高血压病不同血压水平与胰岛素抵抗的相关性研究

目的研究高血压病(EH)不同血压水平与胰岛素抵抗(IR)的相关性。方法选取EH患者413例为EH组,根据血压分级标准分为EHA组(258例)、EHB组(108例)和EHC组(47例),同时选取对照组55例。分别测定空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、尿酸(SUA),并计算胰岛素抵抗指数(HOMA-IR)、β细胞分泌功能指数(HOMA-β),在EH组与对照组间、EHA～C组间进行资料对比。结果 EH组FINS、HOMA-IR及TG比对照组明显增高(P<0.01),HDL-C明显下降(P<0.01),FPG和SUA有增高趋势(P<0.05),HOMA-β和TC在两组间无明显变化(P>0.05)。EH各亚组FINS、HOMA-IR、TC、TG及SUA与血压同步升高(P<0.01),HDL-C进行性下降(P<0.01),而HOMA-β无明显变化(P>0.05)。结论 EH患者血压、FINS、TG、TC、SUA与IR正相关,HDL-C与之负相关;EH患者存在高胰岛素血症,但HOMA-β在正常代偿范围,并使血糖在正常区间波动。

The Correlation between Level of Essential Hypertension and Insulin Resistance

To investigate the relationship of level of essential hypertension(EH) with insulin resistance(IR).Methods 413 patients with EH were selected as EH group,and divided into EHA group(258 cases),EHB group(108 cases) and EHC group(47 cases) according to the different blood pressure grades.55 normal subjects were chosen as control group.Fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),serum uric acid(SUA) were measured,and insulin resistance index(HOMA-IR),the function index of islet beta-cell(HOMA-β) were calculated.All of the data were compared between EH group and control group,also among the three hypertension groups.Results FINS,HOMA-IR and TG in EH group were significantly higher than those in the control group(P<0.01),but HDL-C was significantly lower(P<0.01).FPG and SUA in EH group had the trend of increment(P<0.05).HOMA-β and TC had no difference between the two groups(P>0.05).FINS,HOMA-IR,TC,TG and SUA increased gradually with the level of hypertension in the three inferior groups(P<0.01),and HDL-C presented progressive decline(P<0.01).HOMA-β had no obvious variation among them(P>0.05).Conclusion Blood pressure,FINS,TG,TC,SUA in the patients with EH have positive relations with IR,and some negative connection between HDL-C and IR;the patients with EH bear hyperinsulinemia,but HOMA-β is in the normal range,which can regulate FPG.