title: Insulin resistance is associated with reduced nocturnal falls of blood pressure in normotensive, nonobese type 2 diabetic subjects.
abstract: To assess the relationship between insulin resistance and ambulatory blood pressure (BP) pattern, we determined glucose infusion rate (GIR) as a marker of insulin resistance using a glucose clamp method, and measured 24-h BPs in 25 normotensive, nonobese type 2 diabetic subjects. They were divided into two groups: 11 dippers and 14 nondippers. Clinical characteristics were similar in the two groups except for orthostatic fall in systolic BP. The median GIR level was significantly lower in nondippers than in dippers (P < 0.05). Spearman's rank correlation revealed that the GIRs were negatively correlated with the systolic, diastolic and mean BPs during nighttime (P < 0.05 or less), but not with daytime or whole day BPs. Moreover, based on a logistic regression analysis, the GIR as well as orthostatic fall in systolic BP discriminated independently between dippers and nondippers. Thus, our results suggest that insulin resistance is associated with decreased nocturnal BP fall in type 2 diabetic subjects.
authors.affiliation: Department of Internal Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan. nakano-s@kanazawa-med.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakano
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Kitazawa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Tsuda
authors.forename: Mariko
authors.initials: M
authors.lastname: Himeno
authors.forename: Hanae
authors.initials: H
authors.lastname: Makiishi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakagawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kigoshi
authors.forename: Kenzo
authors.initials: K
authors.lastname: Uchida
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003971:Diastole; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism / Q000494:pharmacology; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000502:physiology; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013599:Systole
chemical_list: D007328:Insulin; D005947:Glucose