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题名:Parental history of type 2 diabetes, TCF7L2 variant and lower insulin secretion are associated with incident hypertension. Data from the DESIR and RISC cohorts.
作者:BONNET F; ROUSSEL R; NATALI A; CAUCHI S; PETRIE J; LAVILLE M; YENGO L; FROGUEL P; LANGE C; LANTIERI O; MARRE M; BALKAU B; FERRANNINI E;
来源:Diabetologia. 2013 Nov;56(11):2414-23. doi: 10.1007/s00125-013-3021-y. Epub 2013 [ IF= 6.49 ] ]
URL :10.1007/s00125-013-3021-y
日期:20131203
摘要:AIMS/HYPOTHESIS: The relationship between insulin secretion and the incidence of
hypertension has not been well characterised. We hypothesised that both a
parental history of diabetes and TCF7L2 rs7903146 polymorphism, which increases
susceptibility to diabetes because of impaired beta cell function, are associated
with incident hypertension. In a separate cohort, we assessed whether low insulin
secretion is related to incident hypertension. METHODS: Nine year incident
hypertension was studied in 2,391 normotensive participants from the Data from an
Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort. The
relationship between insulin secretion and 3 year incident hypertension was
investigated in 1,047 non-diabetic, normotensive individuals from the
Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC)
cohort. Insulin secretion during OGTT was expressed in relation to the degree of
insulin resistance, as assessed by a hyperinsulinaemic-euglycaemic clamp.
RESULTS: In the DESIR cohort, a parental history of diabetes and the TCF7L2
at-risk variant were both associated with hypertension incidence at year 9,
independently of waist circumference, BP, fasting glucose, insulin levels and
HOMA-IR at inclusion (p = 0.02 for parental history, p = 0.006 for TCF7L2). In
the RISC cohort, a lower insulin secretion rate during the OGTT at baseline was
associated with both higher BP and a greater risk of hypertension at year 3. This
inverse correlation between the insulin secretion rate and incident hypertension
persisted after controlling for baseline insulin resistance, glycaemia and BP (p
= 0.007). CONCLUSIONS/INTERPRETATION: Parental history of diabetes, TCF7L2
rs7903146 polymorphism and a reduced insulin secretion rate were consistently
associated with incident hypertension. A low insulin secretion rate might be a
new risk factor for incident hypertension, beyond insulin resistance.

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