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© 2020. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

BACKGROUND. Salt-sensitive hypertension is often accompanied by insulin resistance in obese individuals, but the underlying mechanisms are obscure. Microvascular function is known to affect both salt sensitivity of blood pressure and metabolic insulin sensitivity. We hypothesized that excessive salt intake increases blood pressure and decreases insulin-mediated glucose disposal, at least in part by impairing insulin-mediated muscle microvascular recruitment (IMMR).

METHODS. In 20 lean and 20 abdominally obese individuals, we assessed mean arterial pressure (MAP; 24-hour ambulatory blood pressure measurements), insulin-mediated whole-body glucose disposal (M/I value; hyperinsulinemic-euglycemic clamp technique), IMMR (contrast-enhanced ultrasound), osmolyte and water balance, and excretion of mineralocorticoids, glucocorticoids, and amino and organic acids after a low- and high-salt diet during 7 days in a randomized, double-blind, crossover design.

RESULTS. On a low-, as compared with a high-salt, intake, MAP was lower, M/I value was lower, and IMMR was greater in both lean and abdominally obese individuals. In addition, natural logarithm IMMR was inversely associated with MAP in lean participants on a low-salt diet only. On a high-salt diet, free water clearance decreased, and excretion of glucocorticoids and of amino acids involved in the urea cycle increased.

CONCLUSION. Our findings imply that hemodynamic and metabolic changes resulting from alterations in salt intake are not necessarily associated. Moreover, they are consistent with the concept that a high-salt intake increases muscle glucose uptake as a response to high salt–induced, glucocorticoid-driven muscle catabolism to stimulate urea production and thereby renal water conservation.

TRIAL REGISTRATION. ClinicalTrials.gov, NCT02068781.

Details

Title
Glucocorticoids affect metabolic but not muscle microvascular insulin sensitivity following high versus low salt intake
Author
Monica T.J. Schütten; Yvo H.A.M. Kusters; Alfons J.H.M. Houben; Niessen, Hanneke E; Jos op ’t Roodt; Jean L.J.M. Scheijen; Marjo P. van de Waardenburg; Schalkwijk, Casper G; de Leeuw, Peter W; Coen D.A. Stehouwer
Section
Research Articles
Publication year
2020
Publication date
Mar 2020
Publisher
American Society for Clinical Investigation
e-ISSN
23793708
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3256004718
Copyright
© 2020. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.