Ⅱ型糖尿病并高血压患者胰岛素和脂蛋白水平的关系

Relevance between insulin and apo in NIDDM with hypertension

目的：通过测定非胰岛素依赖型糖尿病（NIDDM）并高血压患者血中胰岛素浓度以了解高胰岛素血症与高血压脂蛋白代谢异常的关系。方法：配对观察高血压及无高血压糖尿病（HP－NIDDM组及NP－NIDDM组）各35例，行口服葡萄糖耐量和胰岛素释放试验，并与30例正常人（对照组）进行比较，分别测空腹，30、60、120、180min血糖及胰岛素水平，计算出胰岛素曲线下面积，三组均测血浆甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、载脂蛋白AI（apoAI），载脂蛋白B（apoB）及糖化血红蛋白（HbAic）。结果：HP－NIDDM组的体重指数（BMI）、TC、TG、LDL、apoB和HbAic高于对照组，HDL、apoAI低于对照组（均P＜0．05），TG、LDL、apoB和HbAic高于NP－NIDDM组，HDL、apoAI低于NP－NIDDM组（均P＜0．05），而BMI、TC及HbAic无统计学差异（均P＞0．05）；NP－NIDDM组的TC、TG、LDL和HbAic高于对照组，HDL低于对照组（均P＜0．05），余无统计学差异（均P＞0.05）。结论：HP－NIDDM患者存在胰岛素抵抗及高胰岛素血症与血脂apoAI、apoB关系密切。

objective: To explore the relationship between hypertension, hyperinsulinism and abnormality of lipid metabolism. Method: OGTT insulin-set-free-test, TC, TG, HDL, apoAI and apoB were measured in 35 hypertensive NIDDM (HP-NIDDM), 35 normotensive NIDDM (NP-NIDDM) and 30 healthy controls. Blood sugar and insulin were measured at fasting, 1/2, 1, 2 and 3 hour after testing meals. The area below the insulin (ABID) was calculated. Result:The fasting-insulin, ABID, TC, TG, LDL, apoB, HbAic of HP-NIDDM were higher than those of healthy controls, but HDL and apoAI were lower than those of controls (P <0. 05). TC and TG had no difference between NP-NIDDM and HP-NIDDM. BMl,LDL,apoB were higher in HP-NIDDM than in NP-NIDDM (P < 0. 05). An obvious correlation was found between insulin-resistance,hyperinsulinism apoAI and apoB. Conclusion: These results show that hyperinsulinism and insulin-resistance exist in HP-NIDDM and there is an obvious correlation between apoAI,apoB and hyperinsulinism and insulin-resistance.