2型糖尿病伴原发性高血压患者的胰岛素抵抗的研究(英文)

Characteristics of insulin secretion and insulin resistance in subjects of type 2 diabetes with essential hypertension

目的研究2型糖尿病伴原发性高血压(T2DM+EH)患者的胰岛功能及胰岛素抵抗。方法应用BA-ELISA法测定96例正常糖耐量(NGT)、132例T2DM和148例T2DM+EM三个实验组的血清真胰岛素(TI)水平,并计算出胰岛素敏感性指数(IAI)、胰岛素抵抗指数(HomalIR)和β细胞功能指数(HBCI)。结果IAI分别为-2.44±0.83,-3.46±0.99和-3.98±0.68; HBCI分别为4.23±0.18,2.39±0.11和2.41±0.14;Homa-lIR分别为-0.67±0.83,0.35±0.99和0.86±0.68。T2DM及T2DM+EH组IAI、HBCI均低于NGT组,经协方差分析,差异具有非常显著性(P<0.01),HomalIR明显高于NGT组,且差异具有非常显著性(P<0.01)。T2DM+EH组IAI低于T2DM组,差异有显著性(P<0.05),HomalIR高于T2DM组且差异有显著性(P<0.05),T2DM、T2DM+EH二组间HBCI差异无显著性(P>0.05)。结论2型糖尿病伴原发性高血压较单纯2型糖尿病胰岛素抵抗加重,胰岛素敏感性减低,而胰岛素β细胞分泌功能损害并无加重。

Objective:To research the characteristics of insulin secretion and insulin resistance(IR)in sub-jects of type2diabetes with essential hypertension.Method:The fasting serum true insulin(TI)were deter-mined with BA-ELISA method,fasting serum immunoreactive insulin(IRI)with radioimmunoassay,fasting plasma glucose(FPG)with enzyme method in96subjects of impaired glucose tolerance(NGT),132subjects of type2diabetes(T2DM)and148subjects of T2DM with essential hypertension(T2DM+EH),who did not undergone any antihypertensive treatments in two weeks.On the basis of FPG and TI or IRI,insulin secretion index(HBCI)and insulin resistance level(including Homa model insulin resistance index-IR and insulin sensitivity index-IAI)were calculated.Results:There were significant differences in body mass index(BMI)among the three groups.TI value was higher in subjects with T2DM than that in subjects with NGT,but there was no signifi-cance between T2DM and NGT(P>0.05).Subjects in T2DM+EH had higher TI level than those in T2DM and NGT,and there was significant difference among the three groups(P<0.05).Other indexes were as follows:IAI-2.44±0.83(NGT),-3.46±0.99(T2DM)and-3.98±0.68(T2DM+EH).HBCI4.23±0.18(NGT),2.39±0.11(T2DM) and2.41±0.14(T2DM+EH).HomaIR-0.67±0.83(NGT),0.35±0.99(T2DM)and0.86±0.68(T2DM+EH).IAI and HBCI in T2DM and T2DM+EH groups were lower than those in NGT,and the differences were significant.HomaIR in T2DM and T2DM+EH groups was higher than those in NGT group,and the difference was signifi-cant.IAI in T2DM+EH group was significantly lower than that in T2DM group.HomaIR in T2DM+EH group was significantly higher than that in T2DM group.HBCI in T2DM+EH group was higher than that in T2DM group,but the difference was not significant.Conclusion:Insulin resistance is more serious and insulin sensitiv-ity is lower in subjects of type2diabetes with essential hypertension than those in type2diabetes,while in-sulin secretion is not more serious in type2diabetes with essential hypertension.