Insulin resistance affecting skeletal muscle metabolism is present in the prehypertensive state. The aim of our study was to test the hypothesis that blood pressure value is related to skeletal muscle composition, measured by (31)P magnetic resonance (MR) spectroscopy, and to insulin sensitivity in the offspring of hypertensive parents (OH) and healthy controls. Study groups consisted of 10 healthy young lean OH with normal glucose tolerance, confirmed with oral glucose tolerance test, and 13 controls matched for age, sex, and body mass index. Insulin action was estimated as glucose disposal (M), glucose metabolic clearance rate (MCR), and insulin sensitivity index (M/I) during a 10-hour hyperinsulinemic euglycemic clamp. The sum of immunoreactive insulin values from the oral glucose tolerance test was calculated. (31)P MR spectroscopy was performed on a whole-body MR scanner (Siemens Vision, Erlangen, Germany) operating at 1.5 T and equipped with actively shielded gradient coils. There were no differences in common metabolic and anthropometric parameters between OH and controls except for the blood pressure, which was in the range of normal to high-normal level in OH. Mean blood pressure was significantly higher in OH (95.73 +/- 4.39 vs 83.76 +/- 3.95 mm Hg; P < .001). Trend toward insulin resistance was registered in OH with significantly lower M/I (0.74 +/- 0.47 vs 1.42 +/- 0.65 mg x kg(-1) x min(-1) x mIU(-1) x L(-1); P < .05). There were no significant differences in total serum magnesium (sMg) levels between OH and controls, although a positive correlation exists between sMg and insulin sensitivity expressed as M (r = 0.63, P < .01), MCR (r = 0.54, P < .01), and M/I (r = 0.51, P < .05). No differences in signal intensities of phosphocreatine (PCr), phosphomonoesters, phosphodiesters, inorganic phosphates (Pi), adenosine triphosphates (Patp and betaATP), and calculated concentrations of intracellular ionized magnesium (Mgi) and H(+) ions between the groups were detected. Systolic blood pressure correlates positively with PCr/Patp (r = 0.43, P < .05), Pi/Patp (r = 0.413, P < .05), and Pi/betaATP (r = 0.48, P < .05). Diastolic blood pressure correlates positively only with the ratio Pi/betaATP (r = 0.42, P < .05). The sum of immunoreactive insulin values correlates with PCr/betaATP (r = 0.53, P < .01) and with Pi/betaATP (r = 0.6, P < .01). In conclusion, increase in blood pressure and insulin resistance were confirmed in offspring of OH. Insulin sensitivity is related to sMg and the elevation of blood pressure is associated with the activation of energy metabolism in skeletal muscle. The relationship between muscle energetic characteristics and markers of insulin resistance suggests that the alteration of energy metabolism may be present in early stages of metabolic syndrome.

译文

影响骨骼肌代谢的胰岛素抵抗在高血压前期存在。我们研究的目的是检验以下假设: 血压值与通过 (31)P磁共振 (MR) 光谱法测量的骨骼肌组成以及高血压父母 (OH) 和健康的后代的胰岛素敏感性有关对照。研究组由10个健康的年轻lean OH组成,葡萄糖耐量正常,经口服葡萄糖耐量试验证实,以及13个年龄,性别和体重指数相匹配的对照。在10小时的高胰岛素血症正常血糖钳夹中,胰岛素的作用估计为葡萄糖处置 (M),葡萄糖代谢清除率 (MCR) 和胰岛素敏感性指数 (M/I)。计算了口服葡萄糖耐量试验的免疫反应性胰岛素值之和。(31) 在操作于1.5 T并配备有主动屏蔽梯度线圈的全身MR扫描仪 (Siemens Vision,Erlangen,德国) 上进行P MR光谱。OH和对照组之间的常见代谢和人体测量参数没有差异,但血压在OH的正常至正常水平范围内。OH中的平均血压显着更高 (95.73/- 4.39 vs 83.76/-3.95毫米Hg; P <.001)。在OH中记录了胰岛素抵抗的趋势,M/I显著降低 (0.74 +/- 0.47 vs 1.42 +/- 0.65 mg × kg(-1) × min(-1) × mIU(-1) × L(-1); P <.05)。血清总镁 (sMg) 水平与对照组无显著差异,但sMg与胰岛素敏感性呈正相关,表现为M (r = 0.63,P <.01),MCR (r = 0.54,P <.01)。和M/I (r = 0.51,P <.05)。检测到磷酸肌酸 (PCr),磷酸单酯,磷酸二酯,无机磷酸盐 (Pi),三磷酸腺苷 (Patp和 βatp) 的信号强度以及计算的细胞内离子镁 (Mgi) 和H () 离子浓度之间的差异。收缩压与PCr/Patp (r = 0.43,P <.05) 、Pi/Patp (r = 0.413,P <.05) 和Pi/betaATP (r = 0.48,P <.05) 呈正相关。舒张压仅与Pi/βatp比值正相关 (r = 0.42,P <.05)。免疫反应性胰岛素值的总和与PCr/betaATP (r = 0.53,P <.01) 和Pi/betaATP (r = 0.6,P <.01) 相关。总之,在OH的后代中证实了血压升高和胰岛素抵抗。胰岛素敏感性与sMg有关,血压升高与骨骼肌能量代谢的激活有关。肌肉能量特征与胰岛素抵抗标志物之间的关系表明,能量代谢的改变可能存在于代谢综合征的早期阶段。

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