Aldosterone Is Not Associated With Metabolic and Microvascular Insulin Sensitivity in Abdominally Obese Men

Abstract Context Impaired insulin-mediated muscle microvascular recruitment (IMMR) may add to the development of insulin resistance and hypertension. Increased aldosterone levels have been linked to these obesity-related complications in severely to morbidly obese individuals and to impaired microva...

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Published in:The journal of clinical endocrinology and metabolism 2018-02, Vol.103 (2), p.759-767
Main Authors: Schütten, Monica T J, Kusters, Yvo H A M, Houben, Alfons J H M, Scheijen, Jean L J M, van de Waarenburg, Marjo P H, Schalkwijk, Casper G, Joris, Peter J, Plat, Jogchum, Mensink, Ronald P, de Leeuw, Peter W, Stehouwer, Coen D A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aldosterone
Aldosterone - blood
Blood Glucose - metabolism
Blood pressure
Blood Pressure - physiology
Body weight loss
Complications
Confidence intervals
Excretion
Female
Forearm
Glucose
Humans
Hypertension - complications
Hypertension - metabolism
Insulin
Insulin resistance
Insulin Resistance - physiology
Liquid chromatography
Male
Mass spectrometry
Mass spectroscopy
Metabolism
Microvasculature
Microvessels - metabolism
Middle Aged
Muscle, Skeletal - blood supply
Muscle, Skeletal - metabolism
Muscles
Obesity
Obesity, Abdominal - complications
Obesity, Abdominal - metabolism
Obesity, Abdominal - physiopathology
Obesity, Abdominal - therapy
Potassium
Pressure measurement
Sensitivity
Skeletal muscle
Sodium
Thinness - blood
Thinness - metabolism
Thinness - physiopathology
Ultrasound
Weight loss
Weight Loss - physiology
Weight Reduction Programs
Young Adult
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Summary:Abstract Context Impaired insulin-mediated muscle microvascular recruitment (IMMR) may add to the development of insulin resistance and hypertension. Increased aldosterone levels have been linked to these obesity-related complications in severely to morbidly obese individuals and to impaired microvascular function in experimental studies. Objectives To investigate whether aldosterone levels are associated with IMMR, insulin sensitivity, and blood pressure in lean and moderately abdominally obese men, and to study the effect of weight loss. Design, Setting, Participants, Intervention, Main Outcome Measures In 25 lean and 53 abdominally obese men, 24-hour blood pressure measurement was performed, and aldosterone levels were measured using ultra-performance liquid chromatography tandem mass spectrometry. Insulin sensitivity was assessed by determining whole-body glucose disposal during a hyperinsulinemic clamp. IMMR in forearm skeletal muscle was measured with contrast-enhanced ultrasonography. These assessments were repeated in the abdominally obese men following an 8-week weight loss or weight stable period. Results Sodium excretion and aldosterone levels were similar in lean and abdominally obese participants, but sodium excretion was inversely associated with aldosterone concentration only in the lean individuals [lean, β/100 mmol sodium excretion (adjusted for age and urinary potassium excretion) = −0.481 (95% confidence interval, −0.949 to −0.013); abdominally obese, β/100 mmol sodium excretion = −0.081 (95% confidence interval, −0.433 to 0.271); P for interaction = 0.02]. Aldosterone was not associated with IMMR, insulin sensitivity, or blood pressure and was unaffected by weight loss. Conclusion In moderately abdominally obese men, the inverse relationship between sodium excretion and aldosterone concentration is less than that in lean men but does not translate into higher aldosterone levels. The absolute aldosterone level does not explain differences in microvascular and metabolic insulin sensitivity and blood pressure between lean and moderately abdominally obese men. Serum aldosterone is similar in lean and abdominally obese men, is not associated with insulin-mediated muscle microvascular recruitment or whole-body glucose disposal, and is unchanged after weight loss.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2017-01541