高血压病患者胰岛素抗性与细胞钙代谢失常及膜变化的关系  

The relationship between insulin resistance and abnormalities of cellular calcium metabolism and cell membrane abnormalities in patients with essential hypertension.

作　　者：符云峰[1] 王素敏[1] 卢振敏[1] 孙爱励[1] 李红[1] 李素琴[1] 

机构地区：[1]河北省医学科学院生化研究室

出　　处：《中华医学杂志》1997年第6期443-446,共4页National Medical Journal of China

基　　金：卫生部基金

摘　　要：探讨高血压病（ＨＴ）时胰岛素抗性（ＩｎｓｕｌｉｎＲｅｓｉｓｔａｎｃｅ，ＩＲ）与细胞钙代谢失常及膜变化之间的关系。方法２６名正常人（ＮＴ），１７例单纯高血压（ＨＴ）和１６例伴ＩＲ的高血压病（ＨＴ＋ＩＲ）患者，以口服葡萄糖耐量试验（ＯＧＴＴ）观察糖负荷前后血胰岛素（ＩＳ）和血糖（Ｇ）变化及空腹血红细胞膜ＡＴＰ酶活性、胆固醇（Ｃ）、磷脂（Ｐ）、过氧化脂质（ＭＤＡ）含量，并测定细胞液Ｃａ２＋总量［（Ｃａ２＋）ｉ］及膜内面Ｃａ２＋结合力。结果（１）ＨＴ＋ＩＲ组血浆ＩＳ和Ｇ水平明显高于ＨＴ组和ＮＴ组；（２）ＨＴ＋ＩＲ组和ＨＴ组红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶和Ｃａ２＋－ＡＴＰ酶活性明显低于ＮＴ组；（３）ＨＴ＋ＩＲ组红细胞［（Ｃａ２＋）ｉ］明显高于ＨＴ组和ＮＴ组；（４）ＨＴ＋ＩＲ组胰岛素敏感性明显低于ＨＴ组和ＮＴ组；（５）ＨＴ＋ＩＲ组和ＨＴ组膜Ｃ／Ｐ比率及ＭＤＡ含量分别较ＮＴ组显著增高，膜内面Ｃａ２＋结合力皆显著低于ＮＴ组，ＨＴ＋ＩＲ组膜内面Ｃａ２＋结合力减低的程度甚于ＨＴ组。结论高血压患者ＩＲ与细胞钙代谢失常和膜变化之间有一定的因果关系。Objective To investigate the relationship between the insulin resistance (IR) and the abnormalities of cellular calcium metabolism and cell membrane in patients with essential hypertension. Methods Plasma insulin and glucose before and during OGTT, membrane ATPase activity, cholesterol (C) and phospholipid (P), lipid peroxides (MDA), intracellular total calcium concentration [(Ca 2+ )i] and calcium binding capacity of inner surface of membranes were determined in 26 normotensive (NT) subjects, 17 hypertensives (HT), and 16 hypertensives associated with IR (HT+IR). Results The HT+IR group had higher levels of plasma glucose and insulin than that in the NT group and HT group with significant differences. The HT+IR group consistently demonstrated depressed activity of each Na + K + ATPase and Ca 2+ ATPase studied with significant differences when compared with the NT group, but no difference was found if compared with the HT group. There was a higher [(Ca 2+ )i] in the HT+IR group than those in the NT group and even in the HT group with significant differences, respectively. Insulin sensitivity in the HT+IR group was significantly lower than that in both groups of HT and NT, respectively. The membrane C/P molar ratio and MDA content in the HT+IR group and HT group were significantly higher than those in the NT group, respectively. Conclusions It is likely that there is a causal relation between IR and abnomalities of cellular calcium metabolism and membrane lipids in patients with essential hypertension.

关 键 词：高血压 胰岛素 钙代谢障碍 胰岛素抗性 膜 

分 类 号：R544.102[医药卫生—心血管疾病] R361.3[医药卫生—内科学]