[Arterial hypertension in obese patients with heart hypertrophy. Effects of captopril on insulin sensitivity and growth hormone]. / Hipertensão arterial em pacientes obesos com hipertrofia cardíaca. Efeitos do captopril sobre a sensibilidade à insulina e hormônio de crescimento.

PURPOSE: To evaluate the effects of captopril (Cpt).on carbohydrate metabolism and growth hormone (GH) in adults hypertensive obese patients with normal (NGT) or impaired (IGT) glucose tolerance and left ventricular hypertrophy. METHODS: Ten patients (53 +/- 8 years), 8 women and 2 men, white, body mass index (BMI) > or = 26kg/m2, left ventricular mass index (LVMI) > 135g/m2 in man and > 110g/m2 in woman, with diastolic blood pressure (DBP) 95-115mmHg after 3 weeks of placebo, were identified by oral glucose tolerance test (OGTT-75g) as either with NGT or IGT, and treated with Cpt 25mg t.i.d. for 8 weeks. At the 8 weeks, dosage was increased to 50mg b.i.d. if DBP > 90mmHg or the decrease of the DBP < 10%, during the next 8 weeks. OGTT and clonidine tests (0,04mg/kg) with determinations, every 30 minutes of glucose, insulin, and GH during 2 hours, were performed. RESULTS: Cpt lowered SBP and DBP in the NGT group and IGT group. The LVMI and the left ventricular mass (LVM) decreased in the IGT group with no significant change in the NGT group. Cpt promoted in the IGT group decrease in the area under the curve (AUC) of glucose, and AUC of insulin, with increase of the AUC of the percent of the beta cell function, AUC of HC, and insulin sensitivity index with no significantly change in the NGT group. CONCLUSION: Adults hypertensive obese patients with IGT had decreased significantly in mean fasting level of GH concentrations compared to age, race, and BMI matched hypertensive patients with NGT. Treatment with Cpt induced a significant increased of the GH, with improvement of the metabolism in patients with IGT.

Glomerular permeability to macromolecules in gentamicin-treated rats.

1. To determine the effect of gentamicin on the functional properties of the glomerular barrier, 44 Wistar rats received daily doses of 80 mg/kg body weight for 6 days. Glomerular permeability to neutral dextrans and albumin was evaluated by day 6 and albuminuria was determined on the 1st, 3rd and 5th days of treatment. 2. Treatment induced an intense increase in albuminuria from 74 micrograms/24 h to 11.5 mg/24 h on the 5th day of treatment (N = 11). This increase was associated with the presence of large amounts of albumin in elements of the glomerular filter and in the apical region of the proximal tubular cells (N = 4). Fractional clearances of neutral dextrans having molecular radii in the range of 18-41 A were not significantly different in control (N = 5) and gentamicin-treated rats (N = 7). 3. These results show that gentamicin, a polycation at pH 7.4, produces an increase in the glomerular permeability to negatively charged macromolecules in rats, probably due to interaction of the polycation with negative changes in the glomerular filter.