{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:36:54Z","timestamp":1768322214972,"version":"3.49.0"},"reference-count":63,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,8]],"date-time":"2017-08-08T00:00:00Z","timestamp":1502150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["1I21RX001392\u201001A1"],"award-info":[{"award-number":["1I21RX001392\u201001A1"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["B9212\u2010C"],"award-info":[{"award-number":["B9212\u2010C"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>New Findings<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p><jats:bold>What is the central question of this study?<\/jats:bold><\/jats:p>\n<jats:p>What impact does insulin resistance have on cutaneous perfusion responses to insulin iontophoresis in vascular beds with markedly reduced or functionally ablated sympathetic nervous system vasomotor function resulting from spinal cord injury?<\/jats:p>\n<\/jats:list-item>\n<jats:list-item><jats:p><jats:bold>What is the main finding and its importance?<\/jats:bold><\/jats:p>\n<jats:p>Persons with spinal cord injury have sublesional microvascular endothelial dysfunction, as indicated by a blunted cutaneous perfusion response to acetylcholine iontophoresis, and the presence of insulin resistance has a further confounding effect on endothelium\u2010mediated changes to cutaneous perfusion in the lower extremities.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>Endothelium\u2010mediated mechanisms that regulate skin blood flow might play an integral role in optimizing skin perfusion in vascular beds with sympathetic nervous system vasomotor impairment, such as in spinal cord injury (SCI). Insulin is a vasoactive hormone and second messenger of nitric oxide that facilitates endothelium\u2010mediated dilatation. The effects of insulin resistance (IR) on sublesional cutaneous perfusion responses to insulin provocation have yet to be described in persons with SCI. Persons with SCI and an able\u2010bodied (AB) cohort were divided into subgroups based upon fasting plasma insulin concentration cut\u2010offs for IR (\u226513.13\u00a0mIU\u00a0ml<jats:sup>\u22121<\/jats:sup>) or insulin sensitivity (IS; &lt;13.13\u00a0mIU\u00a0ml<jats:sup>\u22121<\/jats:sup>), as follows: AB, IS (ABIS, <jats:italic>n<\/jats:italic>\u00a0=\u00a021); SCI, IS (SCIS, <jats:italic>n<\/jats:italic>\u00a0=\u00a021); AB, IR (ABIR, <jats:italic>n<\/jats:italic>\u00a0=\u00a09); and SCI, IR (SCIR, <jats:italic>n<\/jats:italic>\u00a0=\u00a011). Laser Doppler flowmetry characterized peak blood perfusion unit (BPU) responses (percentage change from baseline) to insulin, acetylcholine or placebo iontophoresis in the lower extremities; BPU responses were log<jats:sub>10<\/jats:sub> transformed to facilitate comparisons, and the net insulin response (NetIns) BPU response was calculated (insulin minus placebo BPU response). The NetIns was significantly greater in both IS groups compared with their corresponding IR group. The acetylcholine\u2010mediated BPU responses in the SCI subgroups were significantly lower than those in the ABIS group. The proportional BPU responses of NetIns to acetylcholine in the IS cohorts (i.e. ABIS and SCIS) were significantly greater (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05) than that of each IR subgroup. The presence of IR has a confounding effect on sublesional microvascular endothelium\u2010mediated cutaneous perfusion responses to provocation. Preservation of endothelial sensitivity to its agonists appears to be an important modifiable risk factor to optimize cutaneous perfusion in the lower extremities of persons with SCI.<\/jats:p><\/jats:sec>","DOI":"10.1113\/ep086239","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T11:08:06Z","timestamp":1499080086000},"page":"1234-1244","source":"Crossref","is-referenced-by-count":5,"title":["Cutaneous microvascular perfusion responses to insulin iontophoresis are differentially affected by insulin resistance after spinal cord injury"],"prefix":"10.1113","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1376-5152","authenticated-orcid":false,"given":"Michael F.","family":"La Fountaine","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs Rehabilitation Research &amp; Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. Peters Veterans Affairs Medical Center  Bronx NY USA"},{"name":"School of Health and Medical Sciences Seton Hall University  South Orange NJ USA"},{"name":"The Institute for Advanced Study of Rehabilitation and Sports Science, School of Health and Medical Sciences Seton Hall University  South Orange NJ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Cirnigliaro","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Rehabilitation Research &amp; Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. Peters Veterans Affairs Medical Center  Bronx NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Frank","family":"Azarelo","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Rehabilitation Research &amp; Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. Peters Veterans Affairs Medical Center  Bronx NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua C.","family":"Hobson","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Rehabilitation Research &amp; Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. Peters Veterans Affairs Medical Center  Bronx NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oriana","family":"Tascione","sequence":"additional","affiliation":[{"name":"State University of New York Downstate College of Medicine  Brooklyn NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten N.","family":"Swonger","sequence":"additional","affiliation":[{"name":"Department of Chemical and Biomolecular Engineering Tulane University  New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Dyson\u2010Hudson","sequence":"additional","affiliation":[{"name":"Kessler Foundation  West Orange NJ USA"},{"name":"Department of Physical Medicine and Rehabilitation Rutgers New Jersey Medical School  Newark NJ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Bauman","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Rehabilitation Research &amp; Development Service National Center for the Medical Consequences of Spinal Cord Injury James J. 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