肥胖伴隐性高血压患者动态动脉硬化指数与胰岛素抵抗的关系

目的探讨肥胖伴隐性高血压（MH）患者动态动脉硬化指数（AASI）与胰岛素抵抗的关系。方法选择诊所血压正常的肥胖患者80例和体质指数正常的健康体检者40例作为对照组，均行24h动态血压（ABP）监测，并测定空腹血糖（FPG）、血浆胰岛素（FINS）和血脂水平。根据ABP结果计算AASI，采用稳态模型评估法计算胰岛素抵抗指数（HOMA—IR），分析MH组的AASI水平与HOMA—IR的相关性。结果MH组的AASI最高（0．51±0．09），对照组和肥胖组的AASI分别为0．41±0．05和0．43±0．05，与MH组比较，差异均有统计学意义（P〈0．01）。MH组的HOMA—IR（4．70±0．96）高于肥胖组（2．46±0．65），肥胖组（2．46＋0．65）高于对照组（1．98±0．42），差异均有统计学意义（P〈0．01，P〈0．05）。Pearson相关分析显示，MH组AASI与HOMA—IR呈正相关（r=0．497，P〈0．01）。结论肥胖患者存在高胰岛素血症，胰岛素抵抗与肥胖伴MH患者的动脉硬化程度有关。

The relationship of ambulatory arterial stiffness index and insulin resistance in patients with masked hypertension and obesity

Objective To investigate the relationship between ambulatory arterial stiffness index （AASI） and insulin resistance in patients with masked hypertension （MH） and obesity. Methods According to the results of ambulatory blood pressure （ABP） monitoring and body mass index （BMI）, 120 subjects with normal clinic blood pressure （CBP） were divided into three groups： obesity group （44 cases）, obesity with MH group （36 cases） and healthy control group （40 subjects）. The ABP monitoring for 24 h, fasting blood glucose （FPG） and fasting plasma insulin （FINS） were examined. According to the result of ABP, AASI was calculated, and the insulin resistance index （HOMA-IR） was assessed by homeostasis model assessment. The correlation between AASI and HOMA-IR in MH group was analyzed. Results AASI （0.51±0.09） in MH group was significantly higher than those （0.41±0.05 and 0.43±0.05, respectively） in obesity and control group （P〈0.01）. HOMA-IR （4.70±0.96） in MH group was significantly higher than those （2.46±0.65 and 1.98±0.42, respectively） in obesity and control group （P〈0.01）. Pearson correlation analysis showed that there was a positive correlation between AASI and HOMA-IR in MH group （r=0.497, P〈0.01 ）. Conclusion The arteriosclerosis may be associated with insulin resistance in patients with MH and obesity.