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Relation between insulinaemia and lipoprotein composition in men with primary arterial hypertension with and without
A Stochmal1, P Goldsztajn, K Kawecka-Jaszcz
1I Cardiac Department, Collegium Medicum Jagiellonian University, Cracow, Poland.
Insights
Men with hypertension exhibit significantly higher insulin levels and altered triglyceride metabolism compared to healthy individuals. These metabolic differences, particularly in insulin secretion and VLDL composition, are key indicators differentiating hypertensive patients.
Area of Science:
- Cardiovascular Medicine
- Metabolic Disorders
- Lipidology
Background:
- Primary arterial hypertension is a significant global health concern.
- Understanding the metabolic underpinnings of hypertension is crucial for effective management.
- Insulin resistance and dyslipidemia are frequently observed in hypertensive populations.
Purpose of the Study:
- To investigate the relationship between high-density lipoprotein (HDL), triglyceride levels, and insulin resistance in individuals with primary arterial hypertension.
- To compare metabolic profiles, including lipoprotein composition and insulin secretion, between hypertensive men and normotensive controls.
Main Methods:
- A case-control study involving 60 hypertensive men and 60 matched normotensive men.
- Assessment of blood pressure, plasma lipoprotein content, and glucose/insulin levels during an oral glucose tolerance test (OGTT).
- Analysis of Very Low-Density Lipoprotein (VLDL) and Low-Density Lipoprotein (LDL) components, including apolipoproteins.
Main Results:
- Hypertensive individuals demonstrated significantly higher insulin secretion (sum ins) during OGTT compared to normotensives.
- Elevated concentrations of triglycerides, free and esterified cholesterol, and apolipoprotein B were observed in VLDL of hypertensive men.
- Distinct apolipoprotein CIII and E isoform profiles were noted in hypertensive subjects, while HDL and LDL composition showed no significant differences.
Conclusions:
- Elevated insulin levels and altered VLDL metabolism, characterized by higher triglycerides and specific apolipoprotein profiles, are strongly associated with primary arterial hypertension in men.
- Insulin secretion, HDL, and protein/cholesterol concentrations are critical biochemical factors distinguishing hypertensive men from healthy controls.
Abstract:
The purpose of the study was to evaluate a relationship between HDL, triglyceride levels and insulinaemia in primary arterial hypertension. The study population consisted of 60 men aged 32-68 years (mean age 50.87 years, s.d. 8.4) with hypertension duration of 11.1 years (s.d. 6.4 years) who were compared with 60 normotensives matched for sex, age and BMI. We examined blood pressure, plasma lipoprotein content, sum of glucose and sum of insulinaemia (sum ins) during OGTT (oral glucose tolerance test). OGTT revealed insulin secretion almost twice as high in hypertensives (P < 0.001 sum ins 11002 microU min/ml, s.d. 4846) than in normotensives (sum ins 6662 microU min/ml, s.d. 3099). Comparison of concentration of selected VLDL components shows that hypertensives were characterised by markedly higher concentration of triglycerides (1.46 mmol/L, s.d. 0.87 in hypertensives and 1.04 mmol/L, s.d. 0.54 in normotensives), free and esterified cholesterol and protein, including apolipoprotein B than normotensives. It was also found that hypertensives had higher levels of apo CIII0 and lower levels of CIII1 VLDL than normotensives. Hypertensive patients showed also a higher frequency of apo E2 isoforms (three-fold) and apo E4 isoforms (two-fold) than healthy subjects. No changes were detected in the composition of LDL and HDL between the groups. Analysing the discriminating ability of biochemical parameters chosen in a step-wise manner it was found that sum ins and HDL, protein and cholesterol concentrations were the factors most powerfully differentiating men with hypertension from healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)