Stiefel P, Montilla C, Muñiz-Grijalvo O, García-Lozano R, Alonso A, Miranda M L, Pamies E, Villar J
Unidad de Hipertensión y Lípidos del S de Medicina Interna, Seville, Spain.
Metabolism. 2001 Feb;50(2):157-60. doi: 10.1053/meta.2001.19429.
The aim of this study was to analyze the influence of the apolipoprotein E (apoE) gene polymorphism on insulin resistance and plasma lipid composition of essential hypertensive patients. A secondary objective was to analyze if differences regarding plasma lipids had an effect on the erythrocyte membrane lipid composition and the activity of the erythrocyte membrane sodium-lithium countertransport. We studied 128 untreated nondiabetic essential hypertensive patients enrolled from our outpatient clinic. We considered as hyperinsulinemic all subjects having more than 80 mU/L of plasma insulin 120 minutes after a 75-g oral glucose intake. The number of hyperinsulinemic subjects among carriers of the epsilon4 allele was higher that in epsilon4 noncarrier subjects (13 of 19 v45 of 109, P < .05; odds ratio [OR], 3.08; confidence interval [CI], 0.99-10.57). Plasma insulin at baseline and plasma insulin and glucose at 120 minutes after overload was higher in carriers of the epsilon4 allele (respectively, 17.5 +/- 6.9 v 12.4 +/- 4.9 mU/L, P < .01; 111.9 +/- 39.9 v 88.7 +/- 48.2, P < .05; and 143.8 +/- 29.3 v 121.2 +/- 30.8 mg/dL, P < .005). Subjects with the epsilon4 allele had a plasma lipid profile more atherogenic than those without this allele. This profile was mainly characterized by higher levels of low-density lipoprotein (LDL) cholesterol (150.1 +/- 31.2 v 133.0 +/- 34.3 mg/dL, P < .05) and very-low-density lipoprotein (VLDL) triglycerides (134.7 +/- 85.5 v 99.2 +/- 68.8 mg/dL, P < .05) and by lower levels of high-density lipoprotein (HDL) cholesterol (41.8 +/- 10.7 v 50.0 +/- 14.7 mg/dL, P < .05). There were no differences between groups regarding erythrocyte membrane cholesterol or phospholipids composition and sodium-lithium countertransport (SLC) activity.
本研究旨在分析载脂蛋白E(apoE)基因多态性对原发性高血压患者胰岛素抵抗和血浆脂质成分的影响。次要目的是分析血浆脂质差异是否对红细胞膜脂质成分及红细胞膜钠-锂逆向转运活性产生影响。我们对从门诊招募的128例未经治疗的非糖尿病原发性高血压患者进行了研究。在口服75克葡萄糖120分钟后,血浆胰岛素超过80 mU/L的所有受试者被视为高胰岛素血症患者。ε4等位基因携带者中的高胰岛素血症受试者数量高于非ε4等位基因携带者(19例中的13例对109例中的45例,P <.05;优势比[OR]为3.08;置信区间[CI]为0.99 - 10.57)。ε4等位基因携带者的基线血浆胰岛素以及负荷后120分钟的血浆胰岛素和葡萄糖水平更高(分别为17.5±6.9对12.4±4.9 mU/L,P <.01;111.9±39.9对88.7±48.2,P <.05;以及143.8±29.3对121.2±30.8 mg/dL,P <.005)。携带ε4等位基因的受试者的血浆脂质谱比不携带该等位基因的受试者更具动脉粥样硬化性。该脂质谱的主要特征是低密度脂蛋白(LDL)胆固醇水平较高(150.1±31.2对133.0±34.3 mg/dL,P <.05)和极低密度脂蛋白(VLDL)甘油三酯水平较高(134.7±85.5对99.2±68.8 mg/dL,P <.05),以及高密度脂蛋白(HDL)胆固醇水平较低(41.8±10.7对50.0±14.7 mg/dL,P <.05)。两组在红细胞膜胆固醇或磷脂成分以及钠-锂逆向转运(SLC)活性方面无差异。