论文部分内容阅读
探讨高血压病与肥胖患者胰岛素抵抗现象。方法用正常血糖胰岛素钳夹技术测定３６例正常血压者，２３例单纯肥胖患者，５１例高血压非肥胖患者及５４例高血压合并肥胖患者的葡萄糖代谢率（Ｍ值），同时做口服葡萄糖耐量试验和胰岛素释放试验。结果发现（１）肥胖、高血压非肥胖和高血压合并肥胖患者口服葡萄糖７５ｇ后，６０和１２０分钟血糖及不同时间点胰岛素值均比正常血压者高（Ｐ＜０．０１）；（２）Ｍ值：正常人、高血压非肥胖患者、单纯肥胖者、高血压合并肥胖患者分别为９．２±１．０、７．６±２．０、６．７±１．５、５．２±１．８ｍｇ·ｋｇ－１·ｍｉｎ－１，差异均有显著意义（Ｐ＜０．０５）；胰岛素敏感性降低在高血压病合并肥胖组为８７．０％，单纯肥胖为６９．６％，高血压非肥胖为４１．１％，正常人为２．８％，差异有显著意义（Ｐ＜０．０５）；（３）多因素回归分析，发现性别、年龄、舒张压对Ｍ值无明显影响，而体重指数每增加１ｋｇ／ｍ２，Ｍ值减少０．４２ｍｇ·ｋｇ－１·ｍｉｎ－１，收缩压每增加１０ｍｍＨｇ，Ｍ值减少０．２０ｍｇ·ｋｇ－１·ｍｉｎ－１。结论胰岛素敏感性降低可能是肥胖与高血压病的发病因素。肥胖对胰岛素敏感性的影响比血压的影响更明显。
To investigate the insulin resistance in patients with hypertension and obesity. Methods The glucose metabolic rate (M) of 36 patients with normal blood pressure, 23 patients with simple obesity, 51 patients with hypertensive non-obesity and 54 patients with hypertension complicated with obesity was measured by the normal blood glucose insulin clamp technique. Meanwhile, oral glucose tolerance Test and insulin release test. The results showed that: (1) The blood glucose and the insulin value at different time points were significantly higher than those of the normal blood pressure at 60 and 120 minutes (P <0.01) after oral administration of 75g of glucose in obese, non-hypertensive and hypertensive patients with obesity; (2) M values: normal, hypertensive non-obese patients, simple obesity, hypertension with obesity patients were 9.2 ± 1.0,7.6 ± 2.0,6.7 ± 1.5,5.2 ± 1.8mg · kg-1 · min-1, the difference was significant (P <0.05); insulin sensitivity decreased in hypertensive patients with obesity was 87.0%, simple obesity was 69.6% (P <0.05); (3) Multivariate regression analysis showed that gender, age, diastolic blood pressure had no obvious effect on M value , While the M value decreased by 0.42mg · kg-1 · min-1 for every 1kg / m2 of body mass index, and the value of M decreased by 0.20m for every 10mmHg of systolic pressure g · kg-1 · min-1. Conclusion The decrease of insulin sensitivity may be the risk factor of obesity and hypertension. The impact of obesity on insulin sensitivity is more pronounced than blood pressure.