原发性高血压对胰岛素抵抗及胰岛β细胞功能影响的研究  

Essential hypertension affects insulin resistance and islet β cell function

作　　者：丁波[1] 高谷[1] 李倩[1] 付丽媛[1] 王竹兰[1] 齐绍康[1] 马建华[1] 

机构地区：[1]南京医科大学附属南京第一医院内分泌科,江苏南京210012

出　　处：《医学研究生学报》2009年第10期1073-1076,共4页Journal of Medical Postgraduates

摘　　要：目的:原发性高血压(EH)患者中2型糖尿病(DM)的患病率远高于血压正常者,氧化应激作为EH和2型DM的共同病理生理基础已成为当前研究的热点。通过检测EH及DM患者血清中丙二醛(MDA)水平及其与胰岛素抵抗的关系,探讨EH在2型DM发生发展过程中的影响。方法:共111例患者,其中EH组41例,新诊断2型DM组32例,新诊断2型DM合并EH组(DM+EH组)38例,比较3组空腹血糖、空腹胰岛素(F ins)、MDA、血脂、体质指数(BM I)等相关临床指标,计算胰岛素抵抗指数(HOMA-IR)及胰岛β细胞功能(HOMA-B)。结果:MDA:DM+EH组显著高于DM组,差异有统计学意义(P<0.01),DM组显著高于EH组,差异有统计学意义(P<0.01);HOMA-IR:DM+EH组高于DM组,差异有统计学意义(P<0.05),DM组显著高于EH组,差异有统计学意义(P<0.01);HOMA-B:EH组显著高于DM组及DM+EH组,差异有统计学意义(P<0.01),DM组与DM+EH组比,差异无统计学意义(P>0.05)。相关分析显示HOMA-IR与年龄、EH病程、MDA、糖化血红蛋白(HbA1 c)正相关(r=0.35,P=0.031;r=0.509,P=0.002,r=0.47,P=0.005,r=0.616,P=0.000),与HDL负相关(r=-0.399,P=0.016)。结论:EH合并2型DM患者体内氧化应激水平显著升高,且与HOMA-IR关系密切。Objective： The prevalence of Type 2 diabetes mellitus（DM） is higher in essential hypertension（EH） than in non-essential hypertension patients.Oxidative stress,as the pathophysiological basis of both essential and non-essential hypertension,has become a focus of current researches.The purpose of this study is to explore the effect of essential hypertension on insulin resistance and isletβcell function in the development of Type 2 DM by determining the concentrations of human malondialdehyde（MDA） in the serum.Methods： A total of 111 patients were divided into an EH group（n=41）,a DM group（n=32） and a DM＋EH group（n=38）.Fasting plasma glucose,fasting insulin,MDA and lipedmia were detected,and HOMA-IR and HOMA-B were measured.Results： MDA and HOMA-IR were significantly higher in the DM＋EH than in the DM group,and in the DN than in the EH group,and so was HOMA-B in the EH than in the DM and DM＋EH groups,with no significant difference between the latter two.HOMA-IR was correlated positively with age,EH course,MDA and HbA1c（r=0.35,P=0.031;r=0.509,P=0.002;r=0.47,P=0.005;r=0.616,P=0.000） but negatively with HDL-C（r=-0.339,P=0.016）.Conclusion： The level of oxidative stress is significantly increased in Type 2 DM patients with essential hypertension and is closely associated with insulin resistance.

关 键 词：原发性高血压 2型糖尿病 氧化应激 胰岛素抵抗 胰岛Β细胞功能 

分 类 号：R544.1[医药卫生—心血管疾病]