What does this research mean for the field?

Insulin resistance in glucose-tolerant offspring of type 2 diabetics is associated with early autonomic dysfunction, including lower day-night systolic blood pressure changes and abnormal sympathetic activation. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To investigate the specific role of insulin resistance in causing autonomic nervous system dysfunction in glucose-tolerant offspring of patients with type 2 diabetes.

May 13, 2003HypertensionOpen Access

Early Autonomic Dysfunction in Glucose-Tolerant but Insulin-Resistant Offspring of Type 2 Diabetic Patients

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Glucose-tolerant offspring of type 2 diabetic patients (n=69). Intervention: Insulin resistance (most insulin-resistant tertile) vs. Insulin sensitivity (most insulin-sensitive tertile). Primary outcome: Change of systolic blood pressure [(day-night/d)]x100 (p=<0.02).

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Key result

Insulin resistance in glucose-tolerant offspring of type 2 diabetics was associated with lower day-night systolic blood pressure changes compared to insulin-sensitive subjects (9.2% vs 12.4%, P<0.02).

Why the study?

Is insulin resistance associated with autonomic dysfunction and abnormal blood pressure control in glucose-tolerant offspring of type 2 diabetic patients?

Population

69 glucose-tolerant offspring of type 2 diabetic patients

Comparison

Most insulin-resistant tertile (IR) vs Most insulin-sensitive tertile and comparable…

Design

Cross-sectional

Authors

SFSimona FrontoniUniversity of Rome Tor Vergata DBDaniela BracagliaUniversity of Rome Tor Vergata ABAlessandra BaroniUniversity of Milan

Discussion

Member takes

Implication

May signal early autonomic dysfunction in at-risk families; hypothesis-generating for causality and longitudinal outcomes.

Key Points

To investigate the specific role of insulin resistance in causing autonomic nervous system dysfunction in glucose-tolerant offspring of patients with type 2 diabetes.
Studied 69 glucose-tolerant offspring of type 2 diabetic patients, comparing the most insulin-resistant (IR) tertile against the most insulin-sensitive (IS) tertile and healthy control subjects.
Performed oral glucose tolerance tests, 24-hour ambulatory blood pressure and ECG monitoring, and intravenous glucose tolerance tests (IVGTT) followed by euglycemic hyperinsulinemic clamps.
Evaluated sympathovagal balance using the low-to-high frequency ratio (LF:HF) via spectral analysis of R-R intervals and calculated day-to-night blood pressure variations.
IR offspring exhibited significantly smaller day-to-night dips in systolic (9.2 ± 5.0% vs. 12.4 ± 3.6%, P < 0.02) and diastolic blood pressure (13.2 ± 6.5% vs. 17.4 ± 5.2%, P < 0.02) compared to IS offspring.
Nocturnal reduction in the LF:HF ratio was significantly blunted in IR subjects compared to IS subjects (43.1 ± 21.0 vs. 61.4 ± 16.9, P < 0.02).
Acute hyperinsulinemia during IVGTT significantly increased LF:HF in IR participants (4.9 ± 3.3 vs. basal 2.3 ± 1.4, P = 0.03), whereas no significant increase occurred in IS participants.

Study Design

Type

Observational (n=69)

Structured PICO

Is insulin resistance associated with autonomic dysfunction and abnormal blood pressure control in glucose-tolerant offspring of type 2 diabetic patients?

Population

69 glucose-tolerant offspring of type 2 diabetic patients

Intervention

Most insulin-resistant tertile (IR)

Comparator

Most insulin-sensitive tertile (IS) and comparable control subjects

Outcome

Sympathovagal balance (LF:HF ratio) and change of systolic and diastolic blood pressure [(day-night/day)]x100surrogate

Main Result

Absolute Event Rate: 9.2% vs 12.4%

p-value: p=<0.02

Insulin resistance in normoglycemic offspring of type 2 diabetics is associated with early autonomic dysfunction and blunted nocturnal blood pressure dipping, potentially increasing future risk of hypertension and diabetes.

