Free Fatty Acid-Induced Hypertension in Obese Subjects With Type 2 Diabetes
Status:
Completed
Trial end date:
2009-12-01
Target enrollment:
Participant gender:
Summary
Insulin resistance has been implicated as the central pathogenetic feature of cardiovascular
risk factor cluster that includes hypertension, impaired glucose tolerance, diabetes,
dyslipidemia, and hemostatic disorders. Recent evidence suggests that increased levels of
free fatty acids (FFA) in obese subjects is a leading candidate in the pathogenesis of
insulin resistance (1-4). In our preliminary studies on the effect of FFA on insulin
secretion and action (lipotoxicity), we have observed that the infusion of Intralipid/heparin
to increase FFA ~ four-fold-baseline levels for 48 hours results in a significant and
reproducible raise in systolic and diastolic blood pressure (BP) in obese African American
subjects with and without diabetes. The increase in blood pressure is apparent after 12 hours
of infusion, reaching a peak increment of 32 mm Hg in systolic and 14 mm Hg in diastolic
pressure at 24 hours. These preliminary findings indicate that, in addition to the well-known
effect on insulin resistance, sustained elevation of FFA results in the development of an
acute metabolic syndrome.