摘要
目的:探讨2型糖尿病家系成员血压与胰岛素抵抗的关系,为糖尿病的一级康复预防提供依据。方法:对2型糖尿病家系成员进行口服葡萄糖耐量试验(OGTT),按1997年美国糖尿病学会诊断标准将家系成员分成糖尿病一级亲属糖耐量正常(NGT)组(96例),糖耐量减低(IGT)组(46例)和新诊断糖尿病组(63例),检测其血压、血脂、血浆胰岛素,计算胰岛素敏感性指数(ISI),与无糖尿病家族史的健康人(57例)相比较。结果:家系各组成员收缩压、舒张压、三酰甘油水平均显著高于正常对照组,如NGT组收缩压(119±17)mmHg,IGT组为(128±18)mmHg,新诊断糖尿病组(129±20)mmHg,正常对照组(109±17)mmHg(P<0.05或P<0.01),ISI和高密度脂蛋白胆固醇(HDL-C)显著低于正常对照组,如ISI在NGT组为-3.80±0.39,在IGT组-4.17±0.50,新诊断糖尿病组-4.53±0.53,正常对照组-3.58±0.58。血压与ISI、HDL-c呈显著负相关关系,与三酰甘油、体质量指数呈显著正相关关系,在多种因素中,ISI对收缩压的影响程度最大。结论:2型糖尿病家系一级亲属在糖耐量正常时,血压均已开始升高,随着代偿性高胰岛素血症持续到IGT及糖尿病阶段,血压进一步升高,而ISI则持续降低。一级亲属的血压变化可能是家族性2型糖尿病的遗传标志之一。
AIM:To investigate the relationship between blood pressure and insulin resistance in members of type 2 diabetic pedigrees. METHODS:Oral glucose tolerance test (OGTT) was conducted in type 2 diabetic pedigree members including 63 cases newly diagnosed as diabetic patients, 96 cases with normal glucose tolerance (NGT), and 46 cases with impaired glucose tolerance (IGT). 57 healthy subjects without family history of diabetes and hypertension served as the normal controls. Blood pressure, plasma lipid and plasma insulin were determined before oral glucose load. Moreover, insulin sensitivity index (ISI) was calculated in all subjects. RESULTS:In members of pedigrees the systolic blood pressure( SBP) , diastolic blood pressure( DBP) , and the level of triglyceride( TG) were higher( P< 0.05- 0.01) , but ISI and high density lipoprotein cholesterol (HDL C) were significantly lower than those of the normal controls( P< 0.01) . For example, the SBP was 118.55± 17.16 in NGT, 127.78± 17.87 in IGT, 128.65± 20.22 in newly diagnosed diabetic patients, and 109.32± 16.76 in the normal controls. ISI was - 3.80± 0.39, - 4.17± 0.50, - 4.53± 0.53, - 3.58± 0.58 in the four groups, respectively. Correlation analysis showed that blood pressure was negatively correlated with ISI and HDL c( P< 0.01) , but positively correlated with the level of triglyceride and body mass index (BMI)( P< 0.01) .Multiply regression analysis showed ISI had the most effect on SBP.
出处
《中国临床康复》
CSCD
2003年第21期2908-2910,共3页
Chinese Journal of Clinical Rehabilitation
基金
重庆市卫生局医学科研项目(002027)~~
关键词
2型糖尿病
家系成员
血压
胰岛素抵抗
口服葡萄糖耐量试验
胰岛素敏感性指数
In first degree relatives of type 2 diabetes pedigrees blood pressure tends to increase in NGT with compensatory hyperinsulinemia, and has a tendency to increase further in IGT and diabetes mellitus. Simultaneously ISI tends to decline. Blood
