Nishant Wadhera1 , Sidharth Mangla2 , Abhishek Gupta3 , Saurabh Singhal4
BACKGROUND Individuals developing type 2 diabetes generally go through phases of insulin resistance and pre-diabetes, though it may often remain un-noticed. This syndrome is due to decreased insulin secretion which even may be a part of a bigger collection of symptoms termed as metabolic syndrome. The study was conducted to correlate insulin resistance with hypertension and its correlations with various parameters such as Homeostatic Model Assessment of Insulin Resistance (HOMA–IR) test, lipid profile, and anthropometric measurements. METHODS This cross-sectional study was performed among 100 patients in the Department of Medicine at Chhatrapati Shivaji Subharti Hospital from December 2018 to March 2020. Data was collected by a preformed structured interviewer-administered questionnaire which was pretested and modified before the study commenced. Patients were interviewed for the demographic, socioeconomic status, medical history and previous treatment history. Anthropometric measurements such as height, weight, and waist circumference, were measured. BMI was recorded. Serum insulin and fasting glucose level in serum were measured as one of the diagnostic parameters for the confirmation of insulin resistance. HOMA-IR (Fasting Insulin (µU / mL) X Fasting Blood Glucose (mg / dL) / 405) was utilised to estimate insulin resistance. RESULTS Insulin resistance was present among 41 % and absent in 59 % of the hypertensive subjects. Mean HOMA-IR was 2.47 ± 0.67, 2.89 ± 0.53 and 3.51 ± 0.74 among subjects with Elevated / Hypertensive Stage I, Hypertensive Stage II and Hypertensive Emergency grades respectively (p < 0.05). Average fasting insulin was 5.93 ± 2.66, 7.61 ± 2.14 and 15.13 ± 4.91 among subjects with Elevated / Hypertensive Stage I, Hypertensive Stage II and Hypertensive Emergency grade respectively. CONCLUSIONS Hyperinsulinaemia and insulin resistance plays a fundamental role in pathophysiology of increased blood pressure. It is proposed that increase in BP is related to change in insulin action, sensitivity, and resistance. The study showed a significant increase of BMI and WC of essential hypertensive patients and more weight gain associated with severity of insulin resistance. Thus, the magnitude of weight gain and obesity is related with enhanced susceptibility to insulin resistance.
