代谢综合征患者胰岛素抵抗与醛固酮水平的相关性研究  

Relationship between insulin resistance and aldosterone level in patients with metabolic syndrome

作　　者：曹彩霞[1] 曾正陪[1] 周亚茹[1] 童安莉[1] 卢琳[1] 王鸥[1] 许岭翎[1] 朱惠娟[1] 满娜[1] 宋爱羚[1] 陈适[1] 李明[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院内分泌科,北京100730

出　　处：《中国糖尿病杂志》2009年第1期33-35,共3页Chinese Journal of Diabetes

基　　金：国家十五科技攻关计划课题(2004BA720A29)

摘　　要：目的探讨代谢综合征(MS)胰岛素抵抗(IR)及高胰岛素血症与血浆醛固酮水平的关系。方法 101例原发性高血压(EH)、135例特发性醛固酮增多症(IHA)患者按是否伴MS各分为两个亚组进行比较。结果 EH伴MS组血浆卧位醛固硐(ALD)水平、胰岛素曲线下面积(Ins_(AUC))、HOMAIR及IR所占百分率均显著高于非MS组;IHA伴MS组血浆卧位ALD水平、Ins_(AUC)、HOMA-IR及IR所占百分率均显著高于非MS组和EH组。相关分析显示,伴MS两亚组的卧位ALD水平均与Ins_(AUC)及HOMA-IR显著正相关。结论 MS患者较高的血浆ALD水平与高胰岛素血症及IR显著正相关,在高血压和心血管并发症的发生中起到一定作用。Objective To analyze the relationship between plasma aldosterone level and insulin resistance in patients with metabolic syndrome. Methods 101 patients were diagnosed as essential hypertension（EH）, 135 cases as idiopathic hyperaldosteronism（IHA） in Peking Union Medical College Hospital from August 2004 to October 2007. Each group was divided into two subgroups according to with or without metabolic syndrome （MS）. All subjects underwent 3h 75g oral glucose tolerance test and aldosterone test. The HOMA-IR was calculated. Results The plasma supine aldosterone levels[11. 5 （9.60-14. 00）ng/dl] ,insulin area under curve[INSAUC 224. 6（126.0-292.7） mU·L^-1·h^-1], HOMA-IR [2.6 （1.7-3.6） ] and prevalence of insulin resistance （45.1%） were significantly higher in EH patients with MS than without MS [10. 0（7. 9-11. 7） ,134. 4（77. 5-174. 4）mU·L6-1·h^-1,1.4（0. 8-2. 3）,20%] （all P〈0.01 or P〈0. 05）. MS subgroup in IHA subjects had higher levels of plasma supine aldosterone [17. 00（14. 70-21.20）ng/dl], INSAUC [291.3（137. 9-425.3）mU·L^-1·h^-1], HOMA-IR[3.1（2. 0-5.9）] and prevalence of insulin resistance（61.0%）than non-MS subjects[14. 0 （11.0 - 18. 0） ng/dl, 164. 1 （126. 7-231.1）mU·L^-1·h^-1 , 1.8（1.2-2. 7） ,25.0%] （all P〈0. 01 or P〈0. 05）. Significant differences were also found between patients with MS in the two groups （P〈0. 01 or P〈0. 05）. Plasma supine aldosterone levels positively correlated with InsAUC and HOMA-IR in each MS subgroup. Conclusions The higher plasma aldosterone levels are related to insulin resistance and hyperinsulinemia in EH or IHA patients with MS and probably play a role in the pathogenesis of hypertension and cardiovascular risk.

关 键 词：醛固酮 代谢综合征 特发性醛固酮增多症 高血压 胰岛素抵抗 

分 类 号：R589[医药卫生—内分泌] R587.1[医药卫生—内科学]