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Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study

OBJECTIVE: Although hyperinsulinemia, a surrogate of insulin resistance, may play a role in the pathogenesis of hypertension (HTN), the longitudinal association between fasting insulin level and HTN development is still controversial. We examined the relation between fasting insulin and incidence of...

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Autores principales: Xun, Pengcheng, Liu, Kiang, Cao, Wenhong, Sidney, Stephen, Williams, O. Dale, He, Ka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379592/
https://www.ncbi.nlm.nih.gov/pubmed/22511258
http://dx.doi.org/10.2337/dc11-2443
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author Xun, Pengcheng
Liu, Kiang
Cao, Wenhong
Sidney, Stephen
Williams, O. Dale
He, Ka
author_facet Xun, Pengcheng
Liu, Kiang
Cao, Wenhong
Sidney, Stephen
Williams, O. Dale
He, Ka
author_sort Xun, Pengcheng
collection PubMed
description OBJECTIVE: Although hyperinsulinemia, a surrogate of insulin resistance, may play a role in the pathogenesis of hypertension (HTN), the longitudinal association between fasting insulin level and HTN development is still controversial. We examined the relation between fasting insulin and incidence of HTN in a large prospective cohort. RESEARCH DESIGN AND METHODS: A prospective cohort of 3,413 Americans, aged 18–30 years, without HTN in 1985 (baseline) were enrolled. Six follow-ups were conducted in 1987, 1990, 1992, 1995, 2000, and 2005. Fasting insulin and glucose levels were assessed by a radioimmunoassay and hexokinase method, respectively. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs of incident HTN (defined as the initiation of antihypertensive medication, systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg). RESULTS: During the 20-year follow-up, 796 incident cases were identified. After adjustment for potential confounders, participants in the highest quartile of insulin levels had a significantly higher incidence of HTN (HR 1.85 [95% CI 1.42–2.40]; P(trend) < 0.001) compared with those in the lowest quartile. The positive association persisted in each sex/ethnicity/weight status subgroup. A similar dose-response relation was observed when insulin-to-glucose ratio or homeostatic model assessment of insulin resistance was used as exposure. CONCLUSIONS: Fasting serum insulin levels or hyperinsulinemia in young adulthood was positively associated with incidence of HTN later in life for both men and women, African Americans and Caucasians, and those with normal weight and overweight. Our findings suggested that fasting insulin ascertainment may help clinicians identify those at high risk of HTN.
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spelling pubmed-33795922013-07-01 Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study Xun, Pengcheng Liu, Kiang Cao, Wenhong Sidney, Stephen Williams, O. Dale He, Ka Diabetes Care Original Research OBJECTIVE: Although hyperinsulinemia, a surrogate of insulin resistance, may play a role in the pathogenesis of hypertension (HTN), the longitudinal association between fasting insulin level and HTN development is still controversial. We examined the relation between fasting insulin and incidence of HTN in a large prospective cohort. RESEARCH DESIGN AND METHODS: A prospective cohort of 3,413 Americans, aged 18–30 years, without HTN in 1985 (baseline) were enrolled. Six follow-ups were conducted in 1987, 1990, 1992, 1995, 2000, and 2005. Fasting insulin and glucose levels were assessed by a radioimmunoassay and hexokinase method, respectively. Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% CIs of incident HTN (defined as the initiation of antihypertensive medication, systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg). RESULTS: During the 20-year follow-up, 796 incident cases were identified. After adjustment for potential confounders, participants in the highest quartile of insulin levels had a significantly higher incidence of HTN (HR 1.85 [95% CI 1.42–2.40]; P(trend) < 0.001) compared with those in the lowest quartile. The positive association persisted in each sex/ethnicity/weight status subgroup. A similar dose-response relation was observed when insulin-to-glucose ratio or homeostatic model assessment of insulin resistance was used as exposure. CONCLUSIONS: Fasting serum insulin levels or hyperinsulinemia in young adulthood was positively associated with incidence of HTN later in life for both men and women, African Americans and Caucasians, and those with normal weight and overweight. Our findings suggested that fasting insulin ascertainment may help clinicians identify those at high risk of HTN. American Diabetes Association 2012-07 2012-06-12 /pmc/articles/PMC3379592/ /pubmed/22511258 http://dx.doi.org/10.2337/dc11-2443 Text en © 2012 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Xun, Pengcheng
Liu, Kiang
Cao, Wenhong
Sidney, Stephen
Williams, O. Dale
He, Ka
Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title_full Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title_fullStr Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title_full_unstemmed Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title_short Fasting Insulin Level Is Positively Associated With Incidence of Hypertension Among American Young Adults: A 20-year follow-up study
title_sort fasting insulin level is positively associated with incidence of hypertension among american young adults: a 20-year follow-up study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379592/
https://www.ncbi.nlm.nih.gov/pubmed/22511258
http://dx.doi.org/10.2337/dc11-2443
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