Cite This Study

Frontoni et al. (2003) conducted an observational in Glucose-tolerant offspring of type 2 diabetic patients (n=69). Insulin resistance (most insulin-resistant tertile) vs. Insulin sensitivity (most insulin-sensitive tertile) was evaluated on Change of systolic blood pressure [(day-night/d)]x100 (p=<0.02). Insulin resistance in glucose-tolerant offspring of type 2 diabetics was associated with lower day-night systolic blood pressure changes compared to insulin-sensitive subjects (9.2% vs 12.4%, P<0.02).

synapsesocial.com/papers/6a154654a4734e8e604e2fe4 https://doi.org/10.1161/01.hyp.0000073062.29546.01

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May 13, 2003HypertensionOpen Access

Early Autonomic Dysfunction in Glucose-Tolerant but Insulin-Resistant Offspring of Type 2 Diabetic Patients

View Full Paper

Ask AI

Bookmark

Key result

Why the study?

Is insulin resistance associated with autonomic dysfunction and abnormal blood pressure control in glucose-tolerant offspring of type 2 diabetic patients?

Population

69 glucose-tolerant offspring of type 2 diabetic patients

Comparison

Most insulin-resistant tertile (IR) vs Most insulin-sensitive tertile and comparable…

Design

Cross-sectional

Authors

SFSimona FrontoniUniversity of Rome Tor Vergata DBDaniela BracagliaUniversity of Rome Tor Vergata ABAlessandra BaroniUniversity of Milan

Discussion

Member takes

Implication

May signal early autonomic dysfunction in at-risk families; hypothesis-generating for causality and longitudinal outcomes.

Key Points

To investigate the specific role of insulin resistance in causing autonomic nervous system dysfunction in glucose-tolerant offspring of patients with type 2 diabetes.
Studied 69 glucose-tolerant offspring of type 2 diabetic patients, comparing the most insulin-resistant (IR) tertile against the most insulin-sensitive (IS) tertile and healthy control subjects.
Performed oral glucose tolerance tests, 24-hour ambulatory blood pressure and ECG monitoring, and intravenous glucose tolerance tests (IVGTT) followed by euglycemic hyperinsulinemic clamps.
Evaluated sympathovagal balance using the low-to-high frequency ratio (LF:HF) via spectral analysis of R-R intervals and calculated day-to-night blood pressure variations.
IR offspring exhibited significantly smaller day-to-night dips in systolic (9.2 ± 5.0% vs. 12.4 ± 3.6%, P < 0.02) and diastolic blood pressure (13.2 ± 6.5% vs. 17.4 ± 5.2%, P < 0.02) compared to IS offspring.
Nocturnal reduction in the LF:HF ratio was significantly blunted in IR subjects compared to IS subjects (43.1 ± 21.0 vs. 61.4 ± 16.9, P < 0.02).
Acute hyperinsulinemia during IVGTT significantly increased LF:HF in IR participants (4.9 ± 3.3 vs. basal 2.3 ± 1.4, P = 0.03), whereas no significant increase occurred in IS participants.

Study Design

Type

Observational (n=69)

Structured PICO

Is insulin resistance associated with autonomic dysfunction and abnormal blood pressure control in glucose-tolerant offspring of type 2 diabetic patients?

Population

69 glucose-tolerant offspring of type 2 diabetic patients

Intervention

Most insulin-resistant tertile (IR)

Comparator

Most insulin-sensitive tertile (IS) and comparable control subjects

Outcome

Sympathovagal balance (LF:HF ratio) and change of systolic and diastolic blood pressure [(day-night/day)]x100surrogate

Main Result

Absolute Event Rate: 9.2% vs 12.4%

p-value: p=<0.02

Cite This Study

synapsesocial.com/papers/6a154654a4734e8e604e2fe4 https://doi.org/10.1161/01.hyp.0000073062.29546.01

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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