Hypertension, Vol 14, 367-374, Copyright © 1989 by American Heart Association
AP Rocchini, V Katch, D Kveselis, C Moorehead, M Martin, R Lampman and M Gregory
The effect of insulin on the renal handling of sodium was studied in obese
and nonobese subjects by using euglycemic hyperinsulinemia. Seven
water-loaded obese (14-19 years old) and five nonobese young adults (18- 21
years old) had insulin given intravenously at a rate of 40 munits/m2/min.
Blood glucose and creatinine clearance were not altered by euglycemic
hyperinsulinemia in either the obese or the nonobese group.
Hyperinsulinemia resulted in a significant decrease in urinary sodium
excretion in both groups of subjects (by 54.2 +/- 3% [mean +/- SEM] in the
obese and by 50.9 +/- 3.1% in the nonobese group). However, the amount of
glucose required to maintain euglycemia was significantly less in the obese
versus nonobese group, 89.5 +/- 6.2 versus 329.2 +/- 16 mg glucose/m2/min
(p less than 0.001). There was no relation in either group between the
amount of glucose required to maintain euglycemia and the change in urinary
sodium excretion. On a separate day, all of the obese subjects underwent 3
hours of water diuresis but without insulin. There was no change in urinary
sodium excretion with sustained water diuresis alone. However, when
compared with the nonobese group, the obese group of subjects had a
significantly higher resting mean arterial pressure, heart rate, and plasma
norepinephrine concentration; during the insulin clamp, neither group
experienced a significant change in mean arterial pressure or heart rate,
and only the nonobese group experienced an increase in plasma
norepinephrine. In obese subjects, we have found, despite the presence of
insulin resistance to carbohydrate metabolism, that euglycemic
hyperinsulinemia was associated with a normal decrease in urinary sodium
excretion.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Insulin and renal sodium retention in obese adolescents
Department of Pediatrics, University of Michigan, Ann Arbor 48109-0204.
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