The Insulin Gradient Phenomenon: A Manifestation of the Effects of Body Weight on Blood Pressure and Insulin Resistance

Dagnovar Aristizabal MD, Jaime Gallo MD, Ricardo Fernández MD, Maria A. Restrepo MD, Nora Zapata RN, Monica Correa RN
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引用次数: 15

Abstract

The relationship between hyperinsulinemia and hypertension is frequently observed in overweight patients; however, population studies have not confirmed an independent association. A population study was conducted to assess whether differences in body mass index and levels of insulinemia modify cardiovascular hemodynamics and arterial pressure. In all, 322 healthy adults underwent a medical evaluation including insulin sensitivity and cardiac performance assessment with echocardiography. A direct relationship between body mass index and blood pressure (r=0.36; P<.01) was shown along with increments in fasting insulin levels. The underlying and progressive rise in insulin levels during blood pressure increase is named the insulin gradient. Left ventricular systolic indexes were significantly greater in the higher-insulin quartile. These findings suggest that body weight increases accompany a rise in systolic pressure and a drop in insulin sensitivity related to the insulin gradient. Increments in ejection fraction and cardiac output with normal total peripheral resistance are related to the blood pressure shift in these persons.

胰岛素梯度现象:体重对血压和胰岛素抵抗影响的一种表现
高胰岛素血症与高血压的关系常见于超重患者;然而,人口研究并没有证实独立的关联。进行了一项人群研究,以评估体重指数和胰岛素血症水平的差异是否会改变心血管血流动力学和动脉压。总共有322名健康成年人接受了包括胰岛素敏感性和心脏功能超声心动图评估在内的医学评估。体重指数与血压有直接关系(r=0.36;P<.01)随空腹胰岛素水平的增加而增加。在血压升高过程中胰岛素水平的潜在和进行性升高被称为胰岛素梯度。胰岛素水平越高,左心室收缩指数越高。这些发现表明,体重的增加伴随着收缩压的升高和与胰岛素梯度相关的胰岛素敏感性的下降。射血分数和心输出量的增加与正常的外周总阻力有关。
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