高血压病的胰岛素抵抗

Insulin Resistance in Hypertension

对 17例治疗的 ,2 0例未治疗的高血压病人和 2 5例正常对照者 ,测定空腹及 75 g葡萄糖刺激后血浆葡萄糖和胰岛素浓度、红细胞胰岛素受体、血脂及脂蛋白。结果表明 :治疗和未治疗的高血压病人 ,血糖和胰岛素对葡萄糖刺激后的反应及胰岛素释放指数均显著高于对照组 ,血甘油三酯 (TG)、低密度脂蛋白(L DL )显著增高 ,高密度脂蛋白 (HDL )显著降低 ,红细胞胰岛素受体分析各组间差异无显著性。葡萄糖刺激后血浆胰岛素反应曲线下面积 (AIA )与收缩期和舒张期血压呈显著正相关 ,与TG,TC,L DL 也呈显著正相关 ,调整年龄、体重指数和血糖后 ,其相关性依然存在 ,说明高血压病存在着胰岛素抵抗 。

Plasma glucose,insulin,lipoprotein concentrations and erythrocyte insulin receptors were determined in patients with hypertension,17 treated and 20 untreated,and compared with those in a control group of 25 normotensives matched with sex,age and body mass index.The results demonstrated a significant increase in both the plasma glucose and insulin response to a 75 g oral glucose challenge,the lower plasma HDL concentration,and the higher TG,LDL.But numbers of erythrocyte insulin receptor and their affinity for insulin were similar in hypertension and control groups.The area under insulin response curve(AIA) after glucose challenge significantly related to SBP,DBP,and TG,TC,LDL,even after adjustment of age and body mass was made.This suggusts that insulin resistance,hyperinsulinemia and dyslipiemia exist in patients with both untreated and treated hypertension,and these metabolic disturbances may play a role in both etiology and clinical course of hypertension.