摘要
目的 :探讨高血压患者同时存在多种代谢异常时胰岛素的敏感性。方法 :高血压组 79例 ,健康对照组 78例 ,分别进行口服葡萄糖耐量试验 (OGTT)、同步血清胰岛素释放试验 ,血清总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (L DL- C)、高密度脂蛋白胆固醇 (HDL- C)及体质量指数 (BMI)测定 ,以胰岛素敏感性指数 (ISI)和胰岛素曲线下面积 (IS- AU C)作为胰岛素敏感性的判定指标。结果 :高血压组空腹胰岛素 (FINS)及餐后 2 h胰岛素 (15± 7及 70± 10 m U/L)均显著高于正常对照组 (8± 3及 9± 4 m U/L) ,均为 P<0 .0 1;OGTT显示葡萄糖耐量降低 ,P<0 .0 1。 TC、TG、L DL- C显著升高 ,均 P<0 .0 1,HDL- C升高 ,P<0 .0 5 ;ISI(绝对值 )和 IS- AUC均显著增高 ,分别为 P<0 .0 5与 P<0 .0 1。二组 BMI与 ISI呈显著负相关 ,r分别为 - 0 .4 9,- 0 .37,P<0 .0 5 ;与 FINS呈显著正相关 ,r分别为 0 .5 3,0 .38,P<0 .0 1。结论 :高血压患者存在着高胰岛素血症 ,同时存在着糖代谢及脂蛋白代谢异常。血糖、血脂、体质量指数均影响胰岛素敏感性。
AIM: To find the relationship between insulin resistance (IR) and metabolic disorder of carbohydrate, lipoprotein in patients with essential hypertension. METHODS: In normal subjects (NS, n=78) and hypertensive patients (n=79) OGTT and IRT were performed and TC,TG,LDL-C and HDL-C were measured by fasting and before BMI was measured. The area under insulin curve (Insulin-Auc) and insulin sensitively index (ISI) were taken as the index of insulin sensitivity. RESULTS:①Fasting serum level and postprandial serum insulin level in patients with hypertension were obviously higher than those of the NS group [FINS, 2 h INS (mU/L): 15±7, 70±10 vs 8±3, 9±4,P<0.01]. The glucose tolerance was decreased in the EH group,P<0.01. Plasma lipids,ISI (absolute value) and IS-AUC were significantly higher in the EH group than in the NS group,P<0.01. The two groups' body mass indexes (BMI) had a negative correlation with insulin sensitivity and a positive correlation with FINS. CONCLUSION: These results suggest that hyperinsulinemia in hypertensive patients seems to coexist with metabolic disorder of carbohydrate and lipoprotein. The blood glucose, the fasting lipoprotein and body mass index were important factors influencing insulin sensitivity.
出处
《心脏杂志》
CAS
2004年第4期349-350,353,共3页
Chinese Heart Journal
