中老年原发性高血压患者胰岛β细胞早期分泌与高血压病程及分级的关系  

β-cell Early Insulin Secretion Function and Insulin Resistance in Various Durations and Grades in Patients with Hypertension

作　　者：张亚萍[1] 杨历新[1] 

机构地区：[1]青海省人民医院心血管高血压科,青海西宁810007

出　　处：《中华高血压杂志》2009年第7期648-651,共4页Chinese Journal of Hypertension

摘　　要：目的探讨中老年原发性高血压(EH)患者胰岛β细胞早期分泌功能变化与高血压病程及分级的关系。方法中老年EH患者106例,年龄(58.4±8.5)岁,按照高血压病程随机分为≤1年组(n=35)、1.1～4.9年组(n=34)和≥5年组(n=37);按照高血压分级随机分为:1级高血压(血压140～159/90～99mmHg,n=53)、2级高血压(血压160～179/100～109mmHg,n=30)、3级高血压(收缩压≥180mmHg、舒张压≥110mmHg,n=23)。治疗前行标准口服葡萄糖耐量试验,同时测空腹和餐后30min血糖、胰岛素及C肽水平和血压等。并计算胰岛素抵抗指数(HOMA-IR)、早期胰岛素分泌指数(ΔI30/ΔG30)的变化。结果≥5年组的ΔI30/ΔG30分泌量(2.1±4.5)较≤1年组(10.3±4.2)和1.1～4.9年组(10.9±4.2),分别下降79.6%和80.7%,但在高血压各分级组无明显差异(P>0.05)。随着EH病程延长,胰岛素抵抗也逐渐加重,≥5年组HOMA-IR(11.8±0.8)比≤1年组(5.5±0.6)和1.1～4.9年组(6.5±0.8),分别增加至2.1和1.7倍(均P<0.01)。3级高血压HOMA-IR(10.4±1.6)比1级高血压(4.2±1.0)和2级高血压(6.5±2.0),分别增加至2.5和1.6倍(均P<0.01)。结论中老EH病程与β细胞早期分泌功能损害和胰岛素抵抗相关,EH分级与胰岛素抵抗相关,与ΔI30/ΔG30无关。Objective To investigate β-cell early insulin secretion function and insulin resistance in different durations and grades patients with hypertension. Methods One hundred and six middle and old age （58.4 ± 8. 5） years hypertension patients were enrolled. According to hypertension durations, patients were categorized as ≤1 year group（n=35）, 1.1-4.9 years group （n=34）, ≥5 years group （n=37）; while based on grades of hypertension, patients were divided as 1^st grade （140-159/90-99 mmHg, n=53）, 2^nd grade （160- 179/ 100-109 mmHg, n 30）, 3^rd grade（≥180/≥110 mmHg, n=23）. Plasm glucose, HOMA-IR, △I30/△G30 were determined and compared among groups. Results Patients with longer duration（≥5 years） had most seriously impairment of β-cell early secretion（△I30/△G30）[≥5 years （2. 1±4. 5） vs 1. 1-4. 9 years （10.9±4.2）, vs ≤1 year （10. 3±4. 2）, all P〈0.01]. HOMA-IR was progressively aggravated from 1^st grade of hypertension to 3^rd grade[≤0 year（4.2±1. 0）vs 1.1-4.9 years （6.5±2.0）, P〈0.05, vs ≥5 years （10.4±1.6）, all P〈0. 01]. However, no changes in early insulin secretion among the 3 grades patients were found. Conclusion The data seems show β- cell early insulin secretion index are related to duration of hypertension and insulin resistance most likely associated with severity of hypertension.

关 键 词：高血压 早期胰岛素分泌 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌] R544.1[医药卫生—内科学]