高血压病eNOS G894T变异与胰岛素抵抗的关系

Positive Relationship between eNOS Gene G894T Mutation and Insulin Resistance in Patients with Essential Hypertension

目的:探讨高血压病一氧化氮合酶基因G894T(eNOS G894T)变异与胰岛素抵抗(IR)的关系及其临床意义.方法:非糖尿病原发性高血压病患者50例,年龄40～82岁,平均(60±9)岁.男17例,女33例,分为IR组(空腹胰岛素＞15μU/ml)和对照组(空腹胰岛素≤15μU/ml).运用聚合酶链反应限制性片段长度多态性(PCR-RFLP)检测G894T变异.根据结果,即基因分型,依空腹胰岛素水平及代谢状况分成亚组,分析血压和代谢指标与eNOS T894的关系.结果:T894等位基因频率IR组高于对照组(32.3%vs 7.6%,P＜0.01)IR组收缩压比对照组高(P＜0.05),舒张压和平均动脉压有增高趋势.PBS和UA显著高于对照组(P＜0.05),TG有增高趋势,HDL-C有下降趋势.各亚组分析中,T894携带者TG、TC和LDL-C有增高趋势,HDL-C有下降趋势.结论:高血压病eNOSG894T变异可能是IR的原因之一,对高危高血压病的预测和早期诊断有重要意义.

Objective： To investigate the clinical implication of the relationship between eNOS gene G894T mutation and insulin resistance （IR） in patients with essential hypertension. Methods： According to the levels of fasting plasma insulin, 50 cases with nondiabetic essential hypertension, aged 40 - 82 years,on average （60± 9） years （F33, M17）, were divided into two groups（IR and control） .Polymerase chain reaction and Ban Ⅱ restriction enzyme digestion [PCR - RFLP） were performed to detect the G894T mutation. Systolic, diastolic, mean arterial pressure and metabolic indexes were compared between two groups with and without IR; and among subgroups with different genotypes at different levels of fasting plasma insulin. Results： G894T mutation was significantly associated with IR. The T allele frequency was higher in the group with IR than that in the control（ 32.3% vs 7.6%, P 〈 0.01 ）. Significantly higher systolic pressure, the levels of PBS and UA（P 〈 0.05 ）, higher trends of diastolic,mean arterial pressure, and TG were found in the former group. Furthermore, lower trend of HDL - C was found in the same group. Among the subgroups, the abnormal metabolic indexes were found in the T894 carriers either with or without IR. Conclusion： Due to eNOS G894T mutation may cause IR with abnormal metabolic indexes, it may be important to predict the trend or early diagnosis of essential hypertension at high risks.