Relations of Insulin Sensitivity to Longitudinal Blood Pressure Tracking

Ärnlöv, Johan; Pencina, Michael J.; Nam, Byung–Ho; Meigs, James B.; Fox, Caroline S.; Levy, Daniel; D’Agostino, Ralph B.; Vasan, Ramachandran S.

doi:10.1161/circulationaha.105.535039

Cited by 48 publications

(24 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The relationship of HOMA-IR to BMI is inconsistent with that observed by Bacha et al (r 2 ¼ 0.308 in our study, compared to r 2 ¼ 0.73) (91). Associations between HOMA-IR and BMI zscore and between HOMA-IR and systolic blood pressure z-score were also reported by Arnlov et al (92). They found that insulin resistance in younger adults with normal BMI and blood pressure was predictive of future hypertension.…”

Section: Discussioncontrasting

confidence: 97%

Metabolic Syndrome in Adolescents With Spinal Cord Dysfunction

Nelson

Widman

Abresch

et al. 2007

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Objective: The purpose of this study was to determine the prevalence of components of the metabolic syndrome in adolescents with spinal cord injury (SCI) and spina bifida (SB), and their associations with obesity in subjects with and without SCI and SB.Methods: Fifty-four subjects (20 SCI and 34 SB) age 11 to 20 years with mobility impairments from lower extremity paraparesis were recruited from a hospital-based clinic. Sixty able-bodied subjects who were oversampled for obesity served as controls (CTRL). Subjects were categorized as obese if their percent trunk fat measured by dual x-ray absorptiometry (DXA) was .30.0% for males and .35.0% for females. Ten SCI, 24 SB, and 19 CTRL subjects were classified as obese. Fasting serum samples were collected to determine serum glucose, insulin, and lipid concentrations. Metabolic syndrome was defined as having !3 of the following components: (a) obesity; (b) high-density lipoprotein (HDL) ,45 mg/dL for males; ,50 mg/dL for females; (c) triglycerides !100 mg/dL; (d) systolic or diastolic blood pressure !95th percentile for age/ height/gender, and (e) insulin resistance determined by either fasting serum glucose 100-125 mg/dL; fasting insulin !20lU /mL; or homeostasis model assessment of insulin resistance !4.0.Results: Metabolic syndrome was identified in 32.4% of the SB group and 55% of the SCI group. Metabolic syndrome occurred at a significantly higher frequency in obese subjects (SB ¼ 45.8%, SCI ¼ 100%, CTRL ¼ 63.2%) than nonobese subjects (SB ¼ 0%, SCI ¼ 10%, CTRL ¼ 2.4%). Conclusions:The prevalence of metabolic syndrome in adolescents with SB/SCI is quite high, particularly in obese individuals. These findings have important implications due to the known risks of cardiovascular diseases and diabetes mellitus associated with metabolic syndrome in adults, particularly those with spinal cord dysfunction.

show abstract

Section: Discussioncontrasting

confidence: 97%

Metabolic Syndrome in Adolescents With Spinal Cord Dysfunction

Nelson

Widman

Abresch

et al. 2007

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

show abstract

“…38 The relationship between log M/I and SBP at Year 3 adjusted for baseline SBP was used in preference to the unadjusted relationship with change in SBP, given that baseline BP and change in BP are usually highly correlated. 3 The relationship was curvilinear when adjusted for study center and age only, but this was no longer the case when baseline SBP was added to the model. β-coefficients for insulin sensitivity are shown along with R 2 for the coefficient of determination for the model.…”

Section: Discussionmentioning

confidence: 98%

“…In the Framingham Offspring study, 3 an insulin sensitivity index estimated from fasting and postload insulin and glucose levels 4 independently predicted blood pressure (BP) tracking during 4 years in nonobese middle-aged men and women. 5,6 The euglycemic clamp technique, requiring intravenous insulin infusion with real-time glucose monitoring, is the acknowledged gold standard for the assessment of insulin sensitivity.…”

