藏族原发性高血压家系正常儿童胰岛素及胰岛素敏感性的研究

目的　观察藏族原发性高血压家族儿童的空腹胰岛素及胰岛素敏感性状况。方法　1997年 6月至 1998年 8月在拉萨地区横断面整群调查的基础上建立高血压家系图及正常对照家系图 ,入选高血压家系的儿童 4 7例和正常血压家系的儿童 2 1例 ,采用病例 对照的研究方法进行研究。结果　高血压家系的儿童空腹血糖略高于对照组 ,但是未达到差异有显著意义。高血压家系儿童空腹胰岛素水平为 (10± 7.0 )mIU/L显著高于对照组为 (6 .6± 2 .8)mIU/L ,两者之间差异有显著意义 (P <0 .0 5 )。高血压家系儿童的胰岛素敏感指数 (0 .0 36± 0 .0 2 4 )显著低于对照家系儿童 (0 .0 4 6±0 .0 2 2 ) ,经调整体重指数后 ,仍然达临界显著性差异水平。结论　藏族原发性高血压家族的正常血压儿童与对照家系儿童相比已经存在高胰岛素血症 ,并且胰岛素敏感性下降 ,提示这些代谢异常可能与成年后高血压及脂质代谢异常的发生有关。

Fasting plasma insulin and insulin sensitivity in the offspring of parents with a family hypertensive history

OBJECTIVE: To investigate the plasma insulin levels and insulin sensitivity in the offspring of parents with family hypertensive history in Tibetan population. METHODS: Tibetan hypertensive pedigrees and normotensive pedigrees based on a door-to-door cross section study performed from 1997 to 1998 in stable communities in the ruban district of Lhasa city were set up, 47 offsprings from hypertensive pedigrees (group I) and 21 offsprings from normotensive pedigrees (group II) were enrolled into this study. Plasma insulin levels using by radioimmunoassay and insulin sensitivity with the formulae insulin sensitivity = 1/(fasting plasma glucose x fasting plasma insulin) were compared between two groups. RESULTS: There were no statistically significant differences in fasting blood glucose levels between group I and group II. But fasting plasma insulin level was 10.20 +/- 6.95 m IU/L in group I and 6.56 +/- 2.81 m IU/L in group II, respectively, and there were statistically significant differences between these two groups. The insulin sensitivity index in group I was significantly lower than that in group II (0.036 +/- 0.024 and 0.046 +/- 0.022, respectively). CONCLUSION: Offspring of Tibetan hypertensive pedigrees were observed to be hyperinsulinemia and reduced insulin sensitivity. These metabolic abnormalities may be associated with hypertension and dyslipidemia in adulthood.