In this study, insulin resistance was common (20%) and could not be reliably diagnosed using conventional risk factors. One-half of the IR patients developed an impaired fasting glucose by 1 year, and, of these individuals, 20% were confirmed as having type 2 diabetes mellitus by 3 years.

Abstract-Abnormal erythrocyte sodium-lithium countertransport is common in a subgroup of patients with essential hypertension and a strong family history of hypertension and cardiovascular disease. We have previously shown that the abnormality in sodium-lithium countertransport is associated with tropomyosin, a cytoskeletal protein required to stabilize actin filament formation. Leukocyte trafficking events, which depend on cytoskeletal reorganization, are also altered in patients with essential hypertension with abnormal sodium-lithium countertransport. The aim of this study was to determine whether there is an abnormality in isoforms of tropomyosin that are common to erythrocytes and leukocytes. Analysis of reticulocyte RNA by reverse transcription (RT) and polymerase chain reaction (PCR) showed expression of TPMN and TPM5b isoforms of tropomyosin. No other isoforms were expressed. These isoforms were also detected in RNA from leukocytes. In patients with essential hypertension with abnormal erythrocyte sodium-lithium countertransport compared with normal control subjects, there was a higher TPMN/TPM5b ratio of protein in erythrocytes (median 3.

Background/Aims: Hypertension, chronic kidney disease (CKD) and cardiovascular disease (CVD) have reached epidemic proportions globally. Patients with CKD are at increased risk of CVD and yet conventional factors have yet to be linked with the risk associated with patients with CKD. The aim of this research was to establish whether there is a link between insulin resistance (IR) and estimated glomerular filtration rate (eGFR), and assess whether insulin-resistant subjects experience a more rapid deterioration in eGFR. Methods: IR was determined using HOMA-IR (homeostasis model assessment for IR) in normoglycaemic, male subjects with treated hypertension and correlated with clinical variables over a period of 5 years. Results: 106 subjects were assigned to three groups according to insulin sensitivity. Patients with IR had a higher body mass index, fasting glucose, triglyceride and lower HDL cholesterol. Half of the insulin-resistant patients developed an impaired fasting glucose by 1 year and 14% were being treated for type 2 diabetes mellitus by 5 years. Baseline and 5-year data revealed that there was no link between IR and eGFR, which deteriorated equally in all groups. Conclusion: We established that both CKD and IR are common and that the majority of subjects with IR developed impaired fasting glucose or type 2 diabetes mellitus in only 5 years. Although eGFR deteriorated in all groups, no link was found between eGFR and IR.

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