One goal of the proposed studies will be to evaluate the possibility that resistance to insulin stimulated glucose uptake is a common defect in patients with hypertension. In order to examine this hypothesis we will attempt to confirm the presence of ambient hyperinsulinemia in patients with hypertension, and to use the insulin clamp technique to see if patients with hypertension are insulin resistant. In addition, we will measure plasma lipid and lipoprotein concentrations in patients with hypertension, both non-diabetic and diabetic, in order to examine the possibility that abnormalities of glucose and insulin metabolism are correlated with the abnormalities of lipid metabolism that have been reported to occur in association with hypertension. In this endeavor we will also control for the effects of anti-hypertensive treatment in order to differentiate between the effects of hypertension, per se, or carbohydrate and lipid metabolism, as contrasted to changes due to the treatment of hypertension. Another major objective of the proposed studies will be to assess the effects of variations in the relative proportion of dietary fat and carbohydrates on plasma glucose, insulin, lipid and lipoprotein concentrations in hypertension and non-insulin-dependent diabetes mellitus (NIDDM). Finally, we will evaluate the effects of NIDDM, before and after glycemia control, on measurements of both low density lipoprotein and high density lipoprotein kinetics.
| Stuhlinger, Markus C; Abbasi, Fahim; Chu, James W et al. (2002) Relationship between insulin resistance and an endogenous nitric oxide synthase inhibitor. JAMA 287:1420-6 |
