DIETARY NACL RESTRICTION DETERIORATES ORAL GLUCOSE-TOLERANCE IN HYPERTENSIVE PATIENTS WITH IMPAIRMENT OF GLUCOSE-TOLERANCE

This study investigated whether the change of glycemic response to oral glucose loading with an increase of dietary NaCl intake is different between salt-sensitive and salt-resistant groups, or whether it is related to glucose tolerance on a low NaCl diet independent of salt sensitivity. The plasma glucose and insulin response to 75 g oral glucose intake was assessed on low (34 mmol/day) and high (342 mmol/day) NaCl diets in 31 patients with essential hypertension, and the area under the curve for both variables (AUC(glu) and AUC(ins)) was calculated. The data on the high NaCl diet were corrected for change in hematocrit. The percentage change in systolic, diastolic, and mean blood pressure between the two diets was defined as the salt sensitivity index (SSI) for systolic blood pressure (SSISBP) diastolic blood pressure (SSIDBP) and mean blood pressure (SSIMBP), respectively. The mean values of both AUC(glu) and AUC(ins) decreased significantly with increase of NaCl intake; however, there was no significant correlation between SSI (SSISBP, SSIDBP, or SSIMBP) and the percentage changes in AUC(glu) and AUC(ins). Meanwhile, the percentage changes in AUC(glu) and AUC(ins) significantly correlated with the respective values of AUC(glu) and AUC(ins) on the low NaCl diet. These results suggest that extreme NaCl restriction may deteriorate glucose metabolism in hypertensive patients, especially in those with diabetes mellitus or impaired glucose tolerance.