Relationship between Insulin Secretion and Arterial Stiffness in Essential Hypertension

Abstract

The study aims to explore the relationship between plasma insulin secretion and arterial stiffness in nondiabetic essential hypertensive patients. A total of 730 nondiabetic essential hypertensive patients registered between January 2016 and October 2020 were enrolled. A two-hour oral glucose tolerance test (OGTT) was performed to detect the levels of C-peptide and blood glucose at 0 hours and 2 hours, as well as the difference between C-peptide (Δ C-peptide) and blood glucose (Δ blood glucose) over the same period. Patients were divided into two groups: the normal glucose tolerance (NGT) group (n = 322) and the impaired glucose tolerance (IGT) group (n = 408). A multiple linear regression analysis was used to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and the other factors. 0 h C-peptide, 2 h C-peptide, and Δ C-peptide were found to be higher in the IGT group. baPWV was positively linear correlated with 2 h C-peptide (r = 0.086, p = 0.020 ) and Δ C-peptide (r = 0.115, p = 0.002 ). baPWV remained independently associated with 0 h C-peptide, 2 h C-peptide, and Δ C-peptide, after adjusting by age, gender, smoking, body mass index (BMI), high-density lipoprotein (HDL), cholesterol, systolic blood pressure (SBP), and triglycerides (TG). Our data shows that higher endogenous insulin secretion might play an important role in the progression of arterial stiffness in nondiabetic essential hypertensive patients.

The bidirectional association of C-peptide with cardiovascular risk in nondiabetic adults and patients with newly diagnosed type 2 diabetes mellitus: a retrospective cohort study

“…It seems that the absence of C-peptide may effectuate increased cardiovascular risk in T1DM patients. However, in nondiabetic individuals, several studies reported a positive linear association between C-peptide and arterial stiffness markers [ 7 , 22 ]. A higher level of C-peptide had been reported to be correlated with higher risks of subclinical myocardial injury and all-cause and cardiovascular-related mortality [ 8 – 10 , 23 ].…”

“…HRs and 95% CIs were derived from a Cox proportional hazard model adjusting for sex, age, smoking status, use of antihypertensive medication, use of lipid-lowering medication, use of antidiabetic medication, BMI, SBP, LDL cholesterol, triglycerides, HbA1c, HOMA-IR, and the interaction between fasting C-peptide and HOMA-IR. BMI body mass index, CI confidence interval, FPG fasting plasma glucose, HbA1c hemoglobin A1c, HOMA-IR homeostasis model assessment of insulin resistance, HR hazard ratio, LDL cholesterol low-density lipoprotein cholesterol, T2DM type 2 diabetes mellitus, 2hPG 2 h plasma glucose C-peptide and arterial stiffness markers [7,22]. A higher level of C-peptide had been reported to be correlated with higher risks of subclinical myocardial injury and allcause and cardiovascular-related mortality [8][9][10]23].…”

“…C-peptide is also viewed as a therapeutic strategy for preventing diabetic vasculopathy in Type 1 DM (T1DM) [2,6]. However, recent studies have shown that C-peptide levels appear to positively correlate with arterial stiffness and cardiovascular and overall death in nondiabetic adults [7][8][9][10]. Additionally, increased levels of C-peptide might play a causal role in early atherogenesis in patients with Type 2 DM (T2DM) [11,12].…”

Hypertension in individuals working in the Arctic on a rotating basis: relationship of arterial stiffness with inflammatory markers and some metabolic risk factors

“…Обращает внимание, что в модель ОШ наличия АГ у обоих полов входит С-пептид (ОШ 2,73 у М и ОШ 1,9 у Ж) во взаимосвязи с сосудистой жесткостью (СПВ). Полученные данные подтверждают, что эндогенная секреция С-пептида может играть важную роль в формировании и прогрессировании артериальной жесткости у пациентов с АГ, даже не страдающих диабетом [17,19]. Вместе с тем последние данные свидетельствуют о том, что повышенный уровень продукта расщепления проинсулина С-пептид может выполнять роль медиатора, являясь причиной атерогенеза, способствуя привлечению моноцитов и лимфоцитов в ранние атеросклеротические поражения и индуцируя пролиферацию гладкомышечных клеток сосудов [19].…”

Home Blood Pressure in Health and Disease

“…In type 2 diabetes, however, insulin levels are often increased at the beginning of the disease (34), and insulin resistance, which characterizes type 2 diabetes, is associated with incident hypertension (35). Insulin resistance and insulin secretion are also associated with increased pulse wave velocity (PWV), a marker of vascular ageing (36,37). However, a causal relationship between insulin and hypertension is uncertain (33,38), and in a study of 596 individuals, insulin levels were not associated with the future development of hypertension (32).…”