{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:48:50Z","timestamp":1775069330989,"version":"3.50.1"},"reference-count":44,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Postprandial hypotension (PPH) is an important clinical condition in patients presenting with postprandial symptoms. The aims of this study were to determine the prevalence of PPH in patients with postprandial symptoms and to investigate the relationship between PPH and insulin, particularly in healthy adults. Methods: This study was conducted with 111 adult patients who were admitted to the clinic due to postprandial symptoms. Patients underwent the mixed meal test (MMT). Blood glucose, insulin, and C-peptide levels were measured at 0, 30, 60, 90, 120, 180, 240, and 300 min along with systolic blood pressure (sBP), diastolic blood pressure (dBP), and heart rate measurements during the MMT. Results: Serum adrenocorticotropic hormone (ACTH) levels were similar (p &gt; 0.05), and cortisol levels were found to be higher in individuals without PPH compared to those with PPH before the MMT (p = 0.014). During the MMT, 23 patients (23.2%) had PPH. At the beginning of the test, serum glucose, insulin, C-peptide, and heart rate values were similar in patients with and without PPH; however sBP and dBP were significantly higher in the PPH group (p = 0.002 and p = 0.010, respectively). No correlation was found between sBP and insulin, glucose, and C-peptide at any time during the MMT except for a moderately significant positive correlation between glucose and sBP at 90 min in patients with PPH (r = 0.490, p = 0.018). A moderately negative correlation was found between the magnitude of sBP fall between 30 and 60 min and insulin and C-peptide levels in people with PPH (r = \u22120.420, p = 0.046; r = \u22120.564, p = 0.005; respectively). However, no significant relationships were observed between the magnitude of sBP fall at other time points and blood parameters (p &gt; 0.05). Conclusions: A significant portion of adults with postprandial symptoms might have PPH, contributing to these symptoms. The lack of a relationship between insulin and glucose suggests that other physiological mechanisms beyond insulin and glucose may play a role in the pathogenesis of PPH in healthy individuals. Therefore, further research is needed to better understand the underlying causes of PPH.<\/jats:p>","DOI":"10.3390\/nu17030479","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T03:26:10Z","timestamp":1738121170000},"page":"479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Postprandial Hypotension in Adults: Exploring Insulin Dynamics During a Mixed Meal Test"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-3501","authenticated-orcid":false,"given":"Rahime Evra","family":"Karakaya","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06760 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas Ali","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sevg\u00fcl","family":"Fak\u0131","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcls\u00fcm","family":"Karaahmetli","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didem","family":"\u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reyhan","family":"Ersoy","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oya","family":"Topalo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara Y\u0131ld\u0131r\u0131m Beyaz\u0131t University, 06800 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"286","DOI":"10.7326\/0003-4819-122-4-199502150-00009","article-title":"Postprandial hypotension: Epidemiology, pathophysiology, and clinical management","volume":"122","author":"Jansen","year":"1995","journal-title":"Ann. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1007\/s12603-019-1271-1","article-title":"Prevalence and risk factors of postprandial hypotension among elderly people admitted in a geriatric evaluation and management unit: An observational study","volume":"23","author":"Schoevaerdts","year":"2019","journal-title":"J. Nutr. Health Aging"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Van Orshoven, N.P., Jansen, P.A.F., Oudejans, I., Schoon, Y., and Oey, P.L. (2010). Postprandial hypotension in clinical geriatric patients and healthy elderly: Prevalence related to patient selection and diagnostic criteria. J. Aging Res.","DOI":"10.4061\/2010\/243752"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hansen, R.M., Krogh, K., Sundby, J., Krassioukov, A., and Hagen, E.M. (2021). Postprandial hypotension and spinal cord injury. J. Clin. Med., 10.","DOI":"10.3390\/jcm10071417"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/jdi.13418","article-title":"Asymptomatic postprandial hypotension in patients with diabetes: The KAMOGAWA-HBP study","volume":"12","author":"Kitae","year":"2021","journal-title":"J. Diabetes Investig."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Luciano, G.L., Brennan, M.J., and Rothberg, M.B. (2010). Postprandial hypotension. Am. J. Med., 123.","DOI":"10.1016\/j.amjmed.2009.06.026"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1097\/HJH.0000000000000150","article-title":"Postprandial hypotension as a risk marker for asymptomatic lacunar infarction","volume":"32","author":"Tabara","year":"2014","journal-title":"J. Hypertens."