Behavior of C-peptide and immunoreactive insulin in essential obesity]

The levels of glucose, immunoreactive insulin and C-peptide were studied in 13 obese patients and 10 control subjects, in basal conditions and after an oral glucose load (OGTT). The IRI and C-peptide levels were higher in the obese patients than in the controls either during fasting or during the OGTT. The C-peptide/IRI ratio decreased after the oral glucose load in both groups studied. However in the obese subjects the values for the C-peptide/IRI ratio were lower than those found in the controls during the same observation period. These results suggest the hypothesis that in the obese patients the high IRI levels which reflect an increased insulin secretion, are, at least in part, due to an early saturation of the hepatic degradation of insulin and/or to a decrease in the specific receptor sites normally present in the cell membranes.     

Gene polymorphisms of the renin-angiotensin-aldosterone system and essential arterial hypertension in childhood

In order to investigate the contribution of candidate genes in the renin-angiotensin-aldosterone system (RAAS) in pathogenesis of essential arterial hypertension (EAH), the I/D polymorphism of ACE gene, the M235T polymorphism of the angiotensinogen gene, and the angiotensin II type 1 receptor (AGT,R) A1166C gene polymorphism in a group of children with EAH were analyzed. Fifty-scven children, aged 8-19 years. with the diagnosis of EAH were included in the association study and were compared with 57 subjects with normal blood pressure (the control group). Arterial hypertension was defined as systolic/diastolic blood pressure measurements higher than 95 age-gender-height percentile of the adopted reference values. A trend was found towards an association between the M235T angiotensinogen gene polymorphism and EAH in childhood in a dominant model (odds ratio (OR) 2.1; 95% confidence interval (CI) 0.9-5.1; P = 0.077), whereas the authors failed to demonstrate an association between the ACE I/D gene polymorphism, or the A1166C AGT1R gene polymorphism and EAH in childhood. Additionally, evidence was found of interaction between the angiotensinogen-TT genotype and obesity on the risk of EAH in childhood (OR 19.3; 95% CI 1.1-77.3; P = 0.014). In conclusion, the M235T angiotensinogen gene polymorphism is considered alone as well as in interaction with obesity to be risk factors for EAH in childhood.     

Aldosterone and magnesium in essential arterial hypertension

Thirty mildly hypertensive patients and 27 patients with severe essential hypertension and high levels of aldosterone were selected for a study of the relationship between plasma aldosterone and magnesium in essential arterial hypertension; levels of calcium and potassium were also studied. Thirty-six individuals were used as a control group. Our findings indicate that as plasma aldosterone levels increase, serum magnesium levels decrease correspondingly: in mild hypertensives with low levels of plasma aldosterone p less than 0.05 and in the most severely hypertensive patients with high levels of plasma aldosterone p less than 0.001. In this latter group we also found an inverse correlation between serum magnesium and systolic arterial pressure (p less than 0.001) and diastolic pressure (p less than 0.01). In these patients a significant increase in urinary excretion of magnesium was found, with levels 3 times higher than in the control group. These findings suggest a close relationship between changes in plasma aldosterone and magnesium. Possibly the aldosterone contributes through this mechanism to maintaining the hypertensive state in essential arterial hypertension. This action is exercised directly through the kidney, leading to a small but constant urinary loss of magnesium. This in turn leads to a chronic depletion of magnesium in hypertensives who have high levels of plasma renin activity and highly elevated plasma aldosterone.     

Psychophysiologic markers of arterial hypertension]

Many studies, concerning cardiovascular reactivity in hypertensives, show contrasting data. The aim of the present study was to check, also measuring extracardiovascular variables, a procedure able to identify a peculiar characteristic of the prehypertensive phase. We studied 47 normotensives, who referred high blood pressure values, but that we did not find in our visit. The cardioneurovascular assessment was evaluated, by means of a non invasive, beat to beat technique, measuring SBP, DBP, HR, muscular contraction and skin conductance level (EMG, SCL), peripheric temperature (PT), during a psychophysiologic session. This was composed by 4 stressors (mental arithmetic and Sacks test, acoustic and electric stimulations), 5 minutes each, preceded and followed by an observation period of 10 minutes. After 18 month follow-up, we could distinguish 26 hypertensives (H), and 21 subjects maintained normal blood pressure values (N). The obtained findings showed, with statistical significance, 1) the hyperresponsiveness of SCL and PT; 2) the failed recovery, with consequent hyperdysreactivity, of SCL and PT; 3) the presence of both these phenomena in the H., while SBP, DBP and HR responses did not result a discriminative tool. These data seem 1) to reinforce the hypothesis that a hypersympathetic phase can characterize the prehypertensive stages of essential hypertension and 2) to suggest the psychophysiological approach as a useful method to diagnose prehypertension.     

Expression of the pro-opiomelanocortin gene in rats with inherited arterial hypertension]

Expression of pro-opiomelanocortin (POMC) gene in pituitary of rats from newly developed hypertensive strain (ISIAH strain) was studied by dot hybridization. The pUC8 plasmid containing 900 base pair (bp) segment or the human POMC gene corresponding to the major portion of the 3'-nontranslated mRNA region and 60 bp coding for the signal peptide, was used as a probe for hybridization. It was found that the expression of the POMC in pituitary of the hypertensive JSJAH rats was more than 3-fold gene lower as compared to normotensive Wistar strain. The latter is the original strain from which the ISIAH rats were bred. The mechanism of this phenomenon and its possible relation to the arterial hypertension are discussed.     

Reactivity of the hypothalamo-pituitary-adrenocortical system in rats with hereditary arterial hypertension

The function of hypothalamo-hypophyseal-adrenocortical system was studied in rats with inherited stress-sensitive arterial hypertension (ISSAH). The rats have been bred from the outbred Wistar strain. It was found that plasma corticosteroid level in ISSAH rats was lower after immobilization stress and higher after stress induced by a combination of stress-factors (ether, 0.7 ml blood loss, novel situation), as compared to Wistar rats. ISSAH rats also showed a reduced reaction to intracerebroventricular noradrenaline (10 micrograms) injection. It was concluded that the changes of noradrenergig brain mechanisms can be responsible for the alterations in the central regulation of blood pressure and adrenocortical function in ISSAH rats.     

Insulin and C-peptide levels in patients with idiopathic arterial hypertension]

Insulinemia in patients with essential hypertension and normal glucose tolerance was assessed. The study involved 25 patients divided into subgroups according body weight and 9 of control subjects. It was found, that hyperinsulinemia seen in hypertensive patients seems to be associated with obesity. Moreover, hyperinsulinemia does not depend primarily on hypersecretion of insulin but may reflect resistance to insulin and ab normal metabolism in the liver.