Diabetes, Vol 43, Issue 3 491-499, Copyright © 1994 by American Diabetes Association

ARTICLES

Impaired insulin-induced glucose uptake by extrahepatic tissue is hallmark of NIDDM patients who have or will develop hypertension and microalbuminuria

R Nosadini, A Solini, M Velussi, B Muollo, F Frigato, M Sambataro, MR Cipollina, F De Riva, E Brocco and G Crepaldi
Department of Internal Medicine, University Hospital, Padua, Italy.

Insulin resistance may be a mechanism linking non-insulin-dependent diabetes mellitus (NIDDM) to hypertension and cardiovascular mortality. Microalbuminuria also is an independent risk factor of cardiovascular mortality and of hypertension. Little information is available in the literature on the relationship between microalbuminuria and insulin action. This study investigated the relationships between blood pressure (BP) levels, microalbuminuria, and insulin resistance in NIDDM patients. Seventy-five NIDDM patients attending the outpatient clinic of the Department of Internal Medicine of the University Hospital in Padua, Italy participated in the cross-sectional part of our study. These subjects were divided into four groups on the basis of BP levels and albumin excretion rate (AER): 28 normotensive normoalbuminuric (NIDDM1), 19 hypertensive normoalbuminuric (NIDDM2), 15 normotensive microalbuminuric (NIDDM3), and 13 hypertensive microalbuminuric patients (NIDDM4). We defined microalbuminuria as an AER > 20 micrograms/min. Patients with BP levels > 145/90 mmHg were considered hypertensive. A group of 20 normal subjects served as control subjects. The results from the cross-sectional study indicate that the mean of insulin-induced whole-body glucose utilization, primarily an index of extrahepatic insulin action, was lower at all insulin infusion steps in the group of hypertensive and/or microalbuminuric patients than in the group of normotensive normoalbuminuric patients and control subjects. Hepatic glucose output, an index of insulin action in the liver, was on average less efficiently inhibited in all of the patients than in the control subjects, regardless of the BP levels or the AER.(ABSTRACT TRUNCATED AT 250 WORDS)
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. Franciosi, F. Pellegrini, M. Sacco, G. De Berardis, M. C.E. Rossi, G. F.M. Strippoli, M. Belfiglio, G. Tognoni, M. Valentini, A. Nicolucci, et al. Identifying Patients at Risk for Microalbuminuria via Interaction of the Components of the Metabolic Syndrome: A Cross-Sectional Analytic Study Clin. J. Am. Soc. Nephrol., September 1, 2007; 2(5): 984 - 991. [Abstract] [Full Text] [PDF]

				R. C.P. Go, R. Desmond, J. M. Roseman, D. S.H. Bell, C. Vanichanan, and R. T. Acton Prevalence and Risk Factors of Microalbuminuria in a Cohort of African-American Women With Gestational Diabetes Diabetes Care, October 1, 2001; 24(10): 1764 - 1769. [Abstract] [Full Text] [PDF]

				A. Solini, F. Di Virgilio, P. Chiozzi, P. Fioretto, A. Passaro, and R. Fellin A Defect in Glycogen Synthesis Characterizes Insulin Resistance in Hypertensive Patients With Type 2 Diabetes Hypertension, June 1, 2001; 37(6): 1492 - 1496. [Abstract] [Full Text] [PDF]

				E. Bonora, G. Targher, M. Alberiche, R. C. Bonadonna, M. B. Zenere, F. Saggiani, and M. Muggeo Intracellular Partition of Plasma Glucose Disposal in Hypertensive and Normotensive Subjects with Type 2 Diabetes Mellitus J. Clin. Endocrinol. Metab., May 1, 2001; 86(5): 2073 - 2079. [Abstract] [Full Text]

				J. E. Gerich The Genetic Basis of Type 2 Diabetes Mellitus: Impaired Insulin Secretion versus Impaired Insulin Sensitivity Endocr. Rev., August 1, 1998; 19(4): 491 - 503. [Abstract] [Full Text] [PDF]

				E. Duner, F. Di Virgilio, R. Trevisan, M. R. Cipollina, G. Crepaldi, and R. Nosadini 4Intracellular Free Calcium Abnormalities in Fibroblasts From Non–Insulin-Dependent Diabetic Patients With and Without Arterial Hypertension Hypertension, April 1, 1997; 29(4): 1007 - 1013. [Abstract] [Full Text]

				S. Bianchi, R. Bigazzi, A. Q. Galvan, E. Muscelli, G. Baldari, N. Pecori, D. Ciociaro, E. Ferrannini, and A. Natali Insulin Resistance in Microalbuminuric Hypertension : Sites and Mechanisms Hypertension, November 1, 1995; 26(5): 789 - 795. [Abstract] [Full Text]

				W.-J. Foyle, E. Carstensen, M. C. Fernandez, and J. S. Yudkin Longitudinal Study of Associations of Microalbuminuria With the Insulin Resistance Syndrome and Sodium-Lithium Countertransport in Nondiabetic Subjects Arterioscler. Thromb. Vasc. Biol., September 1, 1995; 15(9): 1330 - 1337. [Abstract] [Full Text]