a NO-independent mechanism.
Our finding that type I NOS protein can be increased by chronic endurance exercise is another example of a specific protein (i.e., GLUT-4 and hexokinase II) that has a key regulatory role in the control of glucose flux and can be upregulated by increased contractile activity (16, 20). These results support the potentially important regulatory role of specific NOS isoforms in exercise-induced improvement in glucose metabolism.
Our demonstration of increasing NOS protein expression of type I and type III isoforms by chronic endurance training extends the work of others (18) who have demonstrated that chronic exercise increases endothelial cell (type III) NOS gene expression in aortic extracts. It is possible that the increase in skeletal muscle NOS protein is a compensatory mechanism in response to the increase in metabolic demand.
Another major finding of these experiments that reinforces support for the role of NO in glucose transport regulation is that exposure to SNP, a NO donor, increases 2-DG transport in skeletal muscle over a wide range of concentrations. With high concentrations of SNP, 2-DG transport decreased. The stimulatory effects of SNP on glucose transport appear to be varied and dependent on the cell or tissue type examined. For example, Lander and associates (11) found that SNP, S-nitroso-N-acetylpenicillamine, or a NO gas-saturated medium increased glucose uptake in human peripheral blood mononuclear cells . Conversely, Emani and Perry (6) found that SNP had no stimulatory effect on glucose uptake in adipocytes. However, it should be noted that exposure to SNP did enhance triglyceride synthesis and protein synthesis in adipocytes, suggesting NO may selectively enhance certain insulin sensitive processes, depending on cell type (6). Furthermore, it should be noted that higher concentrations of SNP increased lactate dehydrogenase leakage from adipocytes, thus indicating a compromised metabolic integrity of the cell (6).
The concentration of SNP utilized in the majority of the current experiments was the same used by a number of other groups examining NO and skeletal muscle function (8, 13, 14). The aforementioned studies have noted that NO enhances force maintenance and is essential for optimal muscle function. These combined studies suggest that millimolar concentrations of SNP, when added for relatively short periods of times, are not detrimental to integrity of skeletal muscle metabolism.
In agreement with our prior investigation (1), we again demonstrated that NOS inhibition decreases basal glucose transport. However, NOS inhibition did not diminish 2-DG transport in skeletal muscle preparations by either submaximal or maximally stimulating concentrations of insulin. These results are somewhat different from those of Baron and co-workers (2), who observed insulin resistance after a bolus administration of L-NMMA, a NOS inhibitor. The disparity between studies most likely is because of the difference in the models utilized. We are examining skeletal muscle metabolism directly by using an incubated muscle preparation, whereas Baron et al. (2) examined whole body insulin responsiveness. Thus insulin in vivo may increase endothelial cell NO, resulting in vasodilatory responses and improved insulin responsiveness (19).
In conclusion, these new results suggest that modulation of the NO pathway in skeletal muscle could provide a novel approach to increasing glucose transport. Furthermore, the data indicate a potentially important role of NO in mediating exercise-induced glucose transport.
We thank Emilia Balon for technical assistance.
Address for reprint requests: T. W. Balon, Dept. of Diabetes, Endocrinology and Metabolism, City of Hope National Medical Center, Duarte, CA 91010 (E-mail: TBALON{at}smtplink.coh.org).
Received 7 August 1996; accepted in final form 8 October 1996.
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G. D. Thomas, P. W. Shaul, I. S. Yuhanna, S. C. Froehner, and M. E. Adams Vasomodulation by Skeletal Muscle-Derived Nitric Oxide Requires {alpha}-Syntrophin-Mediated Sarcolemmal Localization of Neuronal Nitric Oxide Synthase Circ. Res., March 21, 2003; 92(5): 554 - 560. [Abstract] [Full Text] [PDF] |
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E. Vermes, A. Ducharme, M. G. Bourassa, M. Lessard, M. White, and J.-C. Tardif Enalapril Reduces the Incidence of Diabetes in Patients With Chronic Heart Failure: Insight From the Studies Of Left Ventricular Dysfunction (SOLVD) Circulation, March 11, 2003; 107(9): 1291 - 1296. [Abstract] [Full Text] [PDF] |
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T. Vassilakopoulos, G. Deckman, M. Kebbewar, G. Rallis, R. Harfouche, and S. N. A. Hussain Regulation of nitric oxide production in limb and ventilatory muscles during chronic exercise training Am J Physiol Lung Cell Mol Physiol, March 1, 2003; 284(3): L452 - L457. [Abstract] [Full Text] [PDF] |
