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- Hänni, Arvo
(författare)
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Magnesium and the Insulin Resistance Syndrome
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Insulin resistance, defined as a state of reduced insulin-mediated glucose uptake in peripheral tissues, and disorders such as obesity, hypertension, and dyslipidemia, have been found to be associated in the conglomerate of the insulin resistance syndrome. Some antihypertensive drugs have been shown to decrease insulin sensitivity further. In the studies described in this thesis relations between the magnesium status and some aspects of the insulin resistance syndrome were investigated. In a cross-sectional study serum Mg was found to be directly related to insulin sensitivity and lipoprotein lipase activity, and inversely to fasting glucose concentration. During treatment with angiotensin-converting enzyme inhibitors, ACEi, in patients with essential hypertension, an increase in serum Mg in relation to serum Ca was found to be correlated to improved insulin sensitivity and decreased serum lipid concentrations. In trials with ACEi or bendrofluazide treatment, a reduced Ca/Mg ratio in skeletal muscle was associated with the blood pressure response. A change in Mg concentration in skeletal muscle was inversely correlated to the change in serum glucose, but was not correlated to the insulin sensitivity per se. Atherogenic lipid fractions were more closely related to the plasma ionized Mg concentration than to circulating total Mg levels. Intra-arterial Mg infusion improved endothelium-dependent vasodilation, EDV, in healthy normotensive subjects. In summary, magnesium improves endothelium-dependent vasodilation and lipoprotein lipase activity, which might help to explain the inverse correlations between circulating Mg concentrations and some lipid and glucometabolic variables.The Mg content in skeletal muscle is related to blood pressure response and serum glucose levels during antihypertensive treatment with ACEi or bendrofluazide.
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| 3. |
- Hänni, Arvo, et al.
(författare)
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Systolic blood pressure alterations during hyperinsulinemia are related to changes in ionized calcium status
- 2001
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Ingår i: American Journal of Hypertension. - 0895-7061 .- 1941-7225. ; 14:11 Pt 1, s. 1106-1111
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A correlation between changes in ionized calcium status and changes in systolic blood pressure (BP) has previously been observed during induced euglycemic hyperinsulinemia in patients with essential hypertension. The objective of this study was to evaluate associations between alterations in ion status and BP changes during euglycemic hyperinsulinemia in healthy normotensive subjects. METHODS: Ion status in plasma and BP were measured before and at the end of euglycemic hyperinsulinemic clamp tests performed in 41 healthy normotensive volunteers. RESULTS: During euglycemic hyperinsulinemia plasma sodium increased by 1% (P < .0001), ionized calcium (iCa) by 5% (P < .0001), and ionized magnesium (iMg) by 4% (P < .01), whereas potassium decreased by 10% (P < .0001). The changes in plasma iCa and iMg correlated significantly to changes in systolic BP (r = -0.38, P < .02; r = -0.32, P < .05, respectively), but the correlation between changes in iMg and changes in systolic BP did not remain significant in a multiple regression model. The glucose infusion rate correlated inversely to the change in iMg (r = -0.39, P < .01). CONCLUSIONS: The group mean systolic BP was unaltered during induced euglycemic hyperinsulinemia in healthy normotensive subjects; however, a more pronounced increase in the circulating iCa concentration was associated with a greater decline in systolic BP, which is in accordance with previous observations in patients with essential hypertension. The group mean diastolic BP was decreased; however, the lowered diastolic BP was not correlated to changes in ion status.
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- Lithell, Hans, et al.
(författare)
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Epidemiological and clinical studies on insulin resistance and diabetes
- 2000
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Ingår i: Upsala Journal of Medical Sciences. - 0300-9734. ; 105:2, s. 135-150
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- In Uppsala, extensive epidemiological and clinical studies on insulin resistance and diabetes have been ongoing for the past 30 years. A prospective cohort study of men born 1920-24, living in Uppsala County, was initiated during 1969-74 (the Uppsala Longitudinal Study of Adult Men, ULSAM). Risk factors for cardiovascular disease were examined in 2,322 men, and re-examinations have been performed every 10 years. At the first follow-up, when the men were 60 years old, insulin resistance was found to be a risk factor for development of hypertension and diabetes. In addition, treatment with antihypertensive medication was an independent risk factor for development of diabetes. These findings resulted in a series of clinical studies on metabolic effects of antihypertensive agents. At the second follow-up, when the men were 70 years old, the development of hypertension and diabetes was once again in focus, but at this time, cross-sectional and prospective studies of other cardiovascular determinants, such as circadian blood pressure pattern, left ventricular geometry and function, muscle morphology, ion status, fibrinolysis and cognitive function, were also performed. The cohort has furthermore been linked to the Swedish census and hospital discharge and cause of death registries, it has been used for studies on relationships between birth weight and cardiovascular disease, and genetic analyses have been performed, taking advantage of the long observation time obtained in this cohort. The cohort is currently being re-examined for the third time, and will hopefully continue to provide valuable information on the epidemiology of diabetes and cardiovascular disease in the future.
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