原发性高血压病合并空腹血糖受损患者胰岛素抵抗特征分析

目的分析代谢综合征(MS)病理生理过程中原发性高血压病(EH)合并空腹血糖受损(IFG)患者的胰岛素抵抗(IR)特征。方法根据EH和糖尿病诊断标准分为三组:EH+IFG组(29例)、EH组(30例)和对照组(30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)、身高、体质量,计算胰岛素抵抗指数(HOMA-IR)、β细胞分泌功能指数(HOMA-β)和体质量指数(BMI),对各组数据进行对比分析。结果①三组FPG、FINS、HOMA-IR、TG及HDL-C指标比较差异有统计学意义(P<0.01),BMI比较差异有统计学意义(P<0.05),HOMA-β和TC比较差异无统计学意义(P>0.05)。②EH+IFG组分别与EH组和对照组比较:FPG、FINS、HOMA-IR及BMI均有升高(P<0.05或P<0.01),HDL-C明显下降(P<0.01);EH+IFG组TG与EH组比较差异无统计学意义(P>0.05),与对照组比较明显升高(P<0.01)。结论 EH合并糖代谢异常患者I,R明显增强,并且有血脂动态变化及肥胖趋势,是MS的重要的病理生理状态。肥胖趋势是否为MS的起动因素有待更多的前瞻性研究证实。

Clinical Analysis of Essential Hypertension with Impaired Fasting Glucose on the Features of Insulin Resistance

Objective To study the characteristics of insulin resistance(IR) in essential hypertension(EH) with impaired fasting glucose(IFG)during the pathophysiological process of metabolic syndrome(MS).Methods According to the diagnostic criteria of EH and diabetes mellitus,all of the subjects were divided into three groups:EH+IFG group(29 cases),EH group(30 cases) and control group(30 cases).Fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),stature and weight were tested,and insulin resistance index(HOMA-IR),the function index of islet beta-cell(HOMA-β) and body mass index(BMI) were calculated.The results were comparatively analyzed.Results ①FPG,FINS,HOMA-IR,TG and HDL-C were significantly different among the three groups(P<0.01),and there were some difference on BMI(P<0.05).HOMA-β and TC had no difference among them(P>0.05).②Compared with EH group and the control group individually,FPG,FINS,HOMA-IR and BMI in EH and IFG group increased(P<0.05 or P<0.01),HDL-C decreased(P<0.01);TG was no difference between EH and IFG group and EH group(P>0.05).Compared with the control group,TG in EH and IFG group was significantly higher(P<0.01).Conclusion In EH with glucose metabolic abnormality,IR strengthened obviously,blood lipids and fatness are pathologically developing.All of these varieties are the important pathological states in MS.Whether MS derives from the tendency of fatness,is expecting more prospective researches.