伴空腹血糖受损高血压病患者胰岛素抵抗和胰岛β细胞功能的观察

Hypertensive patients with impaired fasting glucose insulin resistance and β cell function observed

目的研究空腹血糖受损（IFG）的高血压病患者胰岛素抵抗和胰岛β细胞功能状态。方法门诊94例高血压病患者，根据糖耐置情况分为正常糖耐量组（NGT组）35例，IFG组31例，2型糖尿病组（T2DM组）28例。测量血压、身高、体重、腰围、臀围、血脂、空腹及糖负荷后2／小时血糖及胰岛素等参数，计算出体重指数、腰臀围比值、胰岛β细胞功能指标[FINS、FBCI、糖负荷后30分钟净增胰岛素与净增葡萄糖的比值（A130／AG30），HOMA—IS]、胰岛素抵抗指标（IAI，HOMA—IR）。各组间进行统计学比较。结果各组高血压病患者聚集肥胖或超重、腰臀围比值增高、脂代谢紊乱等心血管危险因素；同时，IFG组与T2DM组舒张压高于NGT组，IFG组与T2DM组LDL—C、TG水平高于与NGT组，T2DM组HDL—C低于NGT组；三组之IAI分别为（-3．26±0．62）、（-3．61±0．68）、（-4．01±0．77），HOMA—IR分别为（0．67±0．46）、（0．92±0．53）、（1．01±0．52），HOMA—IS分别为（4．87±1．35）、（4．20±1．02）、（3．51±1．57），FBCI分别为（-2．12±0．35）、（-2．32±0．43）、（-2．39±0．48），△130／△G30分别为（18．3±7．4）、（11．9±4．8）、（2．4±0．9）；统计学分析示ICT组、T2DM组间FBCI、HOMA—IR比较，差异无显著性（P〉0．05），其余各级间比较差异有显著性（P〉0．05或P〉0．01）。随着FBG升高，胰岛素敏感降低，IR增强，胰岛β细胞功能下降，提示IFG组和T2DM组较NGT组都聚集较强的致动脉粥样硬化危险因素。结论IFC组和T2DM组与NCT组比较，IR更强，胰岛B细胞功能下降；住临床上，T2DM组和IFG组聚集更强致冠心病危险因子。

Objective To study impaired fasting glucose （ IFG ） in hypertensive patients insulin resistance and pancreatic β cell function status. Methods 94 cases of out-patients with hypertension, aceording to glucose tolerance group were divided into normal glucose tolerance （ NGT n = 35 ）, IFG group of 31 cases, type 2 diabetes （ T2DM group ） in 28 cases. Blood pressure, height, weight, waist circumference, hip circumference, blood lipids, fasting and 2 hours after glucose load blood glucose and insulin and other parameters, weight and body mass index, waist hip ratio, pancreaticβ cell function index （ FINS, FBCI, after the glucose load net increase of 30 minutes, the ratio of glucose, insulin and a net increase （ ？ 130 / ？ G30 ）, HOMA-IS ）, insulin resistance index （ IAI, HOMA-IR ）were all conducted and analyzed and as well as the statistical comparison between each group. Results Cardiovascular risk factors such as obese or overweight, increased waist-hip ratio, lipid metabolism disorders were gathered in all groups in hypertensive patients; meanwhile, IFG group and the T2DM group diastolic blood pressure higher than NGT group; IFG group and the T2DM group LDL-C, TC level higher than the group with NGT, T2DM group HLDL-C less than the NGT group; Three groups of IAI （ -3.26 ± 0.62 ）, （ -3.61 ± 0.68 ）, （ -4.01 ± 0.77）, HOMA-IR （0.67±0.46）, （0.92±0.53）, （1.01±0.52）, HOMA-IS （4.87±1.35）, （4.20±1.02）, （3.51±1.57）, FBCI（-2.12±0.35）, （-2.32±0.43）, （-2.394±0.48）, ？130/？G30 （ 18.3 ± 7.4 ）, （ 11.9 ± 4.8 ）, （ 2.4 ± 0.9 ）, statistical analysis showed IGT group, T2DM group FBCI, HOMA-IR had no significant difference （ P〉 0.05 ）, between the other levels there were significant differences （ P〉 0.05 or P〉 0.01 ）. With FBG increased, insulin sensitivity decreased, IR enhanced 13-eell function declined, showing that T2DM and IFG groups gathered much stronger risk factors for atheroselerosis than those in NGT group. Conehmion Among the IFG , NGT and the T2DM groups, IR enhanced, β-cell function decreased; clinically, T2DM group and the IFG group gathered more risk factors for coronary artery disease.