四川凉山彝族人群胰岛素抗药性与原发性高血压关系的研究

A case-control study on the relations between insulin resistance and essential hypertension in YI NATIONALITY living in Liangshan,Sichuang Province

目的探讨我国四川省凉山彝族人群胰岛素抗药性(IR)与原发性高血压(EH)的关系。方法应用病例对照研究方法,对113例彝族 EH 患者和156例血压正常的彝族对照进行分析,检测空腹血浆葡萄糖(FPG)和胰岛素(FINS)水平,并以 IR 指数作为衡量 IR 的指标。结果彝族移民空腹血糖受损(IFG)、IR 与 EH 的关联均具有统计学意义,OR 值分别为3.98(2.14～7.42,P<0.001)和2.55(1.35～4.83,P=0.004)。按性别分层,彝族男性移民 IFG、IR 与 EH 的关联仍具有统计学意义,OR 值分别为4.31(2.01～9.24,P<0.001)和3.14(1.45～6.82,P=0.003);彝族女性移民 IFG 与 EH 的关联具有统计学意义,OR 值3.46(1.17～10.22,P=0.022),但未发现 IR 与 EH 的关联具有统计学意义。彝族农民 IFG、IR 与 EH 的关联均不具有统计学意义。logistic 回归分析结果显示,彝族移民 IR 与 EH 的关联有统计学意义,但在彝族农民中未观察到这种现象。结论在四川凉山彝族移民中,IR 可能是 EH 发病的危险因素,但在凉山彝族农民中 IR 是否为 EH 发病的危险因素仍有待进一步研究。

Objective To determine whether insulin resistance （IR） was associated with essential hypertension （EH） in YI nationality living in Liangshan, Sichuang Province. Methods A case-control study consisting of 113 YI hypertensives as cases and 156 YI normotensives as controls were conducted to investigate the level of fasting glucose （FG） and fasting insulin （FINS）, and insulin resistance index was used as the indicator of IR. Results It was found that impaired fasting glucose （IFG） and IR were associated with EH significantly among YI migrants, and OR （95% CI ） were 3.98 （2. 14 - 7. 42, P 〈 0. 001 ） and 2. 55 （ 1.35 - 4. 83, P = 0. 004 ） respectively. Being stratified by sex, both IFG and IR were associated with EH significantly among YI male migrant, and OR were 4. 31 （2. 01 -9.24,P 〈0. 001 ） and 3.14 （ 1.45 - 6. 82, P = 0. 003 ） respectively; but only IFG was associated with EH significantly among YI female migrant and OR was 3.46（ 1.17 - 10. 22 ,P =0. 022）. Among YI farmers, both IFG and IR were not associated with EH significantly. The non-conditional logistic regression analysis showed that IR was associated significantly with EH among YI migrants. This was not as same as observed in YI farmers. Conclusion It is likely that IR is the risk factor of EH among YI migrants in our study. However, the association between IR and EH among YI farmers needs some further studies.