Johnson K C, Graney M J, Applegate W B, Kitabchi A E, Runyan J W, Rutan G H
Department of Preventive Medicine, University of Tennessee, Memphis 38163, USA.
J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M571-6. doi: 10.1093/gerona/54.11.m571.
This report focuses on the glycemic state in relation to insulin and lipid levels of a cohort of elderly hypertensive persons to estimate the prevalence of syndrome X.
A cross-sectional study was performed at the University of Tennessee, Memphis, and the General Clinical Research Center (GCRC) on 95 participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study. A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels and a fasting lipid profile were obtained.
In this sample of healthy elderly participants with hypertension who were taking an antihypertensive medication, 43 (45.3%) had normal glucose tolerance (NGT), 41 (43.2%) had impaired glucose tolerance (IGT), and 11 (11.6%) had undiagnosed non-insulin-dependent diabetes mellitus (NIDDM). Fasting hyperinsulinemia occurred in only one participant, who was in the IGT group. Hypertriglyceridemia and low high density lipoprotein (HDL) occurred in four persons, none of whom had hyperinsulinemia. Persons in the NIDDM and IGT groups had decreased beta cell function compared to persons in the NGT group, but did not have increased peripheral insulin resistance as estimated from the OGTT data.
Our data demonstrated that in this cohort of elderly hypertensive participants with a high prevalence of central obesity, impaired glycemic control was common, but was not associated with fasting hyperinsulinemia or peripheral insulin resistance. Furthermore, we conclude that syndrome X essentially did not occur in these participants and postulate that the primary etiology for their impaired glycemic control is beta cell dysfunction. Further research is needed to elucidate these relationships.
本报告聚焦于一组老年高血压患者的血糖状态与胰岛素及血脂水平的关系，以评估X综合征的患病率。
在田纳西大学孟菲斯分校及综合临床研究中心（GCRC）对95名同意参与辅助研究的老年非药物干预试验（TONE）的参与者进行了一项横断面研究。进行了标准口服葡萄糖耐量试验（OGTT），测定胰岛素和C肽水平以及空腹血脂谱。
在这个服用抗高血压药物的健康老年高血压参与者样本中，43人（45.3%）葡萄糖耐量正常（NGT），41人（43.2%）葡萄糖耐量受损（IGT），11人（11.6%）患有未诊断出的非胰岛素依赖型糖尿病（NIDDM）。仅1名IGT组参与者出现空腹高胰岛素血症。4人出现高甘油三酯血症和低高密度脂蛋白（HDL），他们均无高胰岛素血症。与NGT组相比，NIDDM组和IGT组参与者的β细胞功能降低，但根据OGTT数据估计，外周胰岛素抵抗未增加。
我们的数据表明，在这个中心性肥胖患病率高的老年高血压参与者队列中，血糖控制受损很常见，但与空腹高胰岛素血症或外周胰岛素抵抗无关。此外，我们得出结论，这些参与者基本未发生X综合征，并推测他们血糖控制受损的主要病因是β细胞功能障碍。需要进一步研究以阐明这些关系。
