POSSIBLE RELATIONSHIP BETWEEN HYPERINSULINEMIA AND GLOMERULAR HYPERTROPHY IN NEPHROSCLEROSIS

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.