Journal
DIABETOLOGIA
Volume 56, Issue 11, Pages 2414-2423Publisher
SPRINGER
DOI: 10.1007/s00125-013-3021-y
Keywords
Hypertension; Insulin secretion; Parental history of diabetes; TCF7L2; Type 2 diabetes
Categories
Funding
- Inserm
- CNAMTS
- Lilly
- Novartis Pharma
- Sanofi-Aventis
- Inserm (Reseaux en Sante Publique, Interactions entre les determinants de la sante)
- Cohortes Sante TGIR
- Association Diabete Risque Vasculaire
- Federation Francaise de Cardiologie
- La Fondation de France
- ALFEDIAM
- ONIVINS
- Ardix Medical
- Bayer Diagnostics
- Becton Dickinson
- Cardionics
- Merck Sante
- Novo Nordisk
- Pierre Fabre
- Roche
- Topcon
- EU [QLG1-CT-2001-01252]
- AstraZeneca (Sweden)
- Merck Serono, France
- MRC [G1002084] Funding Source: UKRI
- Medical Research Council [G1002084] Funding Source: researchfish
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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. 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. 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). 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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