Background Insulin resistance is a phenomenon which can be observed in hypertensive patients especially in the non-obese patients with coexistent obesity. But we can observe insulin resistance also in almost 50% of non-obese patients with primary hypertension. Endothelins (ET) are peptides which have a variety of biological functions - the most important of them is vasoconstriction. In this way they can play a role in the development of arterial hypertension. The aim of the study was to mark insulin resistance in non-obese patients with arterial hypertension, to estimate serum endothelin levels (ET), 24-h urinary albumin excretion (UAE) in this population and to find correlations between insulin resistance ET and UAE.
Material and methods In 20 non-obese patients with arterial hypertension insulin resistance was measured by hyperinsulinemic euglycaemic clamp technique. The insulin resistance is expressed as the reciprocal of glucose disposal rate - M. The ET and 24-h UAE were evaluated by radioimmunoassay methods.
Results Insulin resistance was diagnosed in 35% of examined population. The mean value of glucose disposal rate M-value was 273.03 ± 44.65 mg/(m² x min). The mean value of ET was 25.59 ± 8.00 pg/ml, 24-h UAE was 25.92 ± 18.19 mg. We found significant correlation between M and ET (r = –0.6486; p < 0.01) between M and UAE (r = –0.7110; p < 0.001) and ET and UAE (r = 0.6566; p < 0.01).
Conclusion Insulin resistance was observed in 35% of nonobese patients with arterial hypertension. Significant correlation between degree of hypertension and intensity of insulin resistance was found. In hypertensive subjects with BMI in normal range significant correlations between insulin resistance and serum ET concentration and magnitude of UAE were found. The correlations found in our study suggest that non-obese patients with arterial hypertension demonstrated endothelial function defect which is correlated with many metabolic disorders.