2型糖尿病合并原发性高血压患者血清胰岛素原水平与胰岛素抵抗的相关研究

Study on the Relation between Proinsulin and Insulin Resistance in Type 2 Diabetes with Hypertension

目的旨在观察2型糖尿病合并原发性高血压、与不合并原发性高血压患者胰岛素抵抗和胰岛素原水平的差异。方法观察40例合并原发性高血压及40例不合并原发性高血压的2型糖尿病患者的血清胰岛素,血胰岛素原及真胰岛素的变化。结果(1)两组间均数比较分析表明2型糖尿病伴高血压组与不伴高血压组之间,在体重指数、腰臀比值、餐后2小时胰岛素、空腹真胰岛素、空腹及餐后2小时胰岛素原、反应胰岛素抵抗的指标HOMA-IR有显著性差异。伴高血压组空腹胰岛素、餐后真胰岛素水平及反应胰岛素分泌指标的ISI增高,但无统计学意义。脂代谢参数两组差异无显著性(。2)对高血压组进行Pearson相关分析表明,平均血压与年龄、体重指数、腰臀比值、甘油三酯、空腹及餐后2小时免疫活性胰岛素、空腹及餐后胰岛素原、空腹及餐后真胰岛素、HOMA-IR等多变量呈正相关。(3)对高血压组以平均动脉血压(MBP)为应变量,以ISI、HOMA-IR、胰岛素原、真胰岛素、免疫活性胰岛素、血糖、胆固醇、甘油三酯、体重、腰臀比、年龄为自变量作多元线性回归分析,回归方程为MBP=129.993+2.012FPI+4.721TG+0.026PPI-25.674WHR+0.079PTI。结论在2型糖尿病伴高血压中,胰岛素抵抗可能不是独立危险因素,高胰岛素原血症可能是疾病的更主要危险因素。

Objective To compare the difference of proinculin and insulin resistance with type 2 diabetes mellitus with hypertension and without hypertension. Methods A study was carried out to investigate the changes of insulin,proinsulin,true insulin in type 2 diabetic patiens with hypertension and without hypertension. Result （1） It showed that there were significant differences of BMI, WHR, PINS, FTI, FPI, PPI, HOMA-IA（P 〈0.05）.Free insulin, 2h postprangial true insulin, ISI were heightened in patients with hypertention,but no statistics meanings.（2） In the patients with hypertention, Pearson correlation analysis indicated that there existed positive correlations between MDP and age, BMI, WHR, TR, free truesulin and 2h postprangial truesulin free proinsulin and 2h postprangial proinsulin 、 free proinsulin and 2h postprangial proinsulin、 HOMA-IR（P 〈0.05）. （3）In the patients with hypertention, Stepwise regression srggested a regression equation MBP=129.993＋ 2.012FPI＋4.72 ITG＋0.326PPI-25.674WHR＋0.079PTI with MBP as dependent variable and ISI、 HOMA-IR, PI, TI, IRI, glucose, TG, TC, weight, WHR、 age as independent variables.Conclusion The result indicate that insulin resistant may not be an independent factor in type 2 diabetic patients with hypertention, hyper-proinsulinemia seems to have a closer relationship to the disease.