Postprandial hyperglycemia and hyperinsulinemia associated with renal arterio-arteriolosclerosis in chronic kidney disease.

Abstract

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.

• Authors: Ryota Ikee, Kenjiro Honda, Kunihiro Ishioka, Machiko Oka, Kyoko Maesato, Hidekazu Moriya, Sumi Hidaka, Takayaku Ohtake, Shuzo Kobayashi
• Journal: Hypertension research : official journal of the Japanese Society of Hypertension (Hypertens Res) Vol. 33 Issue 5 Pg. 499-504 (May 2010) ISSN: 1348-4214 [Electronic] England
• PMID: 20186145 (Publication Type: Journal Article)

Chemical References

• Insulin
• Creatinine

Topics

• Adolescent
• Adult
• Aged
• Arteriolosclerosis (blood, complications, physiopathology)
• Creatinine (blood)
• Female
• Glucose Tolerance Test
• Humans
• Hyperglycemia (blood, complications, physiopathology)
• Hypertension (blood, complications, physiopathology)
• Insulin (blood)
• Insulin Resistance
• Kidney Failure, Chronic (blood, complications, physiopathology)
• Male
• Middle Aged
• Postprandial Period
• Regression Analysis
• Renal Artery (physiopathology)
• Statistics, Nonparametric