胰岛素抵抗与盐敏感高血压关系研究

目的 研究胰岛素抵抗与盐敏感高血压关系.方法 以高血压家系成员为观察对象,用静脉盐水负荷和速尿利钠相结合的方法确定盐敏感者,以葡萄糖耐量试验、胰岛素释放试验及胰岛素敏感指数判断胰岛素抗性.结果 高血压家系中,无论高血压患者还是血压正常个体,盐敏感者空腹及糖负荷试验各时点的血糖值、胰岛素释放试验各时点血胰岛素水平均大于盐不敏感者(P<0.05或P<0.01);而胰岛素敏感指数小于盐不敏感者(高血压组:0.011±0.004vs0.016±0.005,P<0.01;血压正常者:0.013±0.003vs0.018±0.003,P<0.05).结论 盐敏感者存在胰岛素抵抗现象,胰岛抵抗、高胰岛素血症可能通过钠代谢异常参与盐敏感高血压发病机制.

Study on Association of Insulin Resistance with Salt Sensitive Hypertension

Objective To investigate the relationship between insulin resistance and hypertension with salt sensitivity.Methods Based on our presious studies,238 members in 5 pedigrees were recruited.Venin sodium load and furosemide sodium volume depletion were employed to determine the salt sensitivity;Glucose tolerane test(OGTT),insulin realease test(InsRT)and insulin sensitivity index(InsSI)were performed to determine insulin resistance.Results Compared to NSS,the plasm glucose and insulin concentration in every time point during OGTT and InsRT were much higher(P<0.05 or P<0.01),insulin senstive index was much lower in SS(HBP:0.011±0.004 vs 0.016±0.005,P<0.01;NBP:0.013±0.003 vs 0.018±0.003,P<0.05).Conclusion Insulin resistance,by enhancing tubular sodium reabsorption and increasing sympathetic activity,plays a role in the pathogenesis of salt sensititive hypertension.