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高血压中的代谢紊乱:“1913年出生男性”人群研究的结果

Metabolic disturbances in hypertension: results from the population study 'men born in 1913'.

作者信息

Eriksson H, Welin L, Wilhelmsen L, Larsson B, Ohlson L O, Svärdsudd K, Tibblin G

机构信息

Department of Medicine, University of Göteborg, Ostra Hospital, Göteborg, Sweden.

出版信息

J Intern Med. 1992 Nov;232(5):389-95. doi: 10.1111/j.1365-2796.1992.tb00604.x.

Abstract

A clustering of metabolic disturbances has been indicated in hypertension. The distribution of such factors was assessed among hypertensives and normotensives in a general population sample of 644 men aged 67 years. Fasting serum insulin, glucose and triglyceride levels were measured. In this study hypertension was defined as DBP > or = 95 mmHg or present use of antihypertensives. Impaired glucose tolerance (IGT) or diabetes mellitus, hyperinsulinaemia (> or = 20 mU l-1) and hypertriglyceridaemia (> or = 2.3 mmol l-1) were defined as metabolic disturbances. When all these disturbances were present simultaneously a complete 'metabolic syndrome' was considered to be present. Hypertension was found in 185 (29%) men, IGT in 15%, diabetes mellitus in 11%, hyperinsulinaemia in 18% and hypertriglyceridaemia in 19%. Among hypertensives, 11 (6%) men had a 'metabolic syndrome', compared to 12 (3%) men in the normotensive group (P = 0.039). At least one metabolic disturbance was present in 109 (59%) of the hypertensive men, and in 173 (38%) of the normotensive men (P < 0.001). The prevalence rates of metabolic disturbances did not differ significantly between lean (BMI < 26 kg m-2) and obese (BMI > or = 26 kg m-2) hypertensives. Only hypertriglyceridaemia was more frequent in obese than in lean hypertensives (20% vs. 37%, P = 0.015). The 'metabolic syndrome' was found in 6% of all hypertensives, which was twice as common as in the normotensive population. The 'metabolic syndrome' was uncommon in both lean and obese hypertensives (5% vs. 7%, NS). These findings indicate that hypertension and metabolic disturbances may have a common underlying cause, at least in some individuals.

摘要

高血压患者中已发现存在一系列代谢紊乱。在一个由644名67岁男性组成的普通人群样本中,评估了高血压患者和血压正常者中这些因素的分布情况。测量了空腹血清胰岛素、血糖和甘油三酯水平。在本研究中,高血压定义为舒张压≥95 mmHg或正在使用抗高血压药物。糖耐量受损(IGT)或糖尿病、高胰岛素血症(≥20 mU l-1)和高甘油三酯血症(≥2.3 mmol l-1)被定义为代谢紊乱。当所有这些紊乱同时出现时,则认为存在完整的“代谢综合征”。185名(29%)男性患有高血压,15%患有IGT,11%患有糖尿病,18%患有高胰岛素血症,19%患有高甘油三酯血症。在高血压患者中,11名(6%)男性患有“代谢综合征”,而血压正常组中有12名(3%)男性患有“代谢综合征”(P = 0.039)。109名(59%)高血压男性至少存在一种代谢紊乱,173名(38%)血压正常男性存在至少一种代谢紊乱(P < 0.001)。瘦型(BMI < 26 kg m-2)和肥胖型(BMI≥26 kg m-2)高血压患者的代谢紊乱患病率无显著差异。只有肥胖型高血压患者的高甘油三酯血症比瘦型高血压患者更常见(20%对37%,P = 0.015)。所有高血压患者中有6%患有“代谢综合征”,这一比例是血压正常人群的两倍。“代谢综合征”在瘦型和肥胖型高血压患者中均不常见(5%对7%,无显著性差异)。这些发现表明,高血压和代谢紊乱可能至少在某些个体中有共同潜在病因。

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