老年高血压病与胰岛素抵抗关系的初步研究

A PRELIMINARY STUDY ON THE RELATIONSHIP BETWEEN INSULIN RESISTANCE AND HYPERTENSION IN THE ELDERLY PATIENTS

本文对30例老年高血压(EH)病人与20例正常对照组作了糖耐量试验(OGTT)前后血糖(SG)、胰岛素(IS)及曲线下面积(area under the curve AUC)值测定,经对比观察发现两组OGTT前空腹SG、IS及AUC无显著差异,OGTT后EH组1小时、2小时SG、IS、IS/SG及AUC均显著增高,与对照组有显著差异(p<0.05),提示老年EH有胰岛素抵抗(IR)和高胰岛素血症(HIS);EH组中肥胖病人(BMI≥25kg/m^2)比非肥胖病人IR明显(p<0.05)。同时发现年龄越高,IR更明显(p<0.005),示随年龄增长,肝对IS降解能力下降越明显,越易出现HIS。EH组OGTT后AUC_(IS)与舒张压呈正相关(r=0.32,p=0.05),表明HIS是老年EH发病机制之一。

In this study, serum glucose(SG), insulin(IS) and area under the curve (AUC) values before and after oral glucose tolerance test (OGTT) were measured in thirty elderly parients with essential hypertension (EH) and twenty nor-motensive controls. There were no significant differences in fasting SG, IS and AUC values between these two,groups;while after OGTT, at 1hrrand-2.hr. all theSG IS IS/SG values were markedly and significanlty increased in the EH group (p<0.05), indicating the existence of insulin resistance (IR) and hyperinsuli naemia (HIS) in this group.It was also revealed, that more significant IR wax present in patients with obesity (BMI≥25kg/m2). Moreover, the older the patient, the more significant was the IR (p<0.005), indicating that the capability of IS degradation in liver would markedly decrease as the age increased and HIS were likely to be produced. In the EH group, AUCIS after OGTT was positively correlated with diastolic blood pressure (DBF) r=0.32, p=0.05 suggesting HIS be one of the possible mechanisms in the pathogenesis of EH in the elderly patients.