本態性高血圧患者のイソスリソ感受性と腎機能おぶび昇圧系内分泌因子に対する高インスリン血症の影響
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Insulin resistance and hyperinsulinemia has been reported as linked with essential hypertension. In this study, to clarify the pathophysiological significance of insulin sensitivity and compensative hyperinsulinemia in essential hypertension, 75 g oral glucose tolerance test and eug-lycemic hyperinsulinemic glucose clamp were performed in 26 essential hypertensives (EHT) and 16 normotensive subjects (NT). During the clamp, 40 mU/min/m? insulin was infused continuously, and 20 % glucose solution was infused simultaneously at the rate to maintain the basal glucose level. The mean glucose infusion rate (M value) was used as an indicator of insulin sensitivity. Blood and urine samples were collected immediately before and at the end of 2-hour hyperinsulinemia. There was no significant difference between NT and EHT in fasting blood sugar and fasting plasma insulin levels. In the oral glucose tolerance test, the plasma insulin level at 90 and 120 min-utes, and the summation of plasma insulin level of 0, 30, 60, 90 and 120 minutes after glucose loading (ΣIRI) were significantly higher in EHT than in NT. M value was significantly lower in EHT than in NT. The mean blood pressures measured immediately before glucose loading were significantly correlated with insulin levels at 90 minutes, 120 minutes and ΣIRI after glucose loading. After hyperinsulinemia for 120 minutes glucose clamp, urinary sodium excretion and fractional excretion of sodium were decreased, and plasma norepinephrine, renin activity and aldosterone level were in-creased in both EHT and NT. In these changes, no significant difference was observed between EHT and NT. These results indicate that insulin resistance and compensative hyperinsulinemia exist in Japanese essential hypertensives, and insulin actions for renal sodium retention and augmentation of pressor systems are not disturbed in these patients.
- 札幌医科大学の論文
- 1994-04-01
札幌医科大学 | 論文
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