Jie Fan1, Lian Yong Liu2, Xing Zhen Liu3. 1. Department of Traffic Management Engineering, Zhejiang Police College, No. 555 Binwen Road, Binjiang District, Hangzhou, China. 2. Department of Endocrinology, Punan Hospital of Pudong New District, No. 279 Linyi Road, Pudong, Shanghai, 200336, China. Electronic address: chinallu@163.com. 3. Hangzhou Aeronautical Sanatorium for Special Service of China Air Force, No. 27, Yang Gong Di, Xihu District, Hangzhou, Zhejiang, 310007, China. Electronic address: xzliu7@163.com.
Abstract
BACKGROUND AND AIMS: Although hyperinsulinemia and insulin resistance (IR) together cause metabolic diseases, the available evidence fails to link hyperinsulinemia with blood pressure (BP) elevation. To further understand the role of hyperinsulinemia in the pathophysiology of hypertension, we conducted this study to investigate the moderating effect of fasting insulin (FINS) on the association between IR and BP. METHODS AND RESULTS: The health screening data of 72,076 individuals were analyzed for this moderation analysis. IR was indicated by the homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc). In the adjusted model, three IR indicators were considered independent variables; FINS was used as a moderator, and systolic BP (SBP) and diastolic BP (DBP) were used as dependent variables. The regression coefficient of the interaction term between the three IR indicators and FINS was significantly negative in all moderation models. Simple slope tests and the Johnson-Neymann technique also indicated that FINS negatively moderated the association between IR and BP. CONCLUSIONS: This moderation analysis showed that FINS negatively mediated the association between IR and BP, suggesting that hyperinsulinemia may buffer, not reinforce, the effect of IR on hypertension.
BACKGROUND AND AIMS: Although hyperinsulinemia and insulin resistance (IR) together cause metabolic diseases, the available evidence fails to link hyperinsulinemia with blood pressure (BP) elevation. To further understand the role of hyperinsulinemia in the pathophysiology of hypertension, we conducted this study to investigate the moderating effect of fasting insulin (FINS) on the association between IR and BP. METHODS AND RESULTS: The health screening data of 72,076 individuals were analyzed for this moderation analysis. IR was indicated by the homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TyG), and triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc). In the adjusted model, three IR indicators were considered independent variables; FINS was used as a moderator, and systolic BP (SBP) and diastolic BP (DBP) were used as dependent variables. The regression coefficient of the interaction term between the three IR indicators and FINS was significantly negative in all moderation models. Simple slope tests and the Johnson-Neymann technique also indicated that FINS negatively moderated the association between IR and BP. CONCLUSIONS: This moderation analysis showed that FINS negatively mediated the association between IR and BP, suggesting that hyperinsulinemia may buffer, not reinforce, the effect of IR on hypertension.