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/j.1532-5415.1997.tb05965.x","article-title":"Association of postprandial hypotension with incidence of falls, syncope, coronary events, stroke, and total mortality at 29-month follow-up in 499 older nursing home residents","volume":"45","author":"Aronow","year":"1997","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1093\/ajcn\/nqac158","article-title":"Systematic review and meta-analysis examining the relationship between postprandial hypotension, cardiovascular events, and all-cause mortality","volume":"116","author":"Jenkins","year":"2022","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_10","first-page":"337","article-title":"Postprandial reactive hypoglycemia","volume":"26","author":"Brun","year":"2000","journal-title":"Diabetes Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/MBP.0000000000000450","article-title":"Effect of blood insulin level on postprandial hypotension in elderly people","volume":"25","author":"Hu","year":"2020","journal-title":"Blood Press. Monit."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Borg, M.J., Xie, C., Rayner, C.K., Horowitz, M., Jones, K.L., and Wu, T. (2021). Potential for Gut Peptide-Based Therapy in Postprandial Hypotension. Nutrients, 13.","DOI":"10.3390\/nu13082826"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1056\/NEJM198911233212101","article-title":"Blood glucose measurements during symptomatic episodes in patients with suspected postprandial hypoglycemia","volume":"321","author":"Palardy","year":"1989","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1055\/s-2007-1018995","article-title":"Mixed meal tolerance test and reactive hypoglycemia","volume":"14","author":"Buss","year":"1982","journal-title":"Horm. Metab. Res."},{"key":"ref_15","first-page":"491","article-title":"Oral glucose tolerance test compared with a mixed meal in the diagnosis of reactive hypoglycemia: A caveat on stimulation","volume":"58","author":"Hogan","year":"1983","journal-title":"Mayo Clin. Proc."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hall, M., Walicka, M., Panczyk, M., and Traczyk, I. (2021). Metabolic parameters in patients with suspected reactive hypoglycemia. J. Pers. Med., 11.","DOI":"10.3390\/jpm11040276"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jamda.2015.01.097","article-title":"Postprandial hypotension is associated with more rapid gastric emptying in healthy older individuals","volume":"16","author":"Trahair","year":"2015","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/j.1532-5415.1991.tb03575.x","article-title":"Hormonal mechanisms of postprandial hypotension","volume":"39","author":"Jansen","year":"1991","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_19","first-page":"5501","article-title":"Influence of oral and intravenous glucose loading on blood pressure in normotensive and hypertensive elderly subjects","volume":"5","author":"Jansen","year":"1987","journal-title":"J. Hypertens."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1007\/s10286-004-0220-0","article-title":"Postprandial hypotension treated with acarbose in a patient with type 1 diabetes mellitus","volume":"14","author":"Maule","year":"2004","journal-title":"Clin. Auton. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.jamda.2014.01.011","article-title":"Postprandial hypotension: A systematic review","volume":"15","author":"Trahair","year":"2014","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"afae022","DOI":"10.1093\/ageing\/afae022","article-title":"Prevalence of postprandial hypotension in older adults: A systematic review and meta-analysis","volume":"53","author":"Huang","year":"2024","journal-title":"Age Ageing"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/0895-7061(95)00339-8","article-title":"Mechanisms mediating postprandial blood pressure reduction in young and elderly subjects","volume":"9","author":"Masuo","year":"1996","journal-title":"Am. J. Hypertens."},{"key":"ref_24","first-page":"OC01","article-title":"A Comparative Study of Pre- and Post-prandial Blood Pressure Recordings in Obese and Non-Obese Young Adults","volume":"10","author":"Sequeira","year":"2016","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zhou, X., Wu, T., Sang, M., Qiu, S., Wang, B., Guo, H., Li, K., Wang, Q., Wang, X., and Chen, Q. (2024, June 16). Variations in Blood Pressure Before and After 75 g Oral Glucose in Chinese Community-Dwelling Adults: Implications for the Detection of Both Hypertension and Postprandial Hypotension. Pre-Print, Non-Peer-Reviewed Article. Available online: https:\/\/ssrn.com\/abstract=4448601.","DOI":"10.2139\/ssrn.4448601"},{"key":"ref_26","first-page":"284","article-title":"Postprandial Hypotension in the Elderly: Findings in a Mexican Population","volume":"85","author":"Asensio","year":"2015","journal-title":"Arch. Cardiol. Mex."