非肥胖高血压病患者的胰岛素抵抗现象及药物干预研究

The insulin resistance and pharmaceutical interference in hypertensive patients

目的:观察非肥胖的高血压病(EH)患者中的胰岛素抵抗现象及卡托普利(Captopril)与硝苯地平(Nifedipine)长期治疗后对胰岛素抵抗(IR)现象的影响。方法:68例非肥胖的EH患者降压治疗前及治疗6个月后,分别进行口服葡萄糖耐量试验(OGTT),测定治疗前后的糖耐量及胰岛素分泌水平,并与21例正常人(其年龄、体重指数相当)比较。结果:非肥胖的EH患者糖耐量下降,空腹及服糖后血胰岛素浓度、胰岛素释放曲线下面积明显高于正常人。卡托普利及硝苯地平治疗后糖耐量及高胰岛素血症均有改善,但硝苯吡啶不能降低空腹胰岛素水平。结论:非肥胖的EH患者存在空腹及糖负荷后高胰岛素血症,提示存在IR,卡托普利及硝苯地平均可改善胰岛素的敏感性及IR。

Objective: To investigate the insulin resistance (IR) and the long -term therapeutic effect of Captopril and Nifedipinc to IR in non - obesity patients with essential hypertension (EH). Methods: An oral glucose tolerance test (OGTT) was performed on 68 non - obesity patients with EH before and after 6 months of antihypertensive treatment, and was compared with 21 normal subjects (matched with age and body mass index). The palsma glucose, insulin concentration and integrated area under the curve for palsma insulin level were measured. Results: Non - obesity EH patients were characterized by IR and abnormalities of glucose metabolism, such as decrease in glucose tolerance, elevation in insulin con(?)cntraion and integrated area under the curve for plasma insulin. Captopril and Nifedipine have a beneficial role in improving of glucose tolerance and hyperinsulinemia in non-obesity EH patients, but Nifedipine has no effect in decreasing the fast insulin level. Conclusion :There are an insulin resistant phenomenon and hyperinsulinemia before and after an OGTT in non- obesity EH patients; the insulin sensitivity and insulin resistance can be improved by long -tem therapy of Captopril and Nifedipine.