老年高血压患者的胰岛素抵抗  

Elderly hypertensive patients and insulin resistance

作　　者：毛利民[1] 吴军[1] 王瑞萍[1] 茅皖茹 陈曼丽[1] 李铭[1] 宋晓光[1] 褚德发[1] 周月秀[1] 

机构地区：[1]卫生部北京医院

出　　处：《中华老年医学杂志》1997年第3期165-167,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨高胰岛素血症、胰岛素抵抗、高血脂和肥胖与老年人高血压之间的关系。方法对无糖尿病和糖耐量减低史的老年原发性高血压患者５０例、老年健康对照组１７８例的空腹血糖、胰岛素、血脂、体重指数和胰岛素敏感性指数等进行对比。结果高血压组胰岛素为１８０±１９５ｍＵ／Ｌ，对照组为７７±５４ｍＵ／Ｌ（Ｐ＜０００１），高血压组有明显的高胰岛素血症，其胰岛素敏感性指数亦显著降低（Ｐ＜０００１），血清甘油三酯明显增高和ａｐｏＡ１明显下降（Ｐ＜００５），肥胖者占７０％。结论老年高血压患者同时存在糖代谢和脂蛋白代谢异常，胰岛素抵抗所产生的高胰岛素血症为其基本的代谢异常。Objective\ To find the relationship between hyperinsulinemia,insulin resistance,hy perlipidemia,obesity and hypertension in elderly patients.\ \ Methods\ Fasting plasma glucose,in sulin and lipids,body mass index and insulin sensitivity index were determined in fifty cases of elderly essential hypertension without NIDDM and impaired glucose tolerance(IGT)and the results were com pared those in178 cases of elderly health controls.\ \ Results\ The mean fasting serum insulin level in hypertensives was 18 0±19 5mU/L,as compared with7 7±5 4mU/L in controls.There was marked difference between the two groups(P<0 001).Obvious hyperinsulinemia was present in the hypertensive group.Insulin sensitivity index,as calculated with the formula:1/ log(fasting serumin sulin×fasting plasma glucose)was obviously lower in the hypertensive group than in the control group,showing the presence of pronounced insulin resistance in the hypertensives.It was also noted that body mass index and serum triglyceride level were significantly higher and apoA1level was lowerin the hypertensives.\ \ Conelusions\ These results suggest that in the elderly hypertensive patients hypertension seems to coexist with metabolic disorder of carbohydrate and lipoprotein.The basi cmetabolic disorder was hyperinsulinemia caused by insulin resistance in the peripheral tissue such as muscle.

关 键 词：高血压 血液 高胰岛素血症 胰岛素抗药性 

分 类 号：R544.102[医药卫生—心血管疾病]