The Relationgship Among Microalbuminuria And Hypertension And Insulin Resistance In Nondiabetic Chinese Men

Objective To investigate the relationship among microalbuminuria and hypertension and insulin resistance in nondiabetic Chinese men.Method 70 nondiabetic chinese men aged 41 to 52 years were selected to be enrolled in this study on the basis of the results of a 75g glucose tolerance test. They collected 24-h urine completely. The urinary albumin concentration of collected urine samples was measured by radioimmunoassay. Microalbuminuria(MA) was defined as positive when the urinary albumin excretion per day was >0.03g and <0.3g. and as negative when it was <0.03g. The blood pressure was measured with a mercury sphygmomanometer on the right arm in the sitting position after 5 minutes rest. The blood pressure was measured twice in the morning and the lower were used The body weight and body height were measured ,then the body mass index was calculated as weight (in kilograms) divided by height (in meters) squared. The creatinine clearance(Ccr) was calculated with urinary creatinine and serum creatinine. Fractional excretion of sodium(FENa) was also calculated with urinary Na and serum Na. A 75g oral glucose tolerance test was performed in the morning after 11 to 12 fasting hours before the test. After obtaining a fasting blood specimen ,additional specimens were drawn at 30,60,and 120min after administration of a glucose load(75g). Plasma insulin concentrations were measured with radioimmunoassay using kit (Beijing atomic research institute). Plasma glucose concentration, serum uric acid,sodium,total cholesterol, triglycerides and urine sodium,creatinine in fasting serum were examined.with a Beckman CX-6 auto analyzer(Beckman USA). ISI (insulin sensitivity index) were calculated too.All statistic analysis were performed using the SPSS(SPSS Inc,USA) statistic software. Statistic difference of hypertension according to the presence or absence of MA was evaluated by the X2 test. The mean of clinical characteristics according to the presence or absence of MA by t-test. The relationships among microalbuminuria and Ccr, ISI and other clinical characteristics was evaluated by multiple linear regression analysis using stepwise procedure.Results The prevalence of either hypertension or borderline hypertension of MA-positive subjects was significantly higher than MA-negative subjects.The mean level of clinical characteristics were compared according to the presence of absence of MA.A significant increase in serum uric acid, fasting insulin, uric acid,sodium,total cholesterol, triglyceride, Ccr and insulin at 60,120min after glucose intake in the MA-positive subjects. ISI and FENa in MA-positive subjects was significantly lower than MA-negative subjects.In normotensive subjects ,comparisons of clinical characteristics between subjects with and without MA were carried out. The levels of triglyceride, uric acid, total cholesterol, fasting insulin and insulin at 60,120min remained significantly higher in MA-positive subjects than that in MA-negative subjects. ISI decreased in MA-positive subjects. FENa showed no difference.Ccr, diastolic pressure, uric acid and 60min insulin was showed a significant relation to microalbuminuria by multiple stepwise regression analysis using microalbuminuria as an independent variable and other clinical characteristics as dependent variables.Conclusion The results showed that The Ccr of MA-positive subjects were higher than those of MA-negative ones. The FENa of all the hypertensive subjects decreased. .The findings demonstrate that MA-positive subjects have increased triglyceride,total cholesterol, uric acid and insulin levels. The increased insulin level suggests that MA-positive subjects suffered from insulin resistance. And the results implied that blood pressure and ISI are relative to microalbuminuria remarkably.