Saito I, Nishino M, Kawabe H, Wainai H, Hasegawa C, Saruta T, Nagano S, Sekihara T
Health Center, Keio University, Tokyo, Japan.
Am J Hypertens. 1992 Dec;5(12 Pt 1):915-8. doi: 10.1093/ajh/5.12.915.
To investigate the hypothesis that insulin resistance plays a role in the etiology of hypertension and hyperlipidemia, we measured serum lipid levels, the fasting glucose/insulin ratio, and the insulin response to oral glucose (GTT) in a group of young obese subjects (n = 21) with hypertension and normal glucose tolerance and in normotensive subjects (n = 36) with normal glucose tolerance, matched for age and body mass index. Leisure time physical activity was evaluated by a questionnaire outlining three levels of physical activities during leisure time. Subjects with hypertension had higher fasting serum insulin (19 +/- 2 v 13 +/- 1 microU/mL, P < .01) and lower fasting glucose/insulin ratio (5.3 +/- 0.2 v 7.1 +/- 0.5 mg/dL/microU/mL, P < .01) than normotensive subjects. Subjects with hypertension had higher peak serum insulin and lower plasma glucose area/insulin area ratio in response to glucose (1.8 +/- 0.2 v 2.4 +/- 0.2 mg/dL/microU/mL, P < .05) than normotensive subjects. Serum total cholesterol, low-density cholesterol, and triglycerides were higher in the obese hypertensive subjects than in obese normotensive ones. Blood pressure correlated with either fasting serum insulin, fasting glucose/insulin ratio, or glucose area/insulin area ratio during GTT. The level of leisure time physical activities was lower in obese hypertensive subjects than in obese normotensive ones. There were significant correlations between the levels of physical activity and the fasting plasma glucose/insulin ratio (r = 0.371, P < .01) or the fasting serum insulin concentration (r = -0.282, P < .05). The study provided evidence that a low level of leisure time physical activity is associated with insulin resistance and resultant hyperinsulinemia, which are the key metabolic abnormalities that link hypertension, obesity, and hyperlipidemia in young subjects.
为了探究胰岛素抵抗在高血压和高脂血症病因中发挥作用这一假说，我们测量了一组患有高血压且糖耐量正常的年轻肥胖受试者（n = 21）以及年龄和体重指数相匹配的糖耐量正常的血压正常受试者（n = 36）的血脂水平、空腹血糖/胰岛素比值，以及口服葡萄糖（葡萄糖耐量试验）后的胰岛素反应。通过一份问卷评估休闲时间的身体活动情况，该问卷概述了休闲时间身体活动的三个水平。高血压受试者的空腹血清胰岛素水平高于血压正常受试者（19±2对13±1微单位/毫升，P<.01），空腹血糖/胰岛素比值低于血压正常受试者（5.3±0.2对7.1±0.5毫克/分升/微单位/毫升，P<.01）。高血压受试者口服葡萄糖后血清胰岛素峰值更高，血浆葡萄糖面积/胰岛素面积比值更低（1.8±0.2对2.4±0.2毫克/分升/微单位/毫升，P<.05）。肥胖高血压受试者的血清总胆固醇、低密度胆固醇和甘油三酯水平高于肥胖血压正常受试者。血压与葡萄糖耐量试验期间的空腹血清胰岛素、空腹血糖/胰岛素比值或葡萄糖面积/胰岛素面积比值相关。肥胖高血压受试者的休闲时间身体活动水平低于肥胖血压正常受试者。身体活动水平与空腹血浆葡萄糖/胰岛素比值（r = 0.371，P<.01）或空腹血清胰岛素浓度（r = -0.282，P<.05）之间存在显著相关性。该研究提供了证据，表明休闲时间身体活动水平低与胰岛素抵抗及由此导致的高胰岛素血症相关，而胰岛素抵抗和高胰岛素血症是将年轻受试者中的高血压、肥胖和高脂血症联系起来的关键代谢异常。
