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Elevated basal insulin secretion and normal dynamic insulin sensitivity in borderline hypertension
M G Piccardo1, G Turchetti, M S Rosa
1Metabolic Disease Unit, University of Rome La Sapienza, Policlinico Umberto Primo, Italy.
Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|February 3, 2000
Summary
Borderline hypertensive patients show basal insulin resistance and increased insulin secretion, despite normal glucose tolerance. This suggests a progression towards sustained hypertension-related insulin resistance.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Syndrome
Background:
- Borderline hypertension represents an early stage of established hypertension.
- Understanding metabolic alterations in borderline hypertension is crucial for predicting disease progression.
Purpose of the Study:
- To investigate insulin secretion and hepatic clearance in borderline hypertensive patients.
- To explore the relationship between insulin behavior and glucose metabolism in non-steady-state conditions.
Main Methods:
- Intravenous glucose tolerance test and minimal model analysis were performed on 15 borderline hypertensive patients and 15 controls.
- Key parameters measured included insulin sensitivity, glucose effectiveness, insulin secretion, and hepatic extraction.
Main Results:
- Patients exhibited normal glucose tolerance, glucose effectiveness, and insulin sensitivity.
- Basal insulin and C-peptide levels were significantly higher in patients, indicating basal insulin resistance.
- Elevated insulin secretion and post-hepatic insulin delivery were observed, with normal hepatic extraction.
Conclusions:
- Borderline hypertension is characterized by basal insulin resistance and normal dynamic insulin sensitivity.
- Peripheral hyperinsulinemia results from increased hormone overproduction, particularly in the basal state.
- These findings suggest a metabolic pathway that may lead to the insulin resistance seen in sustained hypertension.