胰岛素抵抗与2型糖尿病直立性低血压的关系

Relationship between insulin resistance and Type 2 diabetes mellitus with postural hypotension

目的:探讨2型糖尿病及糖尿病合并高血压(diabetesmellituswithhy-pertension,DMH)患者发生直立性低血压(posturalhypotension,PH)与胰岛素抵抗,体重指数(BMI)的关系。方法:糖尿病与DMH患者各62例,其中糖尿病组男38例,女24例,年龄32～72岁。DMH组男36例,女26例,年龄36～78岁。检测两组患者卧、立位血压、BMI、C肽和血糖水平,比较不同患者这些指标的差异。结果:糖尿病发生PH低于DMH(24/62和38/62,χ2=6.323,P<0.01);糖尿病+PH患者与DMH+PH患者卧立位收缩压和舒张压变化幅值(mmHg)高于糖尿病患者(收缩压26.40±1.45和22.60±0.83,F=238.8,P<0.01;舒张压12.60±0.89和12.10±1.42,F=56.3,P<0.01),DMH+PH患者的血C肽(mg/L)显著高于DMH+PH患者(1.25±0.33和1.30±0.22,F=9.9,P<0.01),而胰岛素敏感指数显著低于糖尿病发生PH患者(0.02±0.04和0.03±0.07,F=52.8,P<0.01)。结论:糖尿病合并PH者存在明显胰岛素抵抗,糖尿病合并高血压则更易发生PH。

AIM:To explore the postural hypotension(PH) in patients suffering from type Ⅱ diabetes mellitus and diabetes mellitus with or without hypertension(DMH or DM ) and the relationship between PH and Hyperinsulinemia and insulin resistance, B MI. METHODS:Sixty-two DM patients(male 38 and female 24),aged 32-72,and 62 DMH p atients(male 36 and female 26),aged 36-78, were investigated.To measure The lyi ng and standing blood pressure,body mass index(BMI),C peptide(CP), blood sugar l evel of both groups were measured,and the differences were compared. RESULTS:The occurrence rate of PH in DM was lower than in DMH(24/62 and 38/62 respectively,χ2=6.323,P< 0.01), the changes of lying and standing blood pressur e(systolic and diastolic) in DM +PH and DMH+PH(mmHg) were higher than that in DM(systolic pressure: 26.40±1.45 and 22.60±0.83,F= 238.8,P< 0.01).The blood C P of patients in DMH+PH was significantly higher than that in DMH+PH(1.25±0.3 3 and 1.30±0.22,F=9.9,P< 0.01), while the sensitive index of insulin was sign ificantly lower than that in PH(0.02±0.04 and 0.03±0.07,F=52.8,P< 0.01).