有2型糖尿病家族史的高血压病患者糖代谢分析  

Analysis of Glucose Metabolism of Hypertensive Patients with Family History of Type 2 Diabetes Mellitus

作　　者：李佳芮 铉绪敏 曹晓斌 佟来荣 刘博伟 陆强 尹福在 

机构地区：[1]河北沧州中心医院内分泌科,河北沧州 [2]河北秦皇岛第一医院内分泌科,河北秦皇岛066000 [3]秦皇岛第一医院社区门诊,河北秦皇岛066000

出　　处：《医学临床研究》2013年第4期715-717,共3页Journal of Clinical Research

摘　　要：[目的]4g讨有2型糖尿病（T2DM）家族史的原发性高血压病患者糖代谢状态。【方法】2009年1月至2011年6月本院内分泌门诊就诊的高血压病患者136例，据有无糖尿病（DM）家族史分为DM家族史阳性组（FHD＋组）82例和DM家族史阴性组（FHD-组）54例，测量身高、体重及血压，测定血糖及空腹真胰岛素（FTI）水平，行75g葡萄糖耐量试验（OGTT）后比较两组的糖代谢异常情况。【结果】两组体质指数（BMI）、收缩压（SBP）、舒张压（DBP）比较差异无统计学意义。FHD’组OGTT2h血糖（2hPG）、FTI和胰岛素抵抗指数（HOMA-IR）明显高于FHD组（P〈O．05），两组间0GTT0h、1h、3h血糖及B细胞功能指数（HOMA—B）比较差异无统计学意义（P〉O．05）。正常糖耐量（NGT）的检出率19．9％，糖调节受损（IGR）为42．6％，新诊断DM为37．5oA。FHD’组NGT的检出率明显低于FHD一组（P〈O．05），两组IGR及DM的检出率差异无统计学意义（P〉O．05）。多分类logistic回归分析显示：FHD’组发生IGR和DM的风险分别是FHD一组的3．329倍和2．580倍。【结论】有T2DM家族史的高血压病患者更易存在糖代谢异常，应注重此人群的筛查。[Objective]To explore the glucose metabolism state of primary hypertensive patients with family his- tory of type 2 diabetes mellitus（T2DM）. [MethodslTotally 136 hypertensive patients in endocrinology department of our hospital from Jan. 2009 to June 2011 were chosen. According tO with or without family history Of diabetes melli- tus（DM）, all patients were divided into positive-DM family history group（FHD＋ group, n = 82） and negative-DM family history group（FHD group, n =54）. Height, weight and blood pressure were measured. Blood glucose and fasting insulin（FTI） were determined. Abnormal glucose metabolism was compared between the two groups after 75g glucose tolerance test（OGTT）. [ResultslThere was no significant difference in body mass index（BMI）, systolic pres- sure（SBP） and diastolic pressure（DBP） between two groups. The 2h-OGTT blood glucose（PBG）, FTI and insulin resistant index（HOMA-RI） in FHD＋ group were obviously higher than those in FHD group（ P 〈0.05）. There was no significant difference in OGTT at Oh, lh and 3h and β-cell index（HOMA-β） between two groups（ P 〉0.05）. The detection rate of normal glucose tolerance（NGT）, impaired glycoregulation（IGR） and newly diagnosed DM were 19. 9%, 42.6% and 37.5%, respectively. The detection rate of NGT in FHD＋ group was much lower than that in FHD group（ P〈0.05）. There was no significant difference in the detection rate of IGR and DM between two groups（ P〉0.05）. Multinomial logistic regression analysis showed that the risk of IGR and DM in FHD＋ group was 3. 329 and 2. 580 times to that of FHD- group. [ConclusionlHypertensive patients with family history of T2DM are more easily to have abnormal glucose metabolism. The screening of such people should be paid attention.

关 键 词：糖尿病 2型 高血压 葡萄糖代谢障碍 

分 类 号：R587.1[医药卫生—内分泌]