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R. C. Hickner, G. Kemeny, K. McIver, K. Harrison, and M. E. Hostetler Lower Skeletal Muscle Nutritive Blood Flow in Older Women Is Related to eNOS Protein Content J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2003; 58(1): B20 - 25. [Abstract] [Full Text] [PDF] |
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E. J. Henriksen Exercise Effects of Muscle Insulin Signaling and Action: Invited Review: Effects of acute exercise and exercise training on insulin resistance J Appl Physiol, August 1, 2002; 93(2): 788 - 796. [Abstract] [Full Text] [PDF] |
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B. A. Kingwell, M. Formosa, M. Muhlmann, S. J. Bradley, and G. K. McConell Nitric Oxide Synthase Inhibition Reduces Glucose Uptake During Exercise in Individuals With Type 2 Diabetes More Than in Control Subjects Diabetes, August 1, 2002; 51(8): 2572 - 2580. [Abstract] [Full Text] [PDF] |
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J. N. Rottman, D. Bracy, C. Malabanan, Z. Yue, J. Clanton, and D. H. Wasserman Contrasting effects of exercise and NOS inhibition on tissue-specific fatty acid and glucose uptake in mice Am J Physiol Endocrinol Metab, July 1, 2002; 283(1): E116 - E123. [Abstract] [Full Text] [PDF] |
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S. I. McFarlane, R. Muniyappa, R. Francisco, and J. R. Sowers Pleiotropic Effects of Statins: Lipid Reduction and Beyond J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1451 - 1458. [Abstract] [Full Text] [PDF] |
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P. Piatti, L. D. Monti, G. Valsecchi, F. Magni, E. Setola, F. Marchesi, M. Galli-Kienle, G. Pozza, and K. G. M.M. Alberti Long-Term Oral L-Arginine Administration Improves Peripheral and Hepatic Insulin Sensitivity in Type 2 Diabetic Patients Diabetes Care, May 1, 2001; 24(5): 875 - 880. [Abstract] [Full Text] |
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G. D. Thomas, W. Zhang, and R. G. Victor Nitric Oxide Deficiency as a Cause of Clinical Hypertension: Promising New Drug Targets for Refractory Hypertension JAMA, April 25, 2001; 285(16): 2055 - 2057. [Full Text] [PDF] |
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T. Shiuchi, H. Nakagami, M. Iwai, Y. Takeda, T.-X. Cui, R. Chen, Y. Minokoshi, and M. Horiuchi Involvement of Bradykinin and Nitric Oxide in Leptin-Mediated Glucose Uptake in Skeletal Muscle Endocrinology, February 1, 2001; 142(2): 608 - 612. [Abstract] [Full Text] [PDF] |
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Y. Higaki, M. F. Hirshman, N. Fujii, and L. J. Goodyear Nitric Oxide Increases Glucose Uptake Through a Mechanism That Is Distinct From the Insulin and Contraction Pathways in Rat Skeletal Muscle Diabetes, February 1, 2001; 50(2): 241 - 247. [Abstract] [Full Text] |
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J. S. Stamler and G. Meissner Physiology of Nitric Oxide in Skeletal Muscle Physiol Rev, January 1, 2001; 81(1): 209 - 237. [Abstract] [Full Text] [PDF] |
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S. M. Fitzgerald and M. W. Brands Nitric oxide may be required to prevent hypertension at the onset of diabetes Am J Physiol Endocrinol Metab, October 1, 2000; 279(4): E762 - E768. [Abstract] [Full Text] [PDF] |
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R. Tatchum-Talom, R. Schulz, J. R. McNeill, and F. H. Khadour Upregulation of neuronal nitric oxide synthase in skeletal muscle by swim training Am J Physiol Heart Circ Physiol, October 1, 2000; 279(4): H1757 - H1766. [Abstract] [Full Text] [PDF] |
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U. Frandsen, L. Hoffner, A. Betak, B. Saltin, J. Bangsbo, and Y. Hellsten Endurance training does not alter the level of neuronal nitric oxide synthase in human skeletal muscle J Appl Physiol, September 1, 2000; 89(3): 1033 - 1038. [Abstract] [Full Text] [PDF] |
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B. A. KINGWELL Nitric oxide-mediated metabolic regulation during exercise: effects of training in health and cardiovascular disease FASEB J, September 1, 2000; 14(12): 1685 - 1696. [Abstract] [Full Text] |
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D. Javeshghani, D. Sakkal, M. Mori, and S. N. A. Hussain Regulation of diaphragmatic nitric oxide synthase expression during hypobaric hypoxia Am J Physiol Lung Cell Mol Physiol, September 1, 2000; 279(3): L520 - L527. [Abstract] [Full Text] [PDF] |
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L. M A Heunks and P N R. Dekhuijzen Respiratory muscle function and free radicals: from cell to COPD Thorax, August 1, 2000; 55(8): 704 - 716. [Full Text] |
