Ⅱ型糖尿病病人的动态血压与胰岛素的关系

Relationship between Ambulatory Blood Pressure and Plasma Insulin in Patients with NIDDM

目的了解Ⅱ型糖尿病（ＮＩＤＤＭ）病人的动态血压与血中胰岛素的关系。方法对７２例ＮＩＤＤＭ病人行２４ｈ动态血压监测，根据监测结果，分为ＮＩＤＤＭ合并高血压组３６人，未合并高血压组３６人。所有病人行空腹血糖、胰岛素及血脂等检查，并经ｔ检验和多元回归分析。结果ＮＩＤＤＭ合并高血压组较未合并高血压组的空腹血胰岛素浓度显著增高（Ｐ＜０．００１），而且胰岛素浓度分别与２４ｈ平均收缩压和舒张压呈独立的相关性（Ｐ＜０．００１）。结论ＮＩＤＤＭ病人合并高血压较未合并高血压有更高的胰岛素血症，且在ＮＩＤＤＭ病人中高胰岛素血症是高血压的独立的危险因子。

Aim\ To investigate the relationship between ambulatory blood pressure and insulin concentrations in NIDDM.\ Methods\ Seventy two cases of NIDDM were monitored with 24 hour ambulatory blood pressure.\ There are 36 cases complicated with hypertension and 36 subjects without.\ Fasting plasma glucose,insulin,and lipids were measured in all subjects.\ Results\ The hypertensive group had significantly higher fasting plasma insulin ( P <0 001) compared with the normotensive group.Insulin concentrations was independently correlated with mean 24 hour ambulatory systolic blood pressure( β =0 58, P <0 001) and diastolic blood pressure ( β =0 43, P <0 001) respectively.\ Conclusion\ Hypertensive subjects with NIDDM are more associated with hyperinsulinemia than normotensive subjects with NIDDM,and hyperinsulinemia is an independent risk factor for hypertension in subjects with NIDDM.