原发性高血压患者胰岛素抵抗与红细胞膜脂质成分及膜钙结合力之间的关系

目的探讨高血压（ＨＴ）时胰岛素抵抗（ＩＲ）与细胞膜脂质成分、膜内面Ｃａ２＋结合力之间的关系。方法３０例高血压伴ＩＲ（ＨＴ＋ＩＲ）及２５例单纯性高血压（ＨＴ）患者，及３２名正常人（ＮＴ）为研究对象。放免法测定血胰岛素（ＩＳ），氧化酶法测定血糖（Ｇ），比色法测定胆固醇（Ｃ）及磷脂（Ｐ），硫代巴比妥酸反应测定过氧化脂质（ＭＤＡ），原子吸收法测定膜结合Ｃａ２＋。结果（１）ＨＴ组胰岛素敏感性基本正常；与ＮＴ组比较无明显差别；ＨＴ＋ＩＲ组胰岛素敏感性低于ＮＴ组和ＨＴ组（Ｐ＜０．０１）；（２）ＨＴ组和ＨＴ＋ＩＲ组，膜脂Ｃ／Ｐ克分子比率及ＭＤＡ含量，高于ＮＴ组（Ｐ＜０．０５或０．００１）；（３）ＨＴ组和ＨＴ＋ＩＲ组红细胞膜内面Ｃａ２＋结合力皆显著低于ＮＴ组（Ｐ＜０．００１），而且ＨＴ＋ＩＲ组Ｃａ２＋结合力减低的程度甚于ＨＴ组（Ｐ＜０．０５）。结论高血压时ＩＲ对细胞膜Ｃａ２＋结合力具有减低之影响。

The Relationship Between Insulin Resistance and Lipid Components and Calcium Binding Capacity of Red Cell Membranes in Patients with Essential Hypertension

Aim\ To investigate the relationship between insulin resistance(IR) and abnormality of cell membranes in essential hypertensives.\ Methods\ Plasma insulin and glucose before and during the oral glucose tolerance test(OGTT), cholesterol(C), phospholipids(P), lipid peroxides(MDA) and calcium binding capacity of the inner surface of blood red cell membranes were determined in 30 patients with essential hypertension associated with insulin resistance(IR) (HT IR), 25 pure essential hypertensives(HT) without insulin resistance and 32 normotensive control subjects(NT).\ Results\ (1)membrane C/P ratio and MDA level in HT group is similar to the HT IR group, but is significantly higher than that in NT group(P<0 05 and 0 001), respectively;(3)calcium binding capacity of the inner surface of erythrocyte membranes in both HT and HT IR group are significantly lower than that in NT group(P<0 001) respectively. While both parameters were significantly lower in HT IR group than that in the HT group.\ Conclusions\ It seems IR related to the abnormality of the cell membranes, IR may decrease the calcium binding capacity of the inner surface of cell membrances.