老年高血压患者糖代谢异常及胰岛素敏感性调查

目的了解老年高血压住院患者糖代谢异常及胰岛素抵抗的存在情况，为临床干预提供参考。方法住院老年高血压患者465例，既往未诊断糖尿病，分60～74岁组和75岁以上组进行统计比较。行空腹血糖（FPG）、餐后2h血糖（2hPG）、空腹胰岛素（FINS）、餐后2h胰岛素（2hINS）检查，并计算出胰岛素敏感性指数（ISI、2hISI），统计新发现的糖尿病数、糖调节受损数，以及总的糖代谢异常发生率。结果465例老年高血压患者中，新发现糖尿病23例（占4．95％），糖调节受损98例（占21．08％），总的糖代谢异常率26．03％。糖代谢正常组、糖调节受损组和糖尿病组之间的FPG、2hPG、FINS、2hINS、ISI、2hISI，经统计学比较，除糖调节受损组和糖尿病组之间的FPG差异为P〈0．05外，均为P〈0．01。60～74岁组的糖代谢异常发生率明显高于75岁以上组（P〈0．01）。结论在既往未诊断糖尿病的老年高血压患者中，有约1／4的患者存在糖代谢异常，尤以年龄低的老年人更为明显。在临床中对这类患者进行及时的检测诊断与干预，对预防严重并发症的发生具有重要意义。

Investigation on the insulin sensitivity and glucose metabolism abnormality in elderly patients with hypertension

Objective To investigate insulin sensitivity and glucose metabolism abnormality in elderly patients with hypertension, and to access the necessity of intervention. Methods 465 elderly patients with hypertension without knowing diabetes were recruited. FPG, 2hPG, FINS, 2bINS were measured for ISI and 2hISI calculation. Group of patients with 60 - 74 years old was compared with the group patients over 75 year old. Results Of all 465 patients, there was 23 （4. 95% ） diabetes newly diagnosed. 98 （21.08%） with impaired glucose tolerance. Group of 60 -74 year old has significantly higher prevalence of glucose metabolism abnormality （ P 〈 0. 01 ）. Conclusions 1/4 of elderly patients with hypertension without knowing diabetes have glucose metabolism abnormality. Younger elderly seem more susceptible. It is important for investigations on these patients for early diagnosis.