老年高血压患者颈动脉内膜中层厚度与胰岛素抵抗的关系

Study on the relationship between intima-media thickness of carotid and insulin resistance in eldly hypertensive patients

目的探讨老年高血压患者颈动脉内膜中层厚度(IMT)与胰岛素抵抗的关系。方法测定260例老年高血压患者(HT组)、23例老年高血压合并2型糖尿病患者(HT+DM组)和250名健康体检者(NC组)的动态血压、血空腹血糖(FBG)、空腹胰岛素(FINS)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL)及体重指数(BMI),并运用高分辨率B型超声仪检测受试者的颈动脉IMT。结果3组BMI、血压(包括SBP、DBP)、血脂(包括TG、IC、HDL)的差异均无统计学意义(P>0.05);HT组FBG、FINS、IM均显著高于NC组(P<0.05或0.01),而IAI显著低于NC组(P<0.01);HT+DM组FBG、FINS、IMT均显著高于HT组及NC组(P<0.05或0.01),而IAI显著低于HT组及NC组(P<0.05或0.01)。IMT与BMI、FBG呈显著正相关,与IAI呈显著负相关(均P<0.01)。结论老年高血压患者颈动脉IMT高于正常人,而且与高血压患者胰岛素抵抗的发生、发展密切相关。

Objective To investigate the relationship between intima-media thickness of carotid artery（IMT）and insulin resistance（ IR）in elderly hypertensive patients. Methods Two hundred sixty elderly hypertensive patients （HP group） ,230 elderly hypertensive patients with type 2 diabetes mellitus （HP＋DM group） and 250 healthy individuals （NC group） were enrolled in the study. The levels of Ambulatory blood pressure monitoring （ABPM）, fasting blood glucose （FBG）, fasting insulin （FINS）, triglyceride （TG）, Plasma-cholesterol （TC）, high density lipoprotein cholesterol （HDL-C） and Body Mass Index （BMI） were measured in three groups. IMT of carotid was examined with high-resolution ultrasonography. Results There were significant differences in FBG, FINS, IMT, Insulin sensitivity index （IAI） among three groups. The IMT was positively correlated with BMI and FBG; negatively correlated with IAI. Conclusion The IMT in elderly hypertensive patients are higher than that of the healthy individuals, which are significantly associated with the development of IR.