Insulin Resistance in Patients with Essential Hypertension Using Homeostatic Model Assessment

Mohammad Hossein Rasoulzadegan, Hamid Reza Soltani, Masoud Rahmanian, Nakisa Amid


Introduction: Insulin resistance has a strong relationship with the incidence of type II diabetes. It also has a direct relationship with other risk factors of diabetes, which together are known as metabolic syndrome. The aim of this study was to investigate the relationship between insulin resistance and hypertension.

Materials and Methods: In this historical cohort study, 90 patients were divided into three different groups: those without hypertension, those with controlled hypertension, and those with uncontrolled hypertension. Systolic and diastolic blood pressure, body mass index, and laboratory test results such as cholesterol, triglycerides, low- density lipoprotein, high-density lipoprotein, fasting plasma glucose, and fasting plasma insulin were compared among the three groups. Data were analyzed with t-tests and the analysis of variance test, which were performed using statistical package for the social sciences version 20 software.

Results: Age and sex were the same among the three groups; however, BMI, systolic blood pressure, and diastolic blood pressure in the uncontrolled-hypertension group were higher than in the controlled-hypertension and without-hypertension groups (P<0.05). Lipid profile (P<0.05), creatinine (P=0.77), and uric acid (P=0.233) were not significantly different among the groups, although fasting plasma insulin (P=0.012) and homeostatic model assessment of insulin resistance (P=0.038) were significantly higher in the uncontrolled-hypertension group than in the other groups.

Conclusion: Homeostasis model assessment of insulin resistance in patients with uncontrolled hypertension was higher than in patients with controlled hypertension and those without hypertension. Therefore, homeostatic model assessment of insulin resistance can be used as a predictive clinical test for the early diagnosis of diabetes in patients with uncontrolled hypertension.


Hypertension, Diabetes, Homeostatic model assessment, Insulin resistance

Full Text:



- Berzigotti A, Abraldes JG. Impact of obesity and insulin-resistance on cirrhosis and portal hypertension. Gastroenterologia y hepatologia. 2013;36(8):527-33.

- Deng W, Li C, Zhang Y, Zhao J, Yang M, Tian M, et al. Serum C1q/TNF-related protein-3 (CTRP3) levels are decreased in obesity and hypertension and are negatively correlated with parameters of insulin resistance. Diabetology & metabolic syndrome. 2015;7:33.

- Erice E, Llop E, Berzigotti A, Abraldes JG, Conget I, Seijo S, et al. Insulin resistance in patients with cirrhosis and portal hypertension. American journal of physiology Gastrointestinal and liver physiology. 2012;302(12):G1458-65.

- Genovesi S, Brambilla P, Giussani M, Galbiati S, Mastriani S, Pieruzzi F, et al. Insulin resistance, prehypertension, hypertension and blood pressure values in paediatric age. Journal of hypertension. 2012;30(2):327-35.

-Ghoreishian H, Tohidi M, Derakhshan A, Hajsheikholeslami F, Azizi F, Kazempour-Ardebili S, et al. Presence of hypertension modifies the impact of insulin resistance on incident cardiovascular disease in a Middle Eastern population: the Tehran Lipid and Glucose Study. Diabetic medicine : a journal of the British Diabetic Association. 2015;32(10):1311-8.

- Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499–502

- Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–419.

- Naderi N, Boobejame P, Bakhshandeh H, Amin A, Taghavi S, Maleki M. Insulin resistance in pulmonary arterial hypertension, is it a novel disease modifier? Research in cardiovascular medicine. 2014;3(3):e19710.

- Zhou MS, Wang A, Yu H. Link between insulin resistance and hypertension: What is the evidence from evolutionary biology? Diabetology & metabolic syndrome. 2014;6(1):12.

- Bonora E, Targher G, Alberiche M, Formentini G, Calcaterra F, Lombardi S, et al. Predictors of insulin sensitivity in Type 2 diabetes mellitus. Diabet Med 2002;19:535–542.

- Afsar B, Sezer S, Elsurer R, Ozdemir FN. Is HOMA index a predictor of nocturnal nondipping in hypertensives with newly diagnosed type 2 diabetes mellitus? Blood Press Monit 2007;12:133–139.

- Watson KE, Peters Harmel AL, Matson G. Atherosclerosis in type 2 diabetes mellitus: The role of insulin resistance. J Cardiovasc Pharmacol Ther 2003;8:253–260.

- Saad MF, Rewers M, Selby J, Howard G, Jinagouda S, Fahmi S, Zaccaro D, Bergman RN, Savage PJ, Haffner SM. Insulin resistance and hypertension: The Insulin Resistance Atherosclerosis study. Hypertension 2004;43:1324–1331.

- Bonora E, Bonadonna RC, Del Prato S, Gulli G, Solini A, Matsuda M, DeFronzo RA. In vivo glucose metabolism in obese and type II diabetic subjects with or without hypertension. Diabetes 1993;42:764–772.

- Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich-Horvat P, Liu CY, Vasan RS, Murabito JM, Meigs JB, Cupples LA, D’Agostino RB Sr, O’Donnell CJ. Abdominal visceral and subcutaneous adipose tissue compartments: Association with metabolic risk factors in the Framingham Heart Study. Circulation 2007;116:39–48.

- Sironi AM, Gastaldelli A, Mari A, Ciociaro D, Positano V, Buzzigoli E, Ghione S, Turchi S, Lombardi M, Ferrannini E. Visceral fat in hypertension: Influence on insulin resistance and beta-cell function. Hypertension 2004;44:127–133.

- Anderson PJ, Critchley JA, Chan JC, Cockram CS, Lee ZS, Thomas GN, Tomlinson B. Factor analysis of the metabolic syndrome: Obesity vs. insulin resistance as the central abnormality. Int J Obes Relat Metab Disord 2001;25:1782–1788.

- Sarafidis PA, McFarlane SI, Bakris GL. Antihypertensive agents, insulin sensitivity, and newonset diabetes. Curr Diab Rep 2007;7:191–199.

- Guo, S.X.; Yang, Z.M.; Zhang, J.Y.; Guo, H.; Zhang, Y.H.; Xu, S.Z.; Niu, Q. Relationship of Free Fatty Acid and Insulin Resistance to Hypertension in Kazakh and Han Race of Xinjiang. Chin. J. Hypertens. 2010, 18, 459–464.

- Boden, G. Obesity, Insulin Resistance and Free Fatty Acids. Curr. Opin. Endocrinol. Diabetes Obes. 2011, 18, 139–143.

Tabara, Y.; Takahashi, Y.; Kawaguchi, T.; Setoh, K.; Terao, C.; Yamada, R. et al. Association of serum-free fatty acid level with reduced reflection pressure wave magnitude and central blood pressure: The Nagahama study. Hypertension 2014, 64, 1212–1218.

- Guo SX, Yan YZ, Mu LT, Niu Q, He J, Liu JM, et al. Association of Serum Free Fatty Acids with Hypertension and Insulin Resistance among Rural Uyghur Adults in Far Western China. International journal of environmental research and public health. 2015;12(6):6582-90.


  • There are currently no refbacks.