氯沙坦对胰岛素抵抗的影响

The effects of Losartan on the insulin resistance

目的探讨高血压病(EH)患者与胰岛素抵抗(IR)的关系及氯沙坦的干预作用。方法采用己糖激酶法、放射免疫法检测26例EH患者氯沙坦治疗前后空腹血糖(FPG)、空腹胰岛素(FINS) ,采用1/(FPG×FINS)和FINS/FPG分别计算胰岛素敏感性指数(IAI)和胰岛素分泌指数(IS)。与26例正常对照组相比较。结果EH患者FPG、FINS、IS较正常对照组明显增高(P<0.001) ,IAI较正常对照组明显降低(P<0.001)。氯沙坦治疗4周后 ,在有效降压的同时 ,FPG、FINS明显降低 ,与治疗前相比 ,差异有显著性意义(P<0.05或P<0.01) ,IAI增高(P<0.05) ,IS虽有降低 ,但差异无显著性意义(P>0.05)。结论EH患者胰岛素敏感性降低和高胰岛素血症并存即存在IR。氯沙坦治疗4周后 ,在有效降压的同时 ,能提高胰岛素敏感性 。

Objective To discuss the relationship between the patients with essential hypertension(EH) and the insulin resistance(IR), and the curative effects of Losartan. Methods 26 cases with EH were treated with Losartan, before(and after) this treatment, fasting plasma glucose(FPG)?fasting plasma insulin(FINS) were determined by hexokinase method and radioimmunmoassay. The insulin acuity index(IAI) and insulin secreting(IS) were calculated separately by 1/(FPG×FINS) and FINS/FPG. And the data were compared to those of 26 normal persons. Results FPG? FINS?IS of the EH patients were remarkable higher than those of normal persons(P<0.001), but IAI was remarkable lower(P<0.001). After 4 weeks of treatment with Losartan, not only the blood pressure(BP) of the patients were improved, but FPG?FINS were lower than those before treatment(P<0.05或P<0.01), and IAI were risen(P<0.05). Though IS was risen, but were not remarkable(P>0.05). Conclusion It suggests that there is IR if there are symptoms of IAI and hyper_insulinemia(HINS). After 4 weeks of treatment with Losartan, BP is lowered effectively, and IAI is risen simultaneously, IR is improved.