Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

See all formats and pricing
More options …
Volume 44, Issue 12


Insulin resistance and enhanced protein glycation in men with prehypertension

Viswanathan Sathiyapriya
  • Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Hanumanthappa Nandeesha
  • Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Zachariah Bobby
  • Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Purushothaman Pavithran
  • Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nambiar Selvaraj
  • Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nadaradjan Rattina Dasse
  • Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2006-12-13 | DOI: https://doi.org/10.1515/CCLM.2006.264


Background: Insulin resistance and hyperinsulinemia have been reported among patients with hypertension. However, little is known about insulin sensitivity in subjects with prehypertension. The aim of this study was to assess whether the metabolic characteristics of insulin resistance syndrome are present in prehypertensive subjects.

Methods: Plasma fasting glucose, lipid profile, glycated hemoglobin, fructosamine and insulin concentrations were evaluated in 35 prehypertensive subjects and in 30 healthy controls.

Results: Prehypertensive subjects had significantly higher levels of plasma insulin and triglycerides compared with normotensive subjects. The level of high-density lipoprotein cholesterol was significantly lower in prehypertensive subjects compared with controls. There was no significant difference in total cholesterol and low-density lipoprotein cholesterol levels. The levels of glycated hemoglobin and fructosamine were also significantly higher in prehypertensive subjects compared with controls. Plasma insulin levels were positively correlated with systolic and diastolic blood pressure in prehypertensive subjects. Similarly, plasma insulin was significantly positively correlated with triglyceride and negatively correlated with high-density lipoprotein cholesterol.

Conclusions: The present study indicates that prehypertensive non-diabetic subjects have higher insulin resistance and protein glycation compared to normotensive subjects, which may contribute to the pathogenesis of prehypertension.

Clin Chem Lab Med 2006;44:1457–61.

Keywords: hyperinsulinemia; hypertension; insulin resistance; prehypertension; protein glycation


  • 1.

    Reddy KS. Hypertension control in developing countries: generic issues. J Hum Hypertens 1996; 10:S33–8.Google Scholar

  • 2.

    Gupta R. Meta analysis of prevalence of hypertension in India. Indian Heart J 1997; 49:43–8.Google Scholar

  • 3.

    DeFronzo RA, Ferrannini E. Insulin resistance: a multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care 1991; 14:173–94.CrossrefGoogle Scholar

  • 4.

    Salonen JT, Lakka JA, Lakka HM, Valkonen VP, Everson SA, Kaplan GA. Hyperinsulinemia is associated with the incidence of hypertension and dyslipidemia in middle aged men. Diabetes 1998; 47:270–5.CrossrefGoogle Scholar

  • 5.

    Stolar MW. Atherosclerosis in diabetes: the role of hyperinsulinemia. Metabolism 1988; 37:1–9.CrossrefGoogle Scholar

  • 6.

    Reaven GM. Insulin resistance, the insulin resistance syndrome, and cardiovascular disease. Panminerva Med 2005; 47:201–10.Google Scholar

  • 7.

    Sheu WH, Jeng CY, Shieh SM, Fuh MM, Shen DD, Chen YD, et al. Insulin resistance and abnormal electrocardiograms in patients with high blood pressure. Am J Hypertens 1992; 5:444–8.CrossrefGoogle Scholar

  • 8.

    Wolff SP, Jiang ZY, Hunt JV. Protein glycation and oxidative stress in diabetes mellitus and ageing. Free Radic Biol Med 1991; 10:339–52.Google Scholar

  • 9.

    Zhoa R, Shen GX. Functional modulation of antioxidant enzymes in vascular endothelial cells by glycated LDL. Atherosclerosis 2005; 179:277–84.Google Scholar

  • 10.

    Chowdhury TA, Lasker SS. Elevated glycated haemoglobin in non-diabetic patients is associated with an increased mortality in myocardial infarction. Postgrad Med J 1998; 74:480–1.CrossrefGoogle Scholar

  • 11.

