MICROALBUMINURIA, INSULIN SENSITIVITY AND HEMOSTATIC FACTORS IN NONDIABETIC TREATED HYPERTENSIVE MEN

Objective. To examine whether microalbuminuria in non-diabetic, treate d hypertensive men is associated with insulin resistance and measures of endothelial function, thrombogenesis and fibrinolysis. Design. Cros s-sectional study. Setting. Outpatient clinic in city hospital. Patien ts. Ninety-two treated hypertensive men, aged 57-77 years, either with a serum cholesterol of greater than or equal to 6.5 mmol L(-1) or smo kers, or both. Patients with diabetes mellitus or overnight urinary al bumin excretion of > 100 mg 12 h(-1) were excluded. Main outcome measu res. Overnight urinary albumin excretion, insulin-mediated glucose dis posal (hyperinsulinaemic euglycaemic clamp), blood glucose and plasma insulin during oral glucose tolerance test, fibrinogen, von Willebrand factor and plasminogen activator inhibitor activity. Results. Microal buminuric patients had increased blood glucose concentrations during t he oral glucose tolerance test and higher plasma fibrinogen levels com pared with the normoalbuminuric patients. In a randomly selected subgr oup (n = 36), insulin-mediated glucose disposal was lower in microalbu minuric than in normoalbuminuric patients, and an inverse relationship between insulin sensitivity and albuminuria (r = -0.37; P = 0.028) wa s found. This relationship was not significant after adjustment for bo dy-mass index (P = 0.098). In the univariate analyses including all pa tients, albuminuria was associated with blood glucose, serum creatinin e, body-mass index, systolic blood pressure, fibrinogen, von Willebran d factor and cholesterol (negatively). In a multiple regression analys is, only the body-mass index was independently related to urinary albu min excretion. Conclusions. Microalbuminuria was associated with insul in resistance but obesity was a confounding factor. Relationships betw een microalbuminuria and fibrinogen as well as von Willebrand factor w ere found, but only in univariate analysis.