NIDDM者尿白蛋白排泄率与动态血压及胰岛素抵抗的关系

THE RELATIONSHIP OF URINARY ALBUMIN EXCRETION RATE TO AMBULATORY BLOOD PRESSURE AND INSULIN RESISTNACE IN NIDDM

对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）有微白蛋白尿患者（ＭＡ组）１９例，不合并有微白蛋白尿患者（ＮＭＡ）２５例，进行２４ｈ动态血压及胰岛素敏感性（葡萄糖利用常数，Ｋ１）测定，探讨其彼此间关系。结果显示：尿白蛋白排泄率与夜间平均收缩压呈正相关，与昼夜收缩压差值及Ｋ１呈负相关；ＭＡ组白天及夜间平均收缩压均显著高于ＮＭＡ组，但昼夜收缩差值则ＭＡ组低于ＮＭＡ组，Ｋ１值ＭＡ组亦显著低于ＮＭＡ组。提示ＮＩＤ－ＤＭ患者尿白蛋白排泄率与夜间收缩压、血压昼夜节律以及胰岛素敏感性等有明显的关系。

In order to characterise the relationship between urinary albumin excretion, ambulatory blood pressure and insulin sensitivity, 24 hour ambulatory blood pressure and insulin sensitivity (glucose disposal constant, K 1) were examined in 19 microalbuminuric (MA group) and 25 normoalbuminuric patients (NMA group) with NIDDM. The results showed that urinary albumin excretion rate was positively related to mean night systolic blood pressure value, but negatively correlated with diurnal systolic blood pressure difference and K 1. Mean day and night systolic blood pressure were higher in MA group than in NMA group. However, diurnal systolic blood pressure difference and K 1 value were significantly lower in MA group compared with NMA group. The results indicate that significant association exists between urinary albumin excretion rate, night systolic blood pressure, diurnal rhythm of blood pressure and insulin sensitivity in NIDDM patients.