Vascular endothelial growth factor: A novel endocrine defensive response to hypoglycemia

• Published in: The journal of clinical endocrinology and metabolism Vol. 87; no. 2; pp. 835 - 840
• Main Authors: DANTZ, Dorle, BEWERSDORF, Jan, FRUEHWALD-SCHULTES, Bernd, KERN, Werner, JELKMANN, Wolfgang, BORN, Jan, FEHM, Horst L, PETERS, Achim
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.02.2002
• Subjects: Adult; Biological and medical sciences; Blood Glucose - analysis; Brain - physiology; Cognition - physiology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Endothelial Growth Factors - blood; General aspects. Associated endocrine diseases. Endocrine paraneoplasic syndromes; Glucose Clamp Technique; Humans; Hyperinsulinism - blood; Hypoglycemia - blood; Insulin - blood; Lymphokines - blood; Male; Medical sciences; Memory - physiology; Neuropsychological Tests; Osmolar Concentration; Tumors. Hypoglycemia; Vascular Endothelial Growth Factor A; Vascular Endothelial Growth Factors; Human; Hormone; Acute; Memory; Interference; Concentration; Glucose; Regulator; Hypoglycemia; Sympathetic nervous system; Blood brain barrier; Insulin; Hypoglycemic agent; Vascular endothelium growth factor; Blood vessel; Serum; Brain (vertebrata)
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.87.2.835

Glucose, the most important fuel for the brain, is supplied by the actions of counterregulatory hormones and the sympathetic nervous system. Yet to obtain access to the brain, glucose must pass the blood-brain barrier. Here we show that vascular endothelial growth factor (VEGF), a potent regulator of blood vessel function, is a candidate hormone for facilitating glucose passage across the blood-brain barrier under critical conditions. In 16 healthy men, VEGF serum concentrations increased under 6 h of insulin-induced hypoglycemic conditions from 86.1 +/- 13.4 to 211.6 +/- 40.8 pg/ml (P = 0.002), whereas in the hyperinsulinemic euglycemic control condition, no change was observed. During hypoglycemia serum VEGF, but no other counterregulatory hormone, was associated with preserved neurocognitive function, as measured with a memory test (r = 0.539; P = 0.031) and the Stroop interference task (r = 0.569; P = 0.021). Findings show that acute hypoglycemia is accompanied by a brisk increase in circulating VEGF concentration and that VEGF could mediate rapid adaptation of the brain to neuroglycopenia.