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Microalbuminuria, insulin sensitivity and haemostatic factors in non‐diabetic treated hypertensive men
Author(s) -
AGEWALL S.,
FAGERBERG B.,
ATTVALL S.,
LJUNGMAN S.,
URBANAVICIUS V.,
TENGBORN L.,
WIKSTRAND J.
Publication year - 1995
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1995.tb01161.x
Subject(s) - medicine , microalbuminuria , endocrinology , albuminuria , body mass index , diabetes mellitus , insulin resistance , insulin , fibrinogen , renal function , von willebrand factor , platelet
. Objective . To examine whether microalbuminuria in non‐diabetic, treated hypertensive men is associated with insulin resistance and measures of endothelial function, thrombogenesis and fibrinolysis. Design . Cross‐sectional study. Setting . Outpatient clinic in city hospital. Patients . Ninety‐two treated hypertensive men, aged 57–77 years, either with a serum cholesterol of ≥ 6.5 mmol L −1 or smokers, or both. Patients with diabetes mellitus or overnight urinary albumin excretion of > 100 mg 12 h −1 were excluded. Main outcome measures . Overnight urinary albumin excretion, insulin‐mediated glucose disposal (hyper‐insulinaemic euglycaemic clamp), blood glucose and plasma insulin during oral glucose tolerance test, fibrinogen, von Willebrand factor and plasminogen activator inhibitor activity. Results . Microalbuminuric patients had increased blood glucose concentrations during the oral glucose tolerance test and higher plasma fibrinogen levels compared with the normoalbuminuric patients. In a randomly selected subgroup ( n = 36), insulin‐mediated glucose disposal was lower in microalbuminuric than in normoalbuminuric patients, and an inverse relationship between insulin sensitivity and albuminuria ( r = –0.37; P = 0.028) was found. This relationship was not significant after adjustment for body‐mass index ( P = 0.098). In the univariate analyses including all patients, albuminuria was associated with blood glucose, serum creatinine, body‐mass index, systolic blood pressure, fibrinogen, von Willebrand factor and cholesterol (negatively). In a multiple regression analysis, only the body‐mass index was independently related to urinary albumin excretion. Conclusions . Microalbuminuria was associated with insulin resistance but obesity was a confounding factor. Relationships between microalbuminuria and fibrinogen as well as von Willebrand factor were found, but only in univariate analysis.