Corry D B
Olive View-UCLA Medical Center, 14445 Olive View Drive, Sylmar, CA 91342, USA.
Curr Hypertens Rep. 2001 Apr;3(2):124-8. doi: 10.1007/s11906-001-0024-8.
In the insulin resistance (IR) syndrome, sex-specific differences have been reported. First, hypertension more often correlates with hyperinsulinemia in women than in men with the IR syndrome. In addition, salt sensitivity of blood pressure appears to be independent of the activity of the renin-angiotensin system in women, whereas in men there is a strong correlation between the two variables. Secondly, the dyslipidemia found in women with the IR syndrome is characterized by less postprandial plasma insulin, triglycerides, and fatty acid response to a standardized meal. However, this sex difference in lipids disappears after correction for visceral fat mass. Fat physiology and biochemistry differ between the two sexes. In women, adipose cells express less glucocorticoid receptors and less 11beta-hydroxysteroid dehydrogenase. In women visceral fat accumulation appears to be a constant feature of the IR syndrome but in men the syndrome can be present without central obesity. Lastly, during the reproductive years of women, the IR syndrome, such as in pre-eclampsia, may cause fetal growth retardation that has been proposed together with maternal malnutrition to be at the origin of the increased risk for impaired glucose tolerance, hyperinsulinemia, and hypertension in adult life. This gives yet another dimension to this disease in women since in essence they may ultimately transmit this syndrome to both sexes.
在胰岛素抵抗（IR）综合征中，已有性别差异的报道。首先，与患有IR综合征的男性相比，高血压在患有IR综合征的女性中更常与高胰岛素血症相关。此外，女性血压的盐敏感性似乎独立于肾素 - 血管紧张素系统的活性，而在男性中这两个变量之间存在很强的相关性。其次，患有IR综合征的女性中发现的血脂异常的特征是餐后血浆胰岛素、甘油三酯和脂肪酸对标准化餐的反应较小。然而，在纠正内脏脂肪量后，这种血脂的性别差异消失。脂肪生理学和生物化学在两性之间存在差异。在女性中，脂肪细胞表达较少的糖皮质激素受体和较少的11β - 羟类固醇脱氢酶。在女性中，内脏脂肪堆积似乎是IR综合征的一个持续特征，但在男性中，该综合征可能在没有中心性肥胖的情况下出现。最后，在女性的生育期，IR综合征，如子痫前期，可能导致胎儿生长受限，有人提出这与母亲营养不良一起是成年后糖耐量受损、高胰岛素血症和高血压风险增加的根源。这为女性的这种疾病赋予了另一个层面的意义，因为从本质上讲，她们最终可能将这种综合征传递给两性。
