老年高血压患者动态血压与血糖、糖化血红蛋白、胰岛素水平关系

Clinical study on relationship between circadian rhythm of ambulatory blood pressure and level of blood sugar,glycohemoglobin and insulin in senile patients with hypertension

目的探讨老年高血压患者血压昼夜节律与血糖、糖化血红蛋白、胰岛素水平之间的关系。方法对52例老年原发性高血压患者进行动态血压监测(ABPM)、葡萄糖耐量实验(OGTT)、糖化血红蛋白含量及胰岛素水平的测定。根据葡萄糖耐量实验分为糖耐量正常(NGT)、糖耐量减低(IGT)和2型糖尿病(T2DM)三组,对三组间动态血压参数和糖代谢指标进行统计学分析。结果IGT组24hDBP和nDBP显著低于T2DM组(P<0.05)。T2DM组非杓型和反杓型的血压节律发生率明显高于NGT组(P<0.01)。T2DM组血糖、糖化血红蛋白含量、胰岛素水平显著高于NGT、IGT组(P<0.05)。结论脉压增大与餐后血糖、糖化血红蛋白密切相关,非杓型血压与糖化血红蛋白、胰岛素水平显著相关。

Objective To observe the relationship between circadian rhythm of ambulatory blood pressure and lever of blood sugar, glycohemoglobin and insulin in senile patients with hypertension. Methods Ambulatory blood pressure monitoring and oral glucose tolerance test （OGTF） and glycohemoglobin and plasma insulin concentra- tion were detected in 52 senile hypertensive patients. The patients were divided into nomal glucose tolerance （NGT） group and type 2 diabetes mellitus （T2DM） and impaired glucose tolerance （IGT） group to analyze ambulatory blood pressure parameters and glucose metabolism. Results 24h DBP and nDBP were lower in IGT group than those of T2DM （P 〈 0.05 ）. In T2DM group, Circadian rhythm of non-dipper and reverse dipper were increased than that of NGT group （ P 〈 0.01 ）. Blood sugar and glycohemoglobin and plasma insulin concentration in T2DM group were sig- nificantly higher than those of NGT and IGT group （ P 〈 0.05 ）. Logistic regressive analysis showed increased pulse pressure was related to 2h PG and glycohemoglobin level, circadian rhythm of non-dipper and glycohemoglobin and plasma insulin were positively correlated. Conclusions Increased pulse pressure is closely related to the post prandi- al glucose and glycohemoglobin, and non-dipper blood pressure has positive relationship with glycohemoglobin and plasma insulin level.