Aldosterone Production and Insulin Resistance in Healthy Adults
Aldosterone Production and Insulin Resistance in Healthy Adults
复制标题
DOI：
10.1210/jc.2009-2521
复制
发表时间：
2010-04-01
影响因子：
5.8
通讯作者：
Adler, Gail K.
中科院分区：
文献类型：
--
作者：
Garg, Rajesh;Hurwitz, Shelley;Adler, Gail K.
背景：醛固酮的产生与肥胖和高血压患者的胰岛素抵抗有关。然而，其对健康受试者胰岛素敏感性的影响尚不清楚。目的：本研究的目的是检验健康受试者中醛固酮产生增加与胰岛素敏感性降低相关的假设。设计：这是对以前作为国际高血压病型联盟的一部分进行的研究期间收集的数据的分析。参与者和干预措施：84例无任何医学或精神疾病的受试者入选本研究。他们在标准化高钠饮食7天后进行研究，24小时尿钠超过200 mEq。在口服75 g葡萄糖负荷后，在0、30、60和120 min测量葡萄糖和胰岛素，计算胰岛素敏感性指数（ISI）。（3 ng/kg/min）输注。ISI与年龄、体重指数（BMI）、舒张压、血管紧张素II刺激的醛固酮水平（P < 0.01）。多元回归分析显示，在校正年龄、BMI和舒张压后，刺激性醛固酮水平是ISI的独立预测因子。刺激醛固酮水平预测ISI变异的8%（P = 0.003），年龄、BMI和舒张压共同预测ISI变异的23%。因此，最终的回归模型预测ISI的方差为31%（P < 0.0001）。结论：醛固酮的产生与正常血压健康受试者的胰岛素抵抗独立的传统危险因素。（临床内分泌代谢杂志95：1986-1990，2010）
Context: Aldosterone production is associated with insulin resistance in obese and hypertensive subjects. However, its effect on insulin sensitivity in healthy subjects is not clear.Objective: The objective of this study was to test the hypothesis that increased aldosterone production is associated with lower insulin sensitivity in healthy subjects.Design: This is an analysis of data previously collected during studies conducted as part of the International Hypertensive Pathotype Consortium.Participants and Interventions: Eighty-four subjects free of any medical or psychiatric illness were included in this study. They were studied after 7 d of a standardized high-sodium diet confirmed by 24-h urine sodium above 200 mEq. Insulin sensitivity index (ISI) was calculated after a 75-g oral glucose load with glucose and insulin measurements at 0, 30, 60, and 120 min. Serum aldosterone levels were measured after 45 min of angiotensin II (3 ng/kg/min) infusion.Results: There were significant negative correlations between ISI and age, body mass index (BMI), diastolic blood pressure, and angiotensin II-stimulated aldosterone level (P < 0.01). On multivariate regression analysis, stimulated aldosterone level was an independent predictor of ISI after adjusting for age, BMI, and diastolic blood pressure. Stimulated aldosterone level predicted 8% of the variance in ISI (P = 0.003) with age, BMI, and diastolic blood pressure together predicting 23% of the variance in ISI. Thus, the final regression model predicted 31% of the variance in ISI (P < 0.0001).Conclusions: Aldosterone production is associated with insulin resistance in normotensive healthy subjects independent of traditional risk factors. (J Clin Endocrinol Metab 95: 1986-1990, 2010)