Influence of non-steady state during isoglycemic hyperinsulinemic clamp inhypertension - A LIFE substudy

Citation
Mh. Olsen et al., Influence of non-steady state during isoglycemic hyperinsulinemic clamp inhypertension - A LIFE substudy, BLOOD PRESS, 8(4), 1999, pp. 207-213
Citations number
32
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
BLOOD PRESSURE
ISSN journal
08037051 → ACNP
Volume
8
Issue
4
Year of publication
1999
Pages
207 - 213
Database
ISI
SICI code
0803-7051(1999)8:4<207:IONSDI>2.0.ZU;2-4
Abstract
We wanted to investigate whether time to steady state was reached within 2 h of insulin infusion during isoglycemic hyperinsulinemic clamp, comparing the glucose uptake index (M/IG) with Bergman's insulin sensitivity index (S ip). We performed a 2-h oral glucose tolerance test and a 3-h isoglycemic h yperinsulinemic clamp in 26 young, healthy subjects and 43 elderly patients with unmedicated essential hypertension and left ventricular hypertrophy. The 3-h Sip correlated strongly with the 2-h M/IG in the patients (r = 0.88 , p < 0.001) as well as in the healthy subjects (r = 0.96, p < 0.001) with relatively narrow limits of agreement in the patients. However, during the third hour of insulin infusion, M/IG (10.0 vs 12.21(2) x kg(-1) x min(-1) x mmol(-1), p < 0.001) as well as Sip (7.1 vs 9.41(2) x kg(-1) x min(-1) x m mol(-1), p < 0.001) increased significantly in the patients, but not in the healthy subjects. Because the 2-h M/IG correlated strongly with the 3-h Si p with relatively narrow limits of agreement, it is a good measure of insul in sensitivity. However, a 2-h clamp results in lower insulin sensitivity v alues in elderly, hypertensive patients due to the fact that steady state i s not reached, demonstrating a higher prevalence of insulin resistance in s uch a population.