Abstract

CD36 is a membrane protein involved in fatty acids uptake that is expressed in the endothelium, which has been associated with endothelial dysfunction in African Americans (AA). One in four AA is G-allele carriers for coding CD36 SNP rs3211938, which results in ~50% reduction in its expression. We reported that potentiating nitric oxide action (NO) with sildenafil restored endothelial dysfunction in conduit arteries in G-allele carriers. In this study, we tested the hypothesis that in G-allele carriers, sildenafil would improve insulin-induced microvascular recruitment (MBV) in response to fat infusion. We recruited 25 healthy AA (17 non-carriers [ages 34 ± 7.4] and eight G-allele carriers [42 ± 7.4 yrs]). Subjects underwent three visits: Visit 1: Saline infusion and hyperinsulinemic euglycemic clamp (HIE clamp). Visit 2: Lipid infusion and HIE clamp and Visit 3: Lipid infusion and HIE clamp after a four-week sildenafil treatment (60 mg/day). During each visit, the subjects underwent an assessment of MBV at baseline (bsl), after 3-hour insulin (Ins) infusion (40mu/m 2 /min) and after Ins and L-arginine (10mg/kg/min) for 30 min. infusion (Ins+L-arg). Ins+L-arg (saline day) increased the % change in MBV in both groups. However, this increase was less in carriers as compared to non-carriers (13.6±42.4 and 38.9±74.4), Fig. A. Intralipid (IL) infusion increased MBV but only in non-carriers, Fig. B . Treatment with sildenafil in the presence of IL infusion induced a decline in MBV in G-allele carriers Fig. C . In conclusion, healthy AAs with CD36 deficiency had a poor insulin-induced microvascular recruitment and appeared to be worsened by potentiating NO function with sildenafil.

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