超重及肥胖高血压患者空腹胰岛素、胰岛素原、瘦素水平与高血压的关系

Association of Fasting Serum Insulin,Proinsulin and Leptin Levels with Hypertension in Over-weight or Obese Subjects

目的 研究超重和肥胖高血压组和超重肥胖正常血压组病人的临床特征和代谢特点 ,比较血清胰岛素、胰岛素原、瘦素水平 ,并探讨这些因素与高血压的关系。方法 选择肥胖 /超重病人 15 2例 ,年龄 2 0～ 6 5岁 ,BMI≥ 2 5。男性 84例 ,女性 78例。高血压组 78例 ,正常血压组 74例。采用HOMA指数评价胰岛素抵抗程度。比较两组间体脂参数、代谢紊乱特点、空腹血清胰岛素、胰岛素原、瘦素水平 ,分析超重及肥胖病人发生高血压的危险因素。结果 两组胰岛素抵抗程度相同 ,高血压组腰臀比增加 ,糖代谢异常、脂代谢异常程度均大于正常血压组 ,胰岛素原水平高于正常血压组。两组之间空腹瘦素水平差异无显著性。超重及肥胖病人的增龄、腰臀比增加、胰岛素原水平、伴糖代谢异常和脂代谢异常是发生高血压的危险因素 ,经BMI校正后这一关系不再显著。结论 肥胖伴高血压病人呈内脏型肥胖趋势 ,糖代谢、脂代谢紊乱的程度高于正常血压组。肥胖病人发生高血压时已存在胰岛细胞受损。瘦素可能对肥胖病人高血压的发生没有重要作用。该组超重和肥胖病人发生高血压的主要危险因素是BMI增高目的 研究超重和肥胖高血压组和超重肥胖正常血压组病人的临床特征和代谢特点 ,比较血清胰岛素、胰岛素原、瘦素水平 ,并探讨这些因素与高?

Purpose To investigate the association of fasting serum insulin,proinsulin and leptin levels with hypertension in over weight or obese subjects. Methods 152 over weight or obese subjects aged 20 to 65 years were selected.The demographic parameters and metabolic profile in 78 hypertsive subjects were compared with 74 normotesives.Fasting serum insulin,proinsulin and leptin levels were mesured by RIA. Results Hypertensives had significantly higher W,WHR,fasting glucose and triglyceride levels than those of normotensives.Two groups did not differ in fasting serum insulin,leptin,and HOMA.Fasting serum proinsulin and proinsulin/insulin ratio were significantly increased in hypertensive group.Age,waist to hip ratio,proinsulin level,hyperglycemia and dyslipidemia were positively correlated with hypertension.But after adjusted by BMI,this correlation did not exist. Conclusions Hypertensive and normotensive subjects with over weight or obesity had the same insulin sensitivity level.Hypertensive subjects had more visceral fat and higher glucose and triglyceride levels than those of normotensive ones.β cell dysfunction presented in hypertensive patients probably be mediated through dyslipidemia.Leptin seems not to be a major factor to cause hypertension.