老年高血压与胰岛素抵抗的关系

Relation between Old Hypertension and Insulin Resistance

目的 探讨高胰岛素血症、胰岛素抵抗、高血脂和肥胖与老年高血压之间的关系.方法 对无糖尿病病史的老年原发性高血压患者100例,老年对照组50例的空腹血糖及餐后2 h血糖、胰岛素、C肽、血脂、体质量指数和胰岛素敏感指数进行对照分析.结果 空腹胰岛素高血压组为（14.2±6.0）IU/L,对照组为（7.4±5.7）IU/L（P〈0.001）,高血压组有明显的高胰岛素血症,其胰岛素敏感性指数差异显著（P〈0.001）,血清甘油三脂明显增高和载脂蛋白A1（apoA1）明显下降（P〈0.005）,肥胖者占74%.结论 老年高血压患者多伴有糖代谢和脂蛋白代谢异常,胰岛素抵抗所产生的高胰岛素血症为其基本的代谢异常.

Objective To investigate the relationships among hyperinsulinemia, insulin resistance, hyperlipidemia, obesity and hypertension. Methods Fifty patients with fasting plasma glucose, eating plasma glucose after meal for two hours, plasma levels of insulin, C-peptide, lipidemia, body mass index and insulin sensitive index are compared with one hundred patients with old primary hypertension＂ without diabetes mellitus and old controls. Results Compared with controls groups （7.4 ± 5.57） IU, hypertension groups （14.2 ± 6.0）IU, P 〈 0.001） in fasting plasma, the levels of insulin, insulin sensitive index, hypertriglyceridemia, apoA1 obviously falls （P 〈 0. 005 ） in hypertension groups, fat ones are 74%. Conclusion The old patients with hypertension often complicated with abnormal metabolism of the glucose and lipoproteins, but hyperinsulinemia by insulin resistance was basic abnormal metabolism.