Insulin secretion, sensitivity, and metabolic profile of young healthy offspring of hypertensive parents

Impaired insulin action, frequently found in essential hypertension (HT), is modified by other factors, such as higher age, accumulation of body fat, dyslipidaemia, impaired glucose metabolism and endothelial dysfunction. In addition, antihypertensive and insulin-sensitizing medication itself may significantly affect cardiovascular and metabolic milieu. The aim of this study was to assess insulin sensitivity, acute insulin response, lipidaemic status and the adipokines' concentrations with regard to abdominal fat distribution in young, lean male subjects with treatment-naïve essential HT and in matched healthy normotensive (NT) subjects. We studied 27 HT patients (age: 19.9 ± 0.6 years; body mass index (BMI): 22.9±0.5 kg m À2) and 15 NT controls (age: 22.3±1.0 years; BMI: 23.7 ± 0.6 kg m À2). The subjects underwent an oral and an intravenous glucose tolerance test (OGTT, IVGTT) on separate days in random order. Higher fasting insulin (Po0.001), non-esterified fatty acids (Po0.05) and plasminogen activator inhibitor factor 1 concentrations (Po0.05) were found in HT patients when compared with NT patients. Despite comparable anthropometric parameters and body fat distribution assessed by magnetic resonance imaging in both groups, newly diagnosed untreated young hypertensive male subjects showed decreased insulin sensitivity, augmented insulin response to both oral and intravenous glucose load (Po0.01; Po0.05 respectively) and 'higher still normal' 2-h plasma glucose levels during OGTT. Untreated, young, lean hypertensive male subjects, with distribution of abdominal adipose tissue and lipid profile comparable with their healthy NT matched counterparts, showed considerable signs of insulin resistance and hyperinsulinaemia. We hypothesize that insulin resistance is the initial feature, which is influenced by several environmental factors, and HT is one of their common consequences.

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“…[55][56][57][58][59][60] In this study, however, family history of HT among first-degree relatives was comparable in both groups.…”

contrasting

confidence: 60%

Insulin resistance in young, lean male subjects with essential hypertension

Penesová

Cizmárová²,

Белан

et al. 2010

J Hum Hypertens

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“…Previous investigations of the effect of familial diabetes on insulin secretion have produced inconsistent results [34][35][36], although a genetic influence on insulin secretion cannot be ruled out. No other variables were significant for insulin secretion in this cohort, although family history prevalence of diabetes was low, particularly in men, which may suggest underestimation of true family history.…”

Section: Comparisons With Other Studiesmentioning

confidence: 95%

Life course determinants of insulin secretion and sensitivity at age 50 years: the Newcastle thousand families study

Pearce

Unwin

Parker

et al. 2005

Diabetes Metabolism Res

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“…Moreover, the normotensive offspring of EH parents demonstrate elevated fasting insulin level and lower insulin sensitivity (Vlasakova et al, 2004), which suggests that certain specific factors may be involved in the pathogenesis of T2D in EH patients. Therefore, clarifying the mechanism underlying glucose metabolism disturbance in EH patients would contribute to detecting EH patients at high risk of T2D and delaying the process of target organ damage.…”

Section: Introductionmentioning

confidence: 99%

Association of KCNJ11 with impaired glucose regulation in essential hypertension

Wang

Xo²,

Zhang

et al. 2011

Genet. Mol. Res.

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ABSTRACT. KCNJ11 is one of the candidate genes for type 2 diabetes, confirmed by genome wide association study, but there are little data on the relationship between KCNJ11 and impaired glucose regulation in essential hypertension patients. To identify the effect of E23K and I337V in the KCNJ11 gene on susceptibility to impaired glucose regulation, we conducted a case control study in 1125 essential hypertension patients with or without impaired glucose regulation among a Han Chinese population. We also evaluated the impact of two SNPs on insulin sensitivity and glucose tolerance estimated through an oral glucose tolerance test. In our case control study, no association of E23K and I337V with impaired glucose regulation was found using any genotypic models. However, lysine carriers of E23K showed a significant association with decreased insulin (30 min) and Cederholm index, and valine carriers of I337V showed association with a lower Cederholm index. All the quantitative tests were performed by linear regression, with adjustment for gender, age, body mass index, blood pressure, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker treatment. These findings provided evidence that the KCNJ11 gene plays a role in the pathogenesis of decreased insulin sensitivity in essential hypertension patients.

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Insulin secretion, sensitivity, and metabolic profile of young healthy offspring of hypertensive parents

Cited by 22 publications

References 51 publications

Insulin resistance in young, lean male subjects with essential hypertension

Insulin resistance in young, lean male subjects with essential hypertension

Life course determinants of insulin secretion and sensitivity at age 50 years: the Newcastle thousand families study

Association of KCNJ11 with impaired glucose regulation in essential hypertension

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