原发性高血压患者糖负荷后血糖和胰岛素变化对游离脂肪酸水平的影响

Effect of blood glucose and insulin on serum free fatty acid level after glucose loading in essential hypertension patients

目的 :探讨糖负荷后血糖和胰岛素变化对血清游离脂肪酸 (FFA)水平的影响。方法 :2 34例高血压病患者 [2型糖尿病 (DM) 2 0例 ,糖耐量低减 (IGT) 74例 ,正常糖耐量 (NGT) 14 0例 ;男 98例 ,女 136例 ]做口服葡萄糖耐量试验 (OGTT) ,测定 0、30、6 0、12 0min时相的葡萄糖、血清胰岛素和FFA水平。结果 :空腹血清FFA浓度 (μmol/L) :DM组 (10 4 8 7± 4 81 6 )显著高于IGT组 (70 6 1± 332 1) (P <0 0 5 )和NGT组 (72 5 8± 35 3 9) (P <0 0 5 )。DM组OGTT血糖水平显著升高 ,胰岛素释放曲线呈反应低平 ,高峰不明显或呈延迟相。 3组FFA释放均呈低下 ,DM组更为显著。30、6 0、12 0min时相的血清FFA水平 ,3组均无显著差异。结论 :糖尿病患者空腹血清FFA水平升高 ,OGTT中糖尿病患者胰岛素分泌的绝对不足未能增大DM组FFA水平与IGT及NGT组的差异 ,相反缩小了与IGT和NGT组的差距 。

AIM: To investigate the effects of internal change of serum insulin and plasma glucose levels on serum free fatty acid (FFA) concentrations after glucose loading. METHODS: Serum insulin, plasma glucose and FFA concentrations were measured simultaneously in 234 essential hypertension patients who were undergoing oral glucose tolerance test (OGTT) [ including 20 cases with 2 type diabetes mellitus (DM), 74 impaired glucose tolerance (IGT), 140 normal glucose tolerance (NGT); 98 males, 136 females]. RESULTS: Fasting serum FFA concentration (μmol/L) in DM ((1 048.47)±481.6) was higher than that in IGT (760.1±332.1) (P<0.05) and in NGT (725.8±353.9) ((P<0.05)). Compared with the NGT group, the glucose curve was elevated and the insulin releasing curve was characterized by a low response and a delayed peak in DM group. As for the FFA releasing curve, three groups showed a significantly decreasing trend, which was more evident in DM group. Serum FFA levels at 30 min, 60 min and 120 min after glucose ingestion were not significantly different between the three groups. CONCLUSIONS: Easting serum FFA levels were elevated in DM group. The absolute deficiency of insulin secretion decreased rather increased the difference of FFA level difference between DM group and IGT group, NGT group during OGTT. These results suggest the level of glucose utilization may have an important effect on serum FFA concentration. [