    Sabater J, Quereda C, Herrera I, Pascual J, Villafruella JJ, Ortuno J. Nonenzymatic glycosylation of hemoglobin and total plasmatic proteins in end-stage renal disease. Am J Nephrol 1991; 11:37–43.CrossrefGoogle Scholar

  • 12.

    Nilsson PM, Lind L, Pollare T, Berne C, Lithell HO. Increased level of hemoglobin A1C, but not impaired insulin sensitivity, found in hypertensive and normotensive smokers. Metabolism 1995; 44:557–61.CrossrefGoogle Scholar

  • 13.

    Roberts RN, Traub AI, Kennedy AL, Hadden DR. Glycosylated haemoglobin and hypertension arising in pregnancy. Br J Obest Gynaecol 1998; 105:1122–4.CrossrefGoogle Scholar

  • 14.

    Kanauchi M, Kanauchi K, Hashimoto T, Saito Y. Metabolic syndrome and new category “pre-hypertension” in a Japanese population. Curr Med Res Opin 2004; 20:1365–70.CrossrefGoogle Scholar

  • 15.

    Cordero A, Laclaustra M, León M, Grima A, Casasnovas JA, Luengo E, et al. Prehypertension is associated with insulin resistance state and not with an initial renal function impairment. A Metabolic Syndrome in Active Subjects in Spain (MESYAS) Registry substudy. Am J Hypertens 2006; 19:189–96.CrossrefGoogle Scholar

  • 16.

    Chobanian AV, Bakris GR, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure: the JNC 7 report. J Am Med Assoc 2003; 289:2560–72.Google Scholar

  • 17.

    Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart study: a cohort study. Lancet 2001; 358:1682–6.Google Scholar

  • 18.

    Das SK, Sanyal K, Basu A. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country. Int J Med Sci 2005; 2:70–8.CrossrefGoogle Scholar

  • 19.

    Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18:499–502.Google Scholar

  • 20.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985; 28:412–9.CrossrefGoogle Scholar

  • 21.

    Grunfeld BM, Balzareti M, Romo M, Gimenez M, Gutman R. Hyperinsulinemia in normotensive offspring of hypertensive patients. Hypertension 1994; 3:112–5.Google Scholar

  • 22.

    Cubeddu LX, Hoffmann IS. Insulin resistance and upper-normal glucose levels in hypertension: a review. J Hum Hypertens 2002; 16:S52–5.CrossrefGoogle Scholar

  • 23.

    Capaldo B, Lembo G, Napoli R, Rendina V, Albano G, Sacca L, et al. Skeletal muscle is primary site of insulin resistance in essential hypertension. Metabolism 1991; 40:1320–2.CrossrefGoogle Scholar

  • 24.

    Ferrannini E. Insulin resistance in essential hypertension. N Engl J Med 1987; 317:350–7.Google Scholar

  • 25.

    McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med 2003; 139:802–9.Google Scholar

  • 26.

    McLaughlin T, Reaven G, Abbasi F, Lamendola C, Saad M, Waters D, et al. Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? Am J Cardiol 2005; 96:399–404.CrossrefGoogle Scholar

  • 27.

    Lemieux I, Lamarche B, Couillard C, Pascot A, Cantin B, Bergeron J, et al. Total cholesterol/HDL cholesterol ratio vs. LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study. Arch Intern Med 2001; 61:2685–92.CrossrefGoogle Scholar

  • 28.

    Haffner SM, Valdez RA, Hazuda HP, Mitchell BD, Morales PA, Stern MP. Prospective analysis of the insulin resistance syndrome (syndrome X). Diabetes 1992; 41:715–22.CrossrefGoogle Scholar

  • 29.

    Garg A. Insulin resistance in the pathogenesis of dyslipidemia. Diabetes Care 1996; 19:387–9.CrossrefGoogle Scholar

  • 30.

    Laakso M. The possible pathophysiology of insulin resistance syndrome. Cardiovasc Risk Factors 1993; 3:55–66.Google Scholar

  • 31.

