The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

Abstract

Abstract. The incidence of end-stage renal disease (ESRD) has risen dramatically in the past decade, mainly due to the increasing prevalence of diabetes mellitus, and both impaired glucose tolerance and hypertension are important contributors to rising rates of ESRD. Obesity, especially the visceral type, is associated with peripheral resistance to insulin actions and hyperinsulinemia, which predisposes to development of diabetes. A common genetic predisposition to insulin resistance and hypertension and the coexistence of these two disorders predisposes to premature atherosclerosis. A constellation of metabolic and cardiovascular derangements, which also includes dyslipidemia, dysglycemia, endothelial dysfunction, fibrinolytic and inflammatory abnormalities, left ventricular hypertrophy, microalbuminuria, and increased oxidative stress, is referred to as the cardiometabolic syndrome.

Metformin Improves Metabolic Memory in High Fat Diet (HFD)-induced Renal Dysfunction

“…Clinically, it has been shown that insulin resistance and hypertension are major contributors of renal dysfunction (22). In line with the above study, in our animal model, invasive blood pressure measurement showed an increase in MAP and Ang II-induced ⌬MAP, which could not be reversed upon diet reversal.…”

“…Metformin Improves Cardiovascular Function-It has been postulated that elevated basal MAP exacerbates nephropathy (22). To investigate this phenomenon, invasive blood pressure was measured in our study.…”

Exacerbation of diabetic nephropathy by hyperlipidaemia is mediated by Toll-like receptor 4 in mice

“…Despite progress in pharmacological strategies to control diabetes, hypertension and other metabolic abnormalities, the number of patients entering ESRD because of diabetic nephropathy remains extremely high, and the development of new classes of therapeutic reagents is eagerly anticipated [2]. During recent decades, the pathophysiology of diabetic nephropathy has become complex and serious because of coexisting lifestylerelated disorders, such as hyperlipidaemia, hypertension and obesity [3]. In fact, hyperlipidaemia is an independent risk factor for the progression of diabetic nephropathy in both type 1 and type 2 diabetes [4,5], but the underlying molecular mechanism remains elusive [6].…”

Proteinuria and metabolic syndrome as predictors of cardiovascular death in non-diabetic and type 2 diabetic men and women

“…Microalbuminuria has been shown to be related to insulin resistance and hyperinsulinaemia [35][36][37][38][39], and other components of metabolic syndrome, including blood pressure [40,41], high levels of triglycerides and apolipoprotein B [42,43] and obesity [44]. When the 1998 WHO Consultation report [13] introduced microalbuminuria as a component of metabolic syndrome, this decision was evidently based on the association of microalbuminuria with insulin resistance and other components of metabolic syndrome.…”