Impaired Insulin Action in Primary Hyperaldosteronism
J. Widimský jr., G. Šindelka, T. Haas, M. Prázný, J. Hilgertová, J. Škrha
Third Internal Clinic, Faculty of Medicine, Charles University, Prague, Czech
Republic
Received March 9, 1999
Accepted September 9, 1999
Summary
The presence of insulin resistance is frequently found in
essential hypertension. There are, however, only sparse data with respect to the
potential presence of insulin resistance in patients with secondary
hypertension. We have therefore undertaken a study to reveal the potential
occurrence of insulin resistance in primary hyperaldosteronism (PH). The hyperinsulinemic euglycemic clamp technique together with the evaluation of
insulin receptor characteristics were used to study insulin resistance in 12
patients with PH. The measured parameters were compared to normal values in
control subjects. We have found a significantly lower glucose disposal rate (M, m
mol/kg/min) (18.7± 6 vs. 29.3±
4), decreased tissue insulin sensitivity index (M/I, m
mol/kg/min per mU/l x100) (23.7± 9.8 vs. 37.5±
11.6) and also lower metabolic clearance rate of glucose (MCRg, ml/kg/min) (3.8±
1.5 vs. 7.0± 1.1) in patients with primary hyperaldosteronism. The insulin receptor characteristics on erythrocytes did not
differ in primary hyperaldosteronism as compared to control healthy subjects. We
thus conclude that insulin resistance is also present in secondary forms of
hypertension (primary hyperaldosteronism) which indicates the heterogeneity of
impaired insulin action in patients with arterial hypertension.
Key words
Aldosterone · Insulin ·
Primary hyperaldosteronism · Insulin resistance
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Dr. J. Widimský, Third Internal Clinic, First Faculty of Medicine, Charles
University, U nemocnice 1, 128 21 Prague 2, Czech Republic. e-mail: jwidi@lf1.cuni.cz
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