    Kshirsagar AV, Carpenter M, Bang H, Wyatt SB, Colindres RE. Blood pressure usually considered normal is associated with an elevated risk of cardiovascular events. Am J Med 2006; 119:133–41.Google Scholar

  • 32.

    Sowers JR, Standley PR, Ram JL, Jacober S, Simpson L, Rose K. Hyperinsulinemia, insulin resistance, and hyperglycemia: contributing factors in the pathogenesis of hypertension and atherosclerosis. Am J Hypertens 1993; 6:S260–70.CrossrefGoogle Scholar

  • 33.

    Scherrer U, Randin D, Vollenweider P, Vollenweider L, Nicod P. Nitric oxide accounts for insulin's vascular effects in humans. J Clin Invest 1994; 94:2511–5.CrossrefGoogle Scholar

  • 34.

    Suzuki M, Shinozaki K, Kanazawa A, Hara Y, Hattori Y, Tsushima M, et al. Insulin resistance as an independent risk factor for carotid wall thickening. Hypertension 1996; 28:593–8.CrossrefGoogle Scholar

  • 35.

    Lapolla A, Tessari P, Poli T, Valerio A, Duner E, Iori E, et al. Reduced in vivo activity of in vitro glycosylated insulin. Diabetes 1988; 37:787–91.CrossrefGoogle Scholar

  • 36.

    Jain SK, Palmer M. The effect of oxygen radicals metabolites and vitamin E on glycosylation of proteins. Free Radic Biol Med 1997; 22:593–6.Google Scholar

  • 37.

    Selvaraj N, Bobby Z, Sathiyapriya V. Effect of lipid peroxides and antioxidants on glycation of hemoglobin: an in vitro study on human erythrocytes. Clin Chim Acta 2006; 366:190–5.Google Scholar

About the article

Corresponding author: Dr. Zachariah Bobby, Assistant Professor, Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry-605 006, India Phone: +91-413-2273078, Fax: +91-413-2372067,

Received: 2006-07-14

Accepted: 2006-08-31

Published Online: 2006-12-13

Published in Print: 2006-12-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 44, Issue 12, Pages 1457–1461, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2006.264.

Export Citation

©2006 by Walter de Gruyter Berlin New York.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Alireza Esteghamati, Omid Khalilzadeh, Mehrshad Abbasi, Manouchehr Nakhjavani, Leila Novin, and Abdul Reza Esteghamati
Clinical and Experimental Hypertension, 2008, Volume 30, Number 5, Page 297
Nambiar Selvaraj, Viswanathan Sathiyapriya, Zachariah Bobby, Hanumanthappa Nandeesha, and Agrawal Aparna
Clinical and Experimental Hypertension, 2013, Volume 35, Number 3, Page 195
Selvaraj Nambiar, Sathiyapriya Viswanathan, Bobby Zachariah, Nandeesha Hanumanthappa, Aparna Agrawal, and Rattina Dasse Nadaradjan
Clinical and Experimental Hypertension, 2012, Volume 34, Number 7, Page 517
Kim E. Innes, Terry Kit Selfe, and Abhishek Vishnu
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2011, Volume 5, Number 4, Page 179
Viswanathan Sathiyapriya, Nambiar Selvaraj, Hanumanthappa Nandeesha, Zachariah Bobby, Aparna Agrawal, and Purushothaman Pavithran
Archives of Medical Research, 2007, Volume 38, Number 8, Page 822
Gang Chen, Xiaolan Lai, Qiqin Jiang, Feng Chen, Nianhui Chen, Huibin Huang, Jixing Liang, Liantao Li, Junping Wen, Lixiang Lin, and Jin Yao
Atherosclerosis, 2011, Volume 217, Number 1, Page 279
C.-M. Hwu, T.-L. Liou, L.-C. Hsiao, and M.-W. Lin
QJM, 2009, Volume 102, Number 10, Page 705

Comments (0)

Please log in or register to comment.
Log in