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Titolo:
THE RUBENESQUE PREGNANCY - A PROGRESSION TOWARDS HIGHER BLOOD-PRESSURE CORRELATES WITH A MEASURE OF ENDOGENOUS AND EXOGENOUS INSULIN LEVELS
Autore:
JOVANOVICPETERSON L; MEISEL B; BEVIER W; PETERSON CM;
Indirizzi:
SANSUM MED RES FDN,2219 BATH ST SANTA BARBARA CA 93105
Titolo Testata:
American journal of perinatology
fascicolo: 4, volume: 14, anno: 1997,
pagine: 181 - 186
SICI:
0735-1631(1997)14:4<181:TRP-AP>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
GESTATIONAL DIABETES-MELLITUS; NON-DIPPERS; HYPERTENSION; RESISTANCE; DISEASE; NIDDM; WOMEN; GDM;
Keywords:
GESTATIONAL DIABETES; BLOOD PRESSURE; INSULIN RESISTANCE; CIRCULATING INSULIN LEVELS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
L. Jovanovicpeterson et al., "THE RUBENESQUE PREGNANCY - A PROGRESSION TOWARDS HIGHER BLOOD-PRESSURE CORRELATES WITH A MEASURE OF ENDOGENOUS AND EXOGENOUS INSULIN LEVELS", American journal of perinatology, 14(4), 1997, pp. 181-186

Abstract

Women with gestational diabetes tend to progress to noninsulin-dependent diabetes (NIDDM) with a high cumulative incidence relative to the general population. These women have also been shown to be insulin resistant and may represent a variant of the insulin resistance syndrome or Syndrome X. Our previous studies indicated that administered insulin was associated with an increase in blood pressure in women with gestational diabetes, raising the question that insulin levels per se contribute to blood pressure in these women. We developed a means by whichthe insulin levels of a given pregnant individual might be estimated called the Fraction of Circulating Insulin Level Relative to Normal (FOCILRN = C-PEPTIDE/2.0 + TOTAL DAILY INSULIN DOSE/CALCULATED DAILY INSULIN REQUIREMENT BASED ON WEIGHT AND GESTATIONAL WEEK). The formula was applied to 15 nonhypertensive pregnant women of comparable obese phenotype (Rubenesque) with varying degrees of glucose tolerance (4 normal, 5 gestational diabetes treated with diet alone, 4 gestational diabetes treated with insulin, and 2 noninsulin-dependent diabetes). Blood pressure was quantified at the beginning of the study (gestational weeks 24-34) and again 4-8 weeks later using a 24-hr monitor. Correlationanalysis was used to test for a relationship between the FOCILRN and blood pressure. The increase in mean arterial pressure was found to becontinuous and linear with increasing insulin exposure as quantified by FOCILRN. The correlation was significant for all subjects (r = 0.961, p < 0.001) and remained significant even with removal of patients with NIDDM (r = 0.857, p < 0.001). The nighttime heart rate, systolic and diastolic blood pressures were found to be significantly correlatedwith FOCILRN (r = 0.651, p < 0.01, r = 0.724, p < 0.001, and r = 0.831, p < 0.001, respectively). The difference between the maximum and minimum diastolic blood pressure values between 12:00 AM and 6:00 AM between sessions 1 and 2 significantly differed among the groups with women on insulin having the highest FOCILRN having the least variation inblood pressure. In nonhypertensive women of obese phenotype (Rubenesque), increasing insulin exposure is associated with increasing mean arterial blood pressure and less variability of nocturnal blood pressure. These data provide support for the hypothesis that insulin may mediate blood pressure response in genetically vulnerable individuals. The identification of the Rubenesque phenotype during gestation may be a clinically useful marker for individuals at risk for Syndrome X.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 21:25:27