高血压和高胰岛素血症关系的初步探讨

A preliminary study of the relationship between hypertension and hyperinsulinemia

对１０例体重指数（ＢＭＩ）正常的老年高血压患者和１１例体重指数正常、血压正常的老年对照者进行口服葡萄糖耐量试验（ＯＧＴＴ），检测血糖、血脂、胰岛素水平、红细胞膜钠钾泵活性。结果表明，体重指数正常的高血压患者与对照组比较，存在高胰岛素血症（餐后１２０分钟胰岛素分别为：７４．３±２．３μＵ／ｍｌ及３０．０±２．μＵ／ｍｌ，Ｐ＜０．０５）、高脂血症。多元相关分析进一步表明，去除年龄、体重的影响，收缩压（ＳＢＰ）和餐后１２０分钟胰岛素仍呈正相关（ｒ＝０．５０９９，Ｐ＜０．０５），说明胰岛素是致高血压的一个因素。本实验还发现ＳＢＰ、舒张压（ＤＢＰ）和钠钾泵呈负相关，且钠钾泵和胰岛素曲线下面积（ＡｒｅｎＵｎｄｅｒＣｕｒｖｅ，ＡＵＣ）呈负相关（ｒ＝－０．４５０５，Ｐ＜０．０５）。这证实胰岛素致高血压作用可能是胰岛素抵抗影响钠钾泵活性所致。

Abstract To study the relationship between hypertension and glucose metabolism, we selected 10 untreated non -obese hypertensive elderly patients(age 60-74) and 11 healthy subjects(age 60-72) for control. Their plas maglucose and insulin levels at fasting and following an oral glucose load(75g) as well as plasma cholesterol,triglyceride concentrations and Na+K+pump activity in the membrance of their erythrocytes were determined.The results showed that non-obese hypertensive patients bad hyperinsulinemia(2h insulin: 74.3±2.3vs 30.0±2.2μU/ml, P<0.05)and hyperlipidemia(hypercholesterolemia and hypertriglyceridemia) . In multivariant analysis, after corrected for age and BMI, the systolic pressure(SBP) was positively related to 2h insulin level (r=0.5099, P<0.05) while diastolic pressure(DBP) was not significantly related to insulin level. This result demonstrated that insulin causes high blood pressure independent of other factors. This study also showed that SBP and DBP were negatively related to Na+K+pump and Na+K+pump was negatively related to insulin area under curve(AUC) (r = - 0.4505, P<0.05). These results indicated that the develop ment of hypertension might be due to the effect of insulin resistance on the activity of Na+K+pump.