mentioning

confidence: 99%

Euglycemic Clamp Insulin Sensitivity and Longitudinal Systolic Blood Pressure

Petrie

Malik²,

Balkau³

et al. 2013

Hypertension

View full text Add to dashboard Cite

Abstract-Insulin resistance may be an independent risk factor for the development of hypertension, but change in blood pressure (BP) over time has not been adequately studied in healthy individuals fully characterized for insulin sensitivity.In the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study, we measured insulin sensitivity (M/I) using the euglycemic clamp technique in 1073 healthy European adults (587 women, 486 men) aged 30 to 60 years followed up 3 years later. Systolic BP (SBP) at baseline was higher in insulin-resistant women (ie, those in the low sex-specific M/I tertile) compared with those in the intermediate (P<0.001) or high tertiles (P=0.06; mean±SD: 117±13, 111±12, 114±12 mm Hg, respectively). It did not differ across M/I tertiles in men. After adjustment for age, body mass index, baseline SBP, and other covariates, low insulin sensitivity (M/I) predicted a longitudinal rise in SBP in women but not in men; M/I was not associated with change in diastolic BP. SBP rose over time in both sexes and within all M/I tertiles (P<0.05), except in women with high insulin sensitivity. Therefore, in women (but not in men), low insulin sensitivity was associated with higher SBP at 3 years, and high insulin sensitivity was associated with a lower rise in SBP BP and Physical ExaminationBP was measured sitting after 5-minute rest by trained study nurses (OMRON 705CP, Hamburg, Germany) in triplicate, according to a standard protocol: the median of these readings was used in this analysis. Median systolic BP (SBP) ≥140 mm Hg and median diastolic BP (DBP) ≥90 mm Hg at follow-up were taken to indicate hypertension. 34,35 Participants who had been identified and commenced on treatment in routine care (n=46) were classified as hypertensive. Height was measured by stadiometer. Body weight, percentage of body fat, and lean body mass (lbm) were evaluated by bioimpedance (TBF-300, Tanita International Division, United Kingdom). Insulin SensitivityInsulin sensitivity was measured by a standard hyperinsulinemic euglycemic clamp technique as previously described, after central training of site staff.33 Target plasma glucose concentration was between 4.5 and 5.5 mmol/L; insulin was infused at a rate of 240 pmol·min. Plasma glucose was measured at 5-to 10-minute intervals to ensure it remained within 0.8 mmol/L (±15%) of target glucose concentration. The steady-state period (for calculation of insulin sensitivity) was between 80 and 120 minutes. The glucose infusion rate (M value) was expressed in mg·min Biological SamplesTotal cholesterol, high-density lipoprotein cholesterol, and triglycerides were assayed by enzymatic colorimetric assay (Roche), and low-density lipoprotein cholesterol was calculated by the Friedewald formula. A 75-g oral glucose tolerance test was used to exclude participants with diabetes mellitus at inclusion (or developing diabetes mellitus during follow-up), with glucose assayed centrally by the glucose oxidase method (Cobas Integra, Roche). Other MeasuresPhysical acti...

show abstract

“…Earlier studies have identified various predictors of HTN onset including increased baseline blood pressure, increased heart rate, impaired glucose tolerance and decreased insulin sensitivity among others. 3,4,26,27 All these are also encountered, but in a greater degree, in patients with clinically manifest HTN. A possible explanation for the presence of all these abnormalities before the onset of HTN, as defined by a discrete blood pressure value, is that HTN does not appear suddenly in a moment in time defined by certain blood pressure criterion, but is a continuum that takes at least several years to develop in a predisposed subject (in our case subjects with a genetic predisposition to HTN).…”

Section: Discussionmentioning

confidence: 99%

Abnormalities of left ventricular long-axis function predict the onset of hypertension independent of blood pressure: a 7-year prospective study

et al. 2007

View full text Add to dashboard Cite

Increased blood pressure and left ventricular (LV) mass predict the onset of the clinically manifest hypertension, but little is known regarding the possible predictive value of LV function. The present study was designed to evaluate the association between echocardiographic LV long-axis systolic, and diastolic function and hypertension onset. We prospectively followed 244 normotensive adults with a family history of hypertension (HTN), with echocardiography for 7 years. M-mode derived atrioventricular plane displacement of the mitral and tricuspid annuli (MAVPD and TAVPD respectively), and LV circumferential fractional shortening were calculated. Diastolic function of the left and right ventricle were assessed using Doppler indices of the mitral and tricuspid inflow. During follow-up, 79 subjects developed hypertension (H group) and 165 subjects remained normotensive (N group). H group subjects had diminished MAVPD (13.873.4 vs 15.073.1 mm; P ¼ 0.007), lower mitral E/A ratio, and longer mitral E-wave deceleration time as compared to N group. In multivariate Cox model MAVPD and mitral E/A ratio predicted the onset of hypertension independent of LV mass index, blood pressure, pre-hypertensive status at baseline, age, sex and body mass index. During follow-up, H subjects experienced a significant decline in MAVPD and mitral E/A ratio, whereas the indices of right ventricular function and LV circumferential shortening remained intact. In conclusion, alterations in LV long-axis systolic and diastolic function, as measured by MAVPD and E/A ratio predict the onset of hypertension. These parameters declined during the development of hypertension.

show abstract

Relations of Insulin Sensitivity to Longitudinal Blood Pressure Tracking

Cited by 48 publications

References 50 publications

Metabolic Syndrome in Adolescents With Spinal Cord Dysfunction

Metabolic Syndrome in Adolescents With Spinal Cord Dysfunction

Euglycemic Clamp Insulin Sensitivity and Longitudinal Systolic Blood Pressure

Abnormalities of left ventricular long-axis function predict the onset of hypertension independent of blood pressure: a 7-year prospective study

Contact Info

Product

Resources

About