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Cited by 2,344Diabetes, Cardiovascular Risks, and LipoproteinsBlood Pressure and Hypertension StudiesCardiovascular Function and Risk Factors

The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.

Insulin Resistance in Essential Hypertension

Ferrannini, Eleuterio, Buzzigoli, Giuseppe, Bonadonna, Riccardo, Giorico, Maria Antonietta, Oleggini, Marco, Graziadei, Linda, Pedrinelli, Roberto, Brandi, Luigi, Bevilacqua, Stefano·1987·New England Journal of Medicine
DOI 10.1056/nejm198708063170605
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Abstract

High blood pressure is prevalent in obesity and in diabetes, both conditions with insulin resistance. To test whether hypertension is associated with insulin resistance independently of obesity and glucose intolerance, we measured insulin sensitivity (using the euglycemic insulin-clamp technique), glucose turnover (using [3H]glucose isotope dilution), and whole-body glucose oxidation (using indirect calorimetry) in 13 young subjects (38 +/- 2 years [+/- SEM]) with untreated essential hypertension (165 +/- 6/112 +/- 3 mm Hg), normal body weight, and normal glucose tolerance. In the postabsorptive state, all measures of glucose metabolism were normal. During steady-state euglycemic hyperinsulinemia (about 60 microU per milliliter), hepatic glucose production and lipolysis were effectively suppressed, and glucose oxidation and potassium disposal were normally stimulated. However, total insulin-induced glucose uptake was markedly impaired (3.80 +/- 0.32 vs. 6.31 +/- 0.42 mg per minute per kilogram of body weight in 11 age- and weight-matched controls, P less than 0.001). Thus, reduced nonoxidative glucose disposal (glycogen synthesis and glycolysis) accounted for virtually all the defect in overall glucose uptake (1.19 +/- 0.24 vs. 3.34 +/- 0.44 mg per minute per kilogram, P less than 0.001). Total glucose uptake was inversely related to systolic or mean blood pressure (r = 0.76 for both, P less than 0.001). These results provide preliminary evidence that essential hypertension is an insulin-resistant state. We conclude that this insulin resistance involves glucose but not lipid or potassium metabolism, is located in peripheral tissues but not the liver, is limited to nonoxidative pathways of intracellular glucose disposal, and is directly correlated with the severity of hypertension.

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Citations

Cites

Research works printed but not linked: 14

  1. Stamler, 1978, JAMA, 240, 1607, 10.1001/jama.1978.03290150053024 · DOI
  2. Golay, 1985, Int J Obes, 9, 181
  3. Olefsky, 1982, Am J Physiol, 243, E15
  4. DeFronzo, 1979, Am J Physiol, 237, E214
  5. Ferrannini E, Del Prato S, DeFronzo RA. Glucose kinetics: tracer methods. In: Clarke WL, Lamer J, Pohl SL, eds. Methods in diabetes research. Vol. II: Clinical methods. New York: John Wiley, 1986:107–42.
  6. Jéquier E. Direct and indirect calorimetry in man. In: Garrow JS, Halliday D, eds. Substrate and energy metabolism. London: John Wiley, 1985:8292.
  7. Brandi, 1986, Riv Ital NutrParEnt, 4, 145
  8. Malvano, 1972, J Nucl Biol Med, 16, 24
  9. Pilo A, Ferrannini E, Bjorkman O, et al. Analysis of glucose production and disappearance rates following an oral glucose load in normal subjects: a double tracer approach. In: Cobelli C, Bergman RN, eds. Carbohydrate metabolism: quantitative physiology and mathematical modelling. London: John Wiley, 1981:221–8.
  10. Cobelli, 1987, Am J Physiol, 252, E679
  11. Karam, 1963, J Am Diet Assoc, 12, 197
  12. DeFronzo, 1983, Kidney Int, 24, S-102
  13. Silverberg, 1978, Am J Physiol, 234, E252
  14. Landsberg, 1985, Int J Obes, 9, 63

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Metadata

Authors
Ferrannini, E., Buzzigoli, G., Bonadonna, R., Giorico, M. A., Oleggini, M., Graziadei, L., Pedrinelli, R., Brandi, L., & Bevilacqua, S.
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1987-08-06
Volume
317
Issue
6
Pages
350-357
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm198708063170605
OpenAlex
W2319850088
Semantic Scholar
8f94bc06901b356e0488337d786981d8352e8bf1
Cited by
2,344
References
37
Citations by year
2026: 7 · 2025: 16 · 2024: 17 · 2023: 22 · 2022: 21 · 2021: 25 · 2020: 12 · 2019: 23 · 2018: 21 · 2017: 40 · 2016: 28 · 2015: 31 · 2014: 39 · 2013: 47 · 2012: 45
FWCI
45.05
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
insulin resistance, essential hypertension, insulin sensitivity, glucose uptake, nonoxidative glucose disposal, hepatic glucose production, lipolysis, glucose turnover, glucose oxidation, blood pressure, obesity, impaired glucose tolerance
MeSH terms
Adult, Blood Glucose, Female, Humans, Hypertension, Insulin, Insulin Resistance, Male

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