Hypertension has an important function in the formation of renal arterio-
arteriolosclerosis. However, renal arterio-
arteriolosclerosis is sometimes found in biopsy specimens of normotensive patients, which indicates unknown factors may contribute to renal arterio-
arteriolosclerosis. In this study, we aimed to evaluate the effects of
glucose metabolism/
insulin resistance on renal arterio-
arteriolosclerosis. Forty-eight patients with biopsy-proven non-diabetic chronic glomerular disease were included. Renal arterio-
arteriolosclerosis was evaluated as the percentage of vessels showing hyaline changes or wall thickening. We correlated renal arterio-
arteriolosclerosis with clinical parameters including indices obtained by 75 g oral
glucose tolerance test. Of the 48 patients, 30 had
hypertension. The results of univariate analysis showed significant association of renal arterio-
arteriolosclerosis with
hypertension, increased serum
creatinine (S-Cr),
hypertriglyceridemia, increased 2-h plasma
glucose (PG) and increased 2-h plasma
insulin (PI). In stepwise multiple regression analysis,
hypertension (beta=0.344, P=0.009), S-Cr (beta=0.287, P=0.03) and 2-h PG (beta=0.274, P=0.03) were independently associated with renal arterio-
arteriolosclerosis. Eleven of the 30 hypertensive patients did not have renal arterio-
arteriolosclerosis. The hypertensive patients with renal arterio-
arteriolosclerosis showed significantly higher 2-h PG (134+/-25 vs. 106+/-26 mg per 100 ml, P=0.008) and higher 2-h PI (67.7+/-34.9 vs. 48.3+/-30.0 microU ml(-1), P=0.04) compared with those without renal arterio-
arteriolosclerosis, but the difference in S-Cr was not significant.
Postprandial hyperglycemia and
hyperinsulinemia may contribute to the formation of renal arterio-
arteriolosclerosis independently of
hypertension.