高血压患者血浆胰岛素水平与血脂、脂蛋白和载脂蛋白关系

目的 探讨高血压患者血浆胰岛素水平与血脂、脂蛋白和载脂蛋白浓度的关系.方法 按不同体重指数(BMI)和血浆胰岛素浓度将高血压患者进行分组,观察不同BMI的高血压患者血浆、胰岛素水平,血糖和三酰甘油(TG)的改变以及TG与胰岛素浓度的关系.结果 高血压患者体重指数(BMI)、血浆胰岛素水平、血糖、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)较对照组显著升高.高密度脂蛋白胆固醇(HDL-C)和载脂蛋白AI(apoAl)显著降低.MBI与血浆胰岛素(r=0.357,P<0.0001)和血糖浓度(r=0.240,P<0.002)呈正相关.血浆胰岛素浓度与血糖呈正相关(r=0.388,P<0.0001)二者均随BMI而增加.BMI>30和血浆胰岛素浓度>20mU/L患者TG浓度明显高于≤26和≤20mU/L的患者.结论 (1)血浆胰岛素浓度升高即高胰岛素血症(HIS)是高血压患者血脂异常的原因之一.(2)BMI和TG浓度增加可作为临床判断胰岛素抵抗(IR)的指标.

The relationships between plasma insulin levels and lipids .lipoproteins and apolipoproteins in hypertensive patients

Objective Evaluating the effects of plasma insulin concentration on lipids, lipoproteins and apolipopro-teins. Methods Subdivioling the hypertensivies in to different subgreups according to body mass index (BMI) and plasma insulin levels, to observe the changes of plasma insulin glucose and triglyceride (TG) in different BMI groups and the relationship between TG and plasma insulin. Results After compared with the controls, we found that the body mass index (BMI),plasma insulin levels, blood glucose ,total cholesterol (TO ,triglycerides(TG), low density lipoprotein cholestrol (LDL-C) and apolipoprotein B (apoB) were significantly increased and high density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (apo AD were decreased in hypertensives. In hypertensives, the BMI was positively cortelated with the concentration of plasma insulin(r=0. 357,P<0.0001)and glucose(r=0. 240,P<0. 002). Insulin levels elevated with the increasing of BMI and had positive correlation with blood glucose(r = 0. 388,P<0. 0001). The TG levels in patients whose BMI>30 and in whose insulin levels> 20mU/L. was significantly increased than in those ≤26 and those <20mU/L respectively. Conclutions 1 The elevated plamsa insulin(e.g hyperinsulinemia HIS) is one of the important cause of dyslipidemia. 2 high BMI and the increased TG concentration is a valuable indicator to identify insulin-resistance in clinic.