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W. Hirschfield, M. R. Moody, W. E. O'Brien, A. R. Gregg, R. M. Bryan Jr., and M. B. Reid Nitric oxide release and contractile properties of skeletal muscles from mice deficient in type III NOS Am J Physiol Regulatory Integrative Comp Physiol, January 1, 2000; 278(1): R95 - R100. [Abstract] [Full Text] [PDF] |
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C. K. Roberts, R. J. Barnard, A. Jasman, and T. W. Balon Acute exercise increases nitric oxide synthase activity in skeletal muscle Am J Physiol Endocrinol Metab, August 1, 1999; 277(2): E390 - E394. [Abstract] [Full Text] [PDF] |
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E. J. Henriksen, S. Jacob, T. R. Kinnick, E. B. Youngblood, M. B. Schmit, and G. J. Dietze ACE inhibition and glucose transport in insulinresistant muscle: roles of bradykinin and nitric oxide Am J Physiol Regulatory Integrative Comp Physiol, July 1, 1999; 277(1): R332 - R336. [Abstract] [Full Text] [PDF] |
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K. Zierler Whole body glucose metabolism Am J Physiol Endocrinol Metab, March 1, 1999; 276(3): E409 - E426. [Abstract] [Full Text] [PDF] |
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Y. Guo, M. T. Greenwood, B. J. Petrof, and S. N. A. Hussain Expression and Regulation of Protein Inhibitor of Neuronal Nitric Oxide Synthase in Ventilatory Muscles Am. J. Respir. Cell Mol. Biol., February 1, 1999; 20(2): 319 - 326. [Abstract] [Full Text] |
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M. P. Czech and S. Corvera Signaling Mechanisms That Regulate Glucose Transport J. Biol. Chem., January 22, 1999; 274(4): 1865 - 1868. [Full Text] [PDF] |
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D. S. Bredt NO skeletal muscle derived relaxing factor in Duchenne muscular dystrophy PNAS, December 8, 1998; 95(25): 14592 - 14593. [Full Text] [PDF] |
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Y. Fujii, Y. Guo, and S. N. A. Hussain Regulation of nitric oxide production in response to skeletal muscle activation J Appl Physiol, December 1, 1998; 85(6): 2330 - 2336. [Abstract] [Full Text] [PDF] |
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J. G. Tidball, E. Lavergne, K. S. Lau, M. J. Spencer, J. T. Stull, and M. Wehling Mechanical loading regulates NOS expression and activity in developing and adult skeletal muscle Am J Physiol Cell Physiol, July 1, 1998; 275(1): C260 - C266. [Abstract] [Full Text] [PDF] |
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Q. El Dwairi, Y. Guo, A. Comtois, E. Zhu, M. T. Greenwood, D. S. Bredt, and S. N. A. Hussain Ontogenesis of Nitric Oxide Synthases in the Ventilatory Muscles Am. J. Respir. Cell Mol. Biol., June 1, 1998; 18(6): 844 - 852. [Abstract] [Full Text] |
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D. Roy, M. Perreault, and A. Marette Insulin stimulation of glucose uptake in skeletal muscles and adipose tissues in vivo is NO dependent Am J Physiol Endocrinol Metab, April 1, 1998; 274(4): E692 - E699. [Abstract] [Full Text] [PDF] |
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T. Hayashi, J. F. P. Wojtaszewski, and L. J. Goodyear Exercise regulation of glucose transport in skeletal muscle Am J Physiol Endocrinol Metab, December 1, 1997; 273(6): E1039 - E1051. [Abstract] [Full Text] [PDF] |
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L. W. Smith, J. D. Smith, and D. S. Criswell Involvement of nitric oxide synthase in skeletal muscle adaptation to chronic overload J Appl Physiol, May 1, 2002; 92(5): 2005 - 2011. [Abstract] [Full Text] [PDF] |
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T. J. Stephens, Z.-P. Chen, B. J. Canny, B. J. Michell, B. E. Kemp, and G. K. McConell Progressive increase in human skeletal muscle AMPKalpha 2 activity and ACC phosphorylation during exercise Am J Physiol Endocrinol Metab, March 1, 2002; 282(3): E688 - E694. [Abstract] [Full Text] [PDF] |
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P. Iozzo, P. Chareonthaitawee, M. Di Terlizzi, D. J. Betteridge, E. Ferrannini, and P. G. Camici Regional myocardial blood flow and glucose utilization during fasting and physiological hyperinsulinemia in humans Am J Physiol Endocrinol Metab, May 1, 2002; 282(5): E1163 - E1171. [Abstract] [Full Text] [PDF] |
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S. M. Fitzgerald and M. W. Brands Hypertension in L-NAME-treated diabetic rats depends on an intact sympathetic nervous system Am J Physiol Regulatory Integrative Comp Physiol, April 1, 2002; 282(4): R1070 - R1076. [Abstract] [Full Text] [PDF] |
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