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1 School of Kinesiology, University of Minnesota, Minneapolis 55455
2 Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 55417
3 Department of Internal Medicine, Division of Geriatric Medicine, and Geriatric Research, Education and Clinical Center (GRECC), Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan 48105
4 Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania 15261
We evaluated the association between insulin resistance and the angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) gene polymorphism in a group of older hypertensive subjects (63 ± 1 yr, n = 35) before and after a 6-mo aerobic exercise program (AEX). Insulin sensitivity index (SI), assessed by the frequently sampled intravenous glucose tolerance test, was significantly (P = 0.0001) increased following AEX. In addition, there was a significant (P = 0.001) interaction between AEX and ACE genotype. SI increased significantly (P < 0.05) more in those with the II (2.5 ± 0.8 µU x 10-4 · min-1 · ml-1) ACE genotype compared with both the DD and ID (0.7 ± 0.1 and 0.7 ± 0.2 µU x 10-4 · min-1 · ml-1, respectively) ACE genotypes. Similarly, there was a significant (P = 0.036) decrease in the acute insulin response to glucose (AIRG) and a significant (P = 0.05) interaction between AEX and ACE genotype. AIRG decreased significantly (P < 0.05) more in those with the II (-17.6 ± 5.6 mU/ml) ACE genotype compared with both the DD and ID (-1.4 ± 6.2 and -3.6 ± 2.5 mU/ml) ACE genotypes. In conclusion, we demonstrated that those older hypertensives with the ACE II genotype have the greatest improvement in insulin action following AEX.
angiotensin-converting enzyme; blood pressure; genetics; glucose metabolism
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