肥胖和非肥胖高血压患者胰岛β细胞早期分泌相的改变

Changes of Earlyphase Insulin Secretion in Hypertensive Patients with or without Obesity

目的了解肥胖高血压和非肥胖高血压患者胰岛β细胞早期分泌相的变化规律。方法用左旋精氨酸（Ｌ－Ａｒｇ）刺激法对高血压患者胰岛β细胞分泌功能进行了研究。结果（１）空腹胰岛素（ＩＮＳ）、Ｃ肽值肥胖高血压组明显高于对照组和非肥胖高血压组（Ｐ＜０．０５或Ｐ＜０．０１），后两者间无明显差异（Ｐ＞０．０５）。（２）Ｌ－Ａｒｇ兴奋后肥胖高血压和非肥胖高血压组ＩＮＳ和Ｃ肽分泌在４ｍｉｎ时达峰值，而对照组２ｍｉｎ达峰值。（３）Ｌ－Ａｒｇ兴奋后ＩＮＳ和Ｃ肽各时间点增加值的和（ΔΣ）肥胖高血压组明显高于对照组和非肥胖高血压组，后两者无显著差异。（４）肥胖高血压组ΔΣＩＮＳ与ＤＢＰ和体重身高指数（ＢＭＩ）均呈明显正相关（Ｐ＜０．０５），非肥胖高血压组则无相关性。结论肥胖高血压患者存在胰岛素抵抗，Ｌ－Ａｒｇ刺激胰岛β细胞早期分泌相是增加的；非肥胖高血压患者胰岛素抵抗不明显。

Aim To explore the early plasma insulin secretion in hypertensive patients with and without obesity. Methods With view to defining the changes of early secretion function of islet βcells in hypertensive patients with or without obesity, Larginine(LArg) was used to stimulate insulin secretion of islet β cell. Results (1)The levels of fasting insulin(INS) and cpeptide in obese hypertensive group(OH) were clearly higher than those of control group(CG) and nonobese hypertensive group(NOH). There was no difference between the latter two groups. (2)The peak values of INS and Cpeptide in OH and NOH stimulated by LArg was found at the fourth minutes; while in the control group it occurred at the second minutes. The peak values of INS were highest in OH among the three groups. (3)The increases in INS and Cpeptide (ΔΣ) in NOH and control group were significantly smaller than that of OH patients, but there were no difference between NOH and control group. (4)Multiple regression analysis demonstrated that ΔΣ INS had positive correlation with diastolic pressure and body mass index, fasting INS also positive correlated with body mass index. Conclusion The firstphase insulin secretion responsed to LArg was increased in OH,the mechanism of which may be ascribed to the insulin resistance.