Insulin resistance, not diabetes status, determines blood pressure in obese and type 2 diabetic patients
Bibliographic record
Abstract
Hypertension is often considered to be a complication of type 2 diabetes, yet is often seen in the pre-diabetic state as a component of the metabolic syndrome. The purpose of this study was to determine whether dysglycemia versus insulin resistance was more closely linked to the vascular changes leading to hypertension. Twenty-eight adult subjects, representing a spectrum of blood pressures and insulin sensitivities, took part in this study. None of the subjects were on antihypertensive medication and the five subjects on anti-diabetic medication had this withdrawn prior to the study. Each subject underwent standardized measurement of blood pressure on two occassions, coincident with the measurement of insulin resistance via the hyperinsulinemic, euglycemic clamp as well as by the 13C-glucose breath test. The inter-relationships between insulin resistance, glycemia, blood pressure and demographic variables were then explored using ANOVA, ANCOVA, and various regression analyses. Although results showed a correlation between fasting blood glucose levels and blood pressures, adjustment for insulin sensitivity totally abolished this relationship. Similarly, there was no correlation between hepatic glucose output and blood pressure. On the other hand, there was a correlation between insulin resistance and blood pressures that was unaffected by blood glucose level. For example, mean arterial pressure correlated with insulin senstivity index from the insulin clamp with an r of −0.50 (p=.009). Generally, all measures of insulin resistance and all measures of blood pressure correlated to about this degree, at a similar level of statistical significance. Blood glucose did not influence these relationships in any substantive manner. Categorically, there was no difference in blood pressures between insulin resistant, non diabetic individuals and diabetic individuals, although their blood pressures were collectively higher than non-diabetic, non-insulin resistant individuals. After adjustment for insulin resistance, there was no difference in blood pressure between any of the study subjects regardless of clinical classification. Blood glucose did not affect categorical analyses. We concluded that insulin resistance is a much stronger determinant of vascular status, as measured by blood pressure, than is blood glucose. These results may help explain the increased cardiovascular risk prior to the onset of overt type 2 diabetes. Am J Hypertens (2004) 17, 32A–32A; doi: 10.1016/j.amjhyper.2004.03.073
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".