Ⅱ型糖尿病伴高血压患者胰岛素抵抗与红细胞膜胰岛素受体之间的关系

The Relationship between Insulin Resistance and Insulin Receptors in Patients with Essential Hypertension Associated with Ⅱ type Diabetes Mellitus

目的探讨伴Ⅱ型糖尿病的高血压（ＥＨ＋ＤＭ）患者胰岛素抵抗（ＩＲ）与红细胞膜胰岛素受体之间关系。方法原发性高血压（ＥＨ）患者１８例，Ⅱ型糖尿病（ＤＭ）患者２６例，ＥＨ＋ＤＭ患者２１例，正常人（ＮＴ）２４例作为对照。取晨空腹肘静脉血分离血浆和红细胞，检测血糖（ＢＧ）、血胰岛素（ＩＮＳ）及红细胞膜胰岛素受体（ＩＮＳＲ）数目和亲和力。结果与ＮＴ组比较，ＥＨ组ＢＧ水平（ｍｍｏｌ／Ｌ）在正常范围（６．１±０．７ｖｓ５．１±０．９，Ｐ＞０．０５），ＩＮＳ水平（ｍＵ／Ｌ）明显升高（１９．５±１１．４ｖｓ１３．５±５．２，Ｐ＜０．０１）口服葡萄糖耐量试验中ＢＧ曲线下面积（ｍｍｏｌ／Ｌ·ｈ－１）明显增大（２１．７±４．２ｖｓ１８．４±３．４，Ｐ＜０．０１），ＩＮＳ曲线下面积（ｍｍｏｌ／Ｌ·ｈ－１）明显增大（１７９．８±７３．１ｖｓ１１０．０±４２．５，Ｐ＜０．００１）。高亲和力ＩＮＳＲ数目明显减少（Ｐ＜０．０５）。ＤＭ组和ＥＨ＋ＤＭ组的ＢＧ和ＩＮＳ水平及ＢＧ曲线下面积明显高于ＥＨ组（Ｐ＜０．０１），而后者ＩＮＳ曲线下面积与ＥＨ组无显著性差别，高亲和力ＩＮＳＲ数目较ＥＨ组明显减少（Ｐ＜０．００１）。结论ＩＲ不仅是Ⅱ糖尿病发病的重?

Aim\ To investigate the relationship between insulin resistance(IR)and insulin receptors (INSR)in patients with essential hypertension(EH)associated with Ⅱ type diabetes mellitus (DM).\ Methods\ Plasma glucose (BG) and insulin (INS)before and during the oral glucose tolerance test (OGTT), and erythrocyte INSR were determined in 18 patients with EH,26 patients with DM, 21 patients with EH+DM,and 24 normotensive control subjects (NT).\ Results\ Plasma BG levels in EH was within the normal range,INS level is significantly increased. The area under the curve (AUC) of OGTT is in the upper limited value of normal range. The AUC of INS in OGTT is markedly increased, and the number of INSR with high affinity is significantly decreased in EH group. Plasma BG and INS levels,and AUC of plasma BG are significantly higher in groups of DM and EH+DM. The numbers of INSR with high affinity are significantly decreased than those in EH group( P <0.01).\ Conclusions\ IR is not only the crucial pathogenesis mechanism for diabetes mellitus,it seems to be a main factor for promoting the development of hypertension. Decreased INSR number in erythocyte has been shown to be associated with IR.