},{"key":"ref_27","first-page":"600","article-title":"Prevalence of and Risk Factors for Postprandial Hypotension in Older Chinese Men","volume":"12","author":"Zou","year":"2015","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.1097\/HJH.0b013e328357f16d","article-title":"Meal-Induced Blood Pressure Variation and Cardiovascular Mortality in Ambulatory Hypertensive Elderly Patients: Preliminary Results","volume":"30","author":"Zanasi","year":"2012","journal-title":"J. Hypertens."},{"key":"ref_29","first-page":"2641","article-title":"Clinical Observation of Postprandial Hypotension in Patients with Hypertensive and Coronary Heart Disease","volume":"98","author":"Zhang","year":"2018","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1097\/HJH.0b013e328352b9fd","article-title":"Diastolic Blood Pressure Drop after Standing as a Clinical Sign for Increased Mortality in Older Falls Clinic Patients","volume":"30","author":"Lagro","year":"2012","journal-title":"J. Hypertens."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E2628","DOI":"10.1210\/jc.2014-2475","article-title":"Effects of Exogenous Glucagon-Like Peptide-1 on the Blood Pressure, Heart Rate, Mesenteric Blood Flow, and Glycemic Responses to Intraduodenal Glucose in Healthy Older Subjects","volume":"99","author":"Trahair","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s00415-012-6660-x","article-title":"Role of Intestinal Peptides and the Autonomic Nervous System in Postprandial Hypotension in Patients with Multiple System Atrophy","volume":"260","author":"Fukushima","year":"2013","journal-title":"J. Neurol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"R1524","DOI":"10.1152\/ajpregu.00378.2010","article-title":"Effects of Small Intestinal Glucose Load on Blood Pressure, Splanchnic Blood Flow, Glycemia, and GLP-1 Release in Healthy Older Subjects","volume":"300","author":"Vanis","year":"2011","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1212\/WNL.36.10.1402","article-title":"Insulin-Induced Hypotension and Neurogenic Orthostatic Hypotension","volume":"36","author":"Brown","year":"1986","journal-title":"Neurology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1177\/000331978503600207","article-title":"Peripheral Circulatory Effects of Insulin in Diabetes","volume":"36","author":"Takata","year":"1985","journal-title":"Angiology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/0002-9149(87)90358-4","article-title":"Blood Pressure Reduction after Oral Glucose Loading and Its Relation to Age, Blood Pressure, and Insulin","volume":"60","author":"Jansen","year":"1987","journal-title":"Am. J. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1017\/S0007114510005489","article-title":"Comparative Effects of Glucose and Xylose on Blood Pressure, Gastric Emptying, and Incretin Hormones in Healthy Older Subjects","volume":"105","author":"Vanis","year":"2011","journal-title":"Br. J. Nutr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1007\/s11892-022-01456-1","article-title":"Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia\u2014Implications for Obesity and Insulin Resistance","volume":"22","author":"Limberg","year":"2022","journal-title":"Curr. Diab. Rep."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/cvr\/cvq349","article-title":"Insulin Says NO to Cardiovascular Disease","volume":"89","author":"Yu","year":"2011","journal-title":"Cardiovasc. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"G1227","DOI":"10.1152\/ajpgi.00511.2004","article-title":"Role of nitric oxide mechanisms in gastric emptying of, and the blood pressure and glycemic responses to, oral glucose in healthy older subjects","volume":"288","author":"Gentilcore","year":"2005","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"E355","DOI":"10.1152\/ajpendo.00391.2021","article-title":"Role of the Arterial Baroreflex in the Sympathetic Response to Hyperinsulinemia in Adult Humans","volume":"322","author":"McMillan","year":"2022","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1136\/jim-2016-000295","article-title":"Effectiveness of Acarbose in Treating Elderly Patients with Diabetes with Postprandial Hypotension","volume":"65","author":"Zhang","year":"2017","journal-title":"J. Investig. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e13341","DOI":"10.14814\/phy2.13341","article-title":"Comparative Effects of Glucose and Water Drinks on Blood Pressure and Cardiac Function in Older Subjects with and without Postprandial Hypotension","volume":"5","author":"Trahair","year":"2017","journal-title":"Physiol. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1113\/jphysiol.2001.013442","article-title":"Postprandial Hypotension in Response to Duodenal Glucose Delivery in Healthy Older Subjects","volume":"540","author":"Feinle","year":"2002","journal-title":"J. Physiol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/479\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:38:01Z","timestamp":1759919881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/3\/479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,28]]},"references-count":44,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["nu17030479"],"URL":"https:\/\/doi.org\/10.3390\/nu17030479","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,28]]}}}