Key result
Angiotensin II-stimulated aldosterone levels were independently associated with lower insulin sensitivity in healthy adults, predicting 8% of the variance in the insulin sensitivity index (P=0.003).
Why the study?
Is increased aldosterone production associated with lower insulin sensitivity in healthy subjects?
Observational (n=84)
Yes
Is increased aldosterone production associated with lower insulin sensitivity in healthy subjects?
In healthy normotensive adults, increased aldosterone production is independently associated with lower insulin sensitivity, suggesting a potential early mechanism for metabolic risk.
Association in healthy adults warrants prospective confirmation; does not justify aldosterone modulation for metabolic risk.
CONTEXT: Aldosterone production is associated with insulin resistance in obese and hypertensive subjects. However, its effect on insulin sensitivity in healthy subjects is not clear. OBJECTIVE: The objective of this study was to test the hypothesis that increased aldosterone production is associated with lower insulin sensitivity in healthy subjects. DESIGN: This is an analysis of data previously collected during studies conducted as part of the International Hypertensive Pathotype Consortium. PARTICIPANTS AND INTERVENTIONS: Eighty-four subjects free of any medical or psychiatric illness were included in this study. They were studied after 7 d of a standardized high-sodium diet confirmed by 24-h urine sodium above 200 mEq. Insulin sensitivity index (ISI) was calculated after a 75-g oral glucose load with glucose and insulin measurements at 0, 30, 60, and 120 min. Serum aldosterone levels were measured after 45 min of angiotensin II (3 ng/kg/min) infusion. RESULTS: There were significant negative correlations between ISI and age, body mass index (BMI), diastolic blood pressure, and angiotensin II-stimulated aldosterone level (P < 0.01). On multivariate regression analysis, stimulated aldosterone level was an independent predictor of ISI after adjusting for age, BMI, and diastolic blood pressure. Stimulated aldosterone level predicted 8% of the variance in ISI (P = 0.003) with age, BMI, and diastolic blood pressure together predicting 23% of the variance in ISI. Thus, the final regression model predicted 31% of the variance in ISI (P < 0.0001). CONCLUSIONS: Aldosterone production is associated with insulin resistance in normotensive healthy subjects independent of traditional risk factors.
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Garg et al. (2010) conducted an observational in Healthy adults (n=84). Angiotensin II-stimulated aldosterone was evaluated on Insulin sensitivity index (ISI) (p=0.003). Angiotensin II-stimulated aldosterone levels were independently associated with lower insulin sensitivity in healthy adults, predicting 8% of the variance in the insulin sensitivity index (P=0.003).
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