老年高血压病患者胰岛素抵抗与其他代谢异常的关系

目的　探讨老年高血压病 (EH)患者胰岛素抵抗 (IR)与其他代谢异常的关系。方法　对在我院体检的年龄在 6 0岁以上的高血压病和正常人群共 75例行葡萄糖耐量试验 (OGTT)及胰岛素释放试验。用胰岛素抵抗指数 (HOMA IR)作为胰岛素敏感性评价指标 ,将 75例受试人群分为三组即正常对照组 30例 ,单纯高血压病 (EH)组 2 0例 ,高血压病合并胰岛素抵抗组 (EH +IR)组 2 5例。结果　①老年EH患者HOMA IR值比老年正常对照组明显升高 [(3 0 1± 0 4 8)∶(3 92± 0 2 9) ,P <0 0 1]。 4 5例EH患者中 ,有 5 5 6 % (2 5 /4 5 )存在胰岛素抵抗。②EH +IR组中体重指数、血脂、血压、血尿酸等代谢紊乱的发生率比单纯EH组及正常对照组均明显升高。结论　胰岛素抵抗可能是老年高血压病患者其他各项代谢异常的基础。

Relationship between insulin resistance and metabolic abnormality in old hypertension patients

Objective To investigate the relationship between insulin resistance(IR)and body mass index(BMI),blood pressure,plasm lipid,serum uric acid(Ur) in elderly patients with hypertension(EH).Methods Glucose tolerance test was taken among 75 people aged 60 years and over- who joined the body check in our hospital.HOMA-IR was applied to estimate insulin resistance.All subjects were classified as normotensive group,hypertensive group(EH),and hypertensive group with insulin resistance(EH+IR).Results (1)HOMA-IR in EH was ligher than that in nomal group [(3.01±0.48)∶(3.92±0.29),P<0.01],and the incidence IR was 55.6%(20/45).(2)Blood pressure,BMI,plasm lipid and Ur in EH with IR were significantly higher than those in EH without IR and the normotensive group.Conclusion The data suggest that IR may aggravate abnormality of blood press,BMI,plasm lipid and Ur metabolism in old patients with hypertension.