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A positive association exists between insulin resistance, dyslipidemia, and hypertension, specifically salt-sensitive hypertension. A subgroup of salt-sensitive normal and high renin hypertensives called nonmodulators (NM) manifest an inability to modulate the adrenal and renal blood flow responses to a change in dietary sodium. Therefore, we tested the hypothesis that the NM subgroup would be insulin resistant and dyslipidemic when compared with normal and high renin hypertensives, in whom modulation is intact (M). Forty-six nondiabetic hypertensive individuals were evaluated and their modulation status defined by either renal or adrenal criteria. Fasting blood was drawn for measurement of several metabolic factors. Since the NM group had a greater body mass index (BMI) it was subdivided into a "lean" subgroup that matched the BMI of the M group. The fasting insulin levels in both the total NM and lean NM groups was significantly higher than in the M group (P = .013 and .04, respectively). There were no differences in age, blood pressure, or plasma/serum levels of glucose, triglycerides, total cholesterol, or potassium. NM had elevated fasting insulin levels compared to M, compatible with an insulin resistant state, but this insulin resistance are dissociable in the hypertensive population.

An intravenous glucose tolerance test (IVGTT) was performed on 16 spontaneously hypertensive rats (SHR) and 15 Wistar-Kyoto rats (WKY) by challenging them with an intravenous glucose load of 0.125 g/100 g body weight. Serum glucose and insulin were measured at 0, 15, 30, 60, 120, and 240 min. In a second experiment, oral glucose tolerance testing (OGTT) was performed with a glucose load of 170 mg/100 g body weight. Serum glucose and insulin were measured at 0, 30, 60, 120, and 240 min. A third experiment examined in vivo insulin-stimulated peripheral glucose uptake via the insulin suppression test. Glucose (8 mg/kg/min), insulin (2.5 to 4.0 mU/kg/min), and somatostatin (1 ng/kg/min) were infused for 3 h. Steady state serum glucose (SSSG) and serum insulin (SSSI) were determined at 0, 140, 160, and 180 min. IVGTT data indicated that serum glucose values were significantly increased in the WKY compared to the SHR at 15, 30, 60, and 120 min. Glucose clearance rates between 15 and 60 min were significantly (P less than .0001) lower in WKY (0.65 +/- 0.07%/min) compared to SHR (1.91 +/- 0.17%/min). The SHR exhibited an exaggerated 15-min peak in insulin secretion that was lacking in the WKY in response to an intravenous glucose load. OGTT data also indicated that the area under the serum insulin curves was higher in the WKY than in the SHR (P less than .017). Peripheral insulin sensitivity showed that despite comparable SSSI levels between the two strains, SSSG values were 31% higher in the SHR compared to the WKY (P less than .001). Thus, it appears that the WKY has a diminished insulin secretory capacity in response to a glucose load, while the SHR has lower tissue responsiveness to insulin's action.