Zhang Jianhua, Zhang Chunxiu
Department of Internal Medicine, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030.
J Huazhong Univ Sci Technolog Med Sci. 2002;22(4):337-8, 342. doi: 10.1007/BF02896780.
The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance (IR) under the disorder of glucose metabolism and hypertension were studied. By glucose tolerance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucose tolerance curve (AUCG) to area under insulin release curve (AUCI) were calculated and analyzed. The results showed that ISI was decreased to varying degrees in the patients with hypertension, the mildest in the group of NGT with hypertension, followed by the group of IGT without hypertension, the group of IGT with hypertension and DM (P = 0). There was very significant difference in the ratio of AUCG/AUCI between the hypertensive patients with NGT and controls (P = 0). It was concluded that a significant IR existed during the development of IGT both in hypertension and nonhypertension. The increase of total insulin secretion (AUCI) was associated with nonhypertension simultaneously. IR of the hypertensive patients even existed in NGT and was worsened with the deterioration of glucose metabolism disorder, but the AUCI in the HT group changed slightly. A relative deficiency of insulin secretion or dysfunction of beta-cell of islet existed in IGT and DM of the hypertensive patients.
研究了糖耐量正常（NGT）、糖耐量受损（IGT）和2型糖尿病（DM）的高血压患者的胰岛素敏感性，以及糖代谢和高血压紊乱情况下的胰岛素抵抗（IR）。通过葡萄糖耐量试验和胰岛素释放试验，计算并分析胰岛素敏感性指数（ISI）以及葡萄糖耐量曲线下面积（AUCG）与胰岛素释放曲线下面积（AUCI）的比值。结果显示，高血压患者的ISI均有不同程度降低，其中高血压合并NGT组降低程度最轻，其次是不合并高血压的IGT组、合并高血压的IGT组和DM组（P = 0）。高血压合并NGT患者与对照组的AUCG/AUCI比值差异非常显著（P = 0）。结论是，无论是高血压还是非高血压患者，在IGT发生发展过程中均存在显著的IR。总胰岛素分泌量（AUCI）的增加与非高血压状态同时存在。高血压患者的IR即使在NGT时就已存在，并随着糖代谢紊乱的加重而恶化，但高血压组的AUCI变化轻微。高血压患者的IGT和DM存在胰岛素分泌相对不足或胰岛β细胞功能障碍。
