Hyperinsulinemia is potentially associated with the development of vas
cular sclerosis. On the other hand, the relationship between hyperinsu
linemia and nephrosclerosis has nor been elucidated. In this investiga
tion clinicopathological studies were performed in 40 patients with ne
phrosclerosis, with special attention to the relationship between hype
rinsulinemia and glomerular hypertrophy. Forty patients with biopsy-pr
oven nephrosclerosis were divided into two groups by the 75-g oral glu
cose tolerance test (OGTT): group A, 2-hr plasma glucose concentration
> 140 mg/dL (n = 25); group B, 140 less than or equal to 2-hr plasma
glucose < 200 mg/dL (n = 15). Patients with diabetes mellitus or diabe
tic nephropathy were not included. Morphometric analysis of the glomer
uli revealed a significantly larger mean glomerular volume in subjects
with nephrosclerosis in both subgroups. In addition, the mean glomeru
lar volume was significantly correlated with the fasting insulin level
, while no significant correlation was observed between the mean glome
rular volume and creatinine clearance or degree of global sclerosis. T
hese results indicate that hyperinsulinemia may be intimately related
to glomerular hypertrophy in patients with nephrosclerosis.