What question did this study set out to answer?

This study investigates the relationship between insulin resistance, glomerular hemodynamics, and dietary salt intake in older, obese individuals with hypertension.

July 1, 1996Hypertension

Insulin Resistance, Elevated Glomerular Filtration Fraction, and Renal Injury

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Why the study?

Does dietary salt loading alter the relationship between insulin resistance and glomerular hemodynamics in older, obese, mildly hypertensive subjects?

Key Points

This study investigates the relationship between insulin resistance, glomerular hemodynamics, and dietary salt intake in older, obese individuals with hypertension.
Examined 10 older, obese, mildly hypertensive subjects without diabetes or renal disease.
Utilized radioisotopic renal clearances and hyperinsulinemic euglycemic clamps for measurement.
Subjects underwent a 2-week low sodium (3 g) and a 2-week high sodium (10 g) diet.
Glomerular filtration rate increased from 68.1±7.7 to 78.0±6.6 mL/min per 1.73 m², P=0.08.
Observed an inverse relationship between glomerular filtration fraction and glucose disposal rate, r =−0.70, P=0.04 during low sodium intake.
Relationship between insulin resistance and renal hemodynamics was weakened during high salt intake.

Structured PICO

Does dietary salt loading alter the relationship between insulin resistance and glomerular hemodynamics in older, obese, mildly hypertensive subjects?

Population

10 older (68±6 years), obese (body mass index, 31±4 kg/m2), mildly hypertensive (151±8/82±2 mm Hg), sedentary subjects without clinical evidence of diabetes or renal disease

Intervention

2 weeks of a 10-g sodium diet

Comparator

2 weeks of a 3-g sodium diet

Outcome

Relationship between insulin resistance (glucose disposal rate) and glomerular hemodynamics (glomerular filtration rate and fraction)surrogate

A greater degree of insulin resistance, rather than increased dietary salt, may predispose older mildly hypertensive subjects to renal injury by worsening renal hemodynamics.

Discussion

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Implication

Insulin resistance may drive adverse glomerular hemodynamics more than salt intake in older obese hypertensives; leaves open prospective confirmation and outcome impact.

Cite This Study

Dengel et al. (1996) studied this question.

synapsesocial.com/papers/6a20a175ac6bb08424cd2b5f https://doi.org/10.1161/01.hyp.28.1.127

Topics

Hypertension management

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Implication

Insulin resistance may drive adverse glomerular hemodynamics more than salt intake in older obese hypertensives; leaves open prospective confirmation and outcome impact.