Insulin resistance adds to endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension

Patients and methods. The authors have conducted clinical, functional and laboratory examination of 104 adolescents aged 11-18 years with a primary abdominal obesity type. It was additionally studied the reaction of the brachial artery in the process of conducting endothelial test with reactive hyperemia and calculated of percentage flow-mediated dilation (%FMD). Results. In 66% (n=67) cases it was identified endothelial dysfunction vessel (EDV) among adolescents on the basis of positive endothelial samples (FMD<10%). A further analysis was performed among children with dysfunction of endothelium of the brachial artery. The children were divided into 2 groups: children with essential hypertension and EDV and children without essential hypertension and EDV. Adolescents with essential hypertension had a moderate increase in the percentage content of fat mass (M=31,4±4,7%) and metabolic disorders in the blood are recorded with a frequency: hyperglycemia – 16,6%, ВЕСТНИК НОВЫХ МЕДИЦИНСКИХ ТЕХНОЛОГИЙ – 2015 – № 4 Электронный журнал Библиографическая ссылка: Маскова Г.С., Черная Н.Л., Дадаева О.Б. Патогенетические варианты развития дисфункции эндотелия сосудов у подростков с ожирением // Вестник новых медицинских технологий. Электронное издание. 2015. №4. Публикация 2-4. URL: http://www.medtsu.tula.ru/VNMT/Bulletin/E2015-4/5216.pdf (дата обращения: 18.11.2015). DOI:12737/14921 hypercholesterolemia – 4%, hyperinsulinemia – 27% and insulin resistance – 17%. Children without essential hypertension were characterized by significantly more pronounced metabolic disorders in the blood. In particular, hyperglycemia was reported among 33% of adolescents (p=0,04), hypercholesterolemia among 33% (p=0,04), hyperinsulinemia- 45% (p=0,041) and insulin resistance among 30% (p=0,042). Metabolic disorders of blood were registered at a higher percentage of body fat in the body (M=39,45±4,4%). Conclusion. The results analysis of the selected groups allows to reveal a predominant factor that causes dysfunction of endothelium among adolescents with obesity (high systemic blood pressure or hyperinsulinemia), as well as to determine the pathogenetic variants of further progress obesity: the development essential hypertension or increase metabolic disorders with the formation of diabetes type 2.

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Endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension

Heart ◽

10.1136/heart.85.2.215 ◽

2001 ◽

Vol 85 (2) ◽

pp. 215-217 ◽

Cited By ~ 26

Author(s):

B. ZIZEK

Keyword(s):

Essential Hypertension ◽

Endothelial Dysfunction ◽

Hypertensive Patients

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Insulin resistance is associated with high sodium-lithium countertransport in essential hypertension

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1991.261.6.e684 ◽

1991 ◽

Vol 261 (6) ◽

pp. E684-E691 ◽

Cited By ~ 9

Author(s):

A. Doria ◽

P. Fioretto ◽

A. Avogaro ◽

A. Carraro ◽

A. Morocutti ◽

...

Keyword(s):

Insulin Resistance ◽

Essential Hypertension ◽

Plasma Glucose ◽

Lactate Concentration ◽

Isotopic Dilution ◽

Glucose Turnover ◽

Oral Glucose ◽

Euglycemic Hyperinsulinemic Clamp ◽

Hypertensive Patients ◽

Insulin Levels

The nature of the association between essential hypertension and insulin resistance remains unknown. We measured plasma glucose and insulin levels after an oral glucose tolerance test (OGTT), as well as insulin sensitivity (using a euglycemic hyperinsulinemic clamp), glucose turnover (Rd; using [6,6-2H2]- and [3-3H]glucose isotopic dilution), and forearm net balance of glucose (using arterial-venous difference) in 22 hypertensive patients with high (H2) red blood cell (RBC) sodium-lithium countertransport (Na(+)-Li+ CT; greater than 0.41 mmol.l RBC-1.h-1), 21 hypertensive patients with normal (H1) Na(+)-Li+ CT, and 22 normotensive controls (C). After OGTT, H2 patients had higher plasma glucose and insulin levels than H1 and C. During euglycemic hyperinsulinemia (approximately 100 microU/ml) Rd was lower in H2 [21.7 +/- 1.4 (SE) mumol.kg-1.min-1] than in H1 (44.3 +/- 2.9; P less than 0.01) and C (48.1 +/- 3.0; P less than 0.01), and an inverse correlation was found between rates of Na(+)-Li+ CT and Rd in H1 and H2 (rs = -0.76; P less than 0.01). Forearm glucose uptake was 40-50% lower in H2 compared with H1 and C (P less than 0.01). Lactate concentration increased more in C (from 511 +/- 24 to 1,207 +/- 69 microM) and in H1 (from 564 +/- 40 to 1,122 +/- 99) than in H2 (from 581 +/- 42 to 950 +/- 102, P less than 0.05 vs. both). Forearm blood flow increased more in C (31%, P less than 0.05) and H1 (22%, P less than 0.05) than in H2 (12%).(ABSTRACT TRUNCATED AT 250 WORDS)

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