Nosadini R, Cipollina M R, Solini A, Sambataro M, Morocutti A, Doria A, Fioretto P, Brocco E, Muollo B, Frigato F
Istituto di Medicina Interna, Policlinico Universitario, Padova, Italy.
J Am Soc Nephrol. 1992 Oct;3(4 Suppl):S56-63. doi: 10.1681/ASN.V34s56.
The aim of this study was to investigate the relationships among insulin resistance and albumin excretion rate in 25 nondiabetic patients with essential hypertension and in 28 patients with non-insulin dependent diabetes mellitus (NIDDM). Two groups of healthy subjects matched for age, sex, and weight served as controls. Patients with essential hypertension were divided into two subgroups: without (H1) and with (H2) microalbuminuria. Diabetic patients were divided into four subgroups: those with normoalbuminuria without (NIDDM1) and with (NIDDM2) hypertension and those with microalbuminuria without (NIDDM3) and with (NIDDM4) hypertension. Whole-body glucose utilization during euglycemic hyperinsulinemic clamp (40 mU/m2/min insulin infusion) was calculated by tracer dilution techniques (6,6 2H2 glucose tracer continuous infusion) and was significantly lower in hypertensives with microalbuminuria than in those without (H2 versus H1 versus controls: 3.41 +/- 0.51 versus 6.52 +/- 0.62 versus 7.03 +/- 0.48 mg/kg/min; mean +/- SE). Whole-body glucose utilization in NIDDM patients--NIDDM4 versus NIDDM3 versus NIDDM2 versus NIDDM1 versus controls--was: 1.86 +/- 0.31 versus 2.21 +/- 0.39 versus 2.01 +/- 0.40 versus 5.98 +/- 0.77 versus 5.52 +/- 0.92 mg/kg/min (mean +/- SE). Whereas the first three subgroups did not differ among themselves, they had significantly lower glucose utilization than did the normotensive NIDDM1 patients without microalbuminuria and nondiabetic controls (P < 0.01). Hypertensives with microalbuminuria had higher Vmax of sodium-lithium countertransport (Na/Li CTT) in red blood cells than did both hypertensives without microalbuminuria and controls. It was also observed that NIDDM patients with microalbuminuria had higher Vmax of Na/Li CTT than did NIDDM patients without microalbuminuria and controls.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在调查25例原发性高血压非糖尿病患者及28例非胰岛素依赖型糖尿病（NIDDM）患者中胰岛素抵抗与白蛋白排泄率之间的关系。两组年龄、性别和体重匹配的健康受试者作为对照。原发性高血压患者分为两个亚组：无微白蛋白尿组（H1）和有微白蛋白尿组（H2）。糖尿病患者分为四个亚组：无高血压的正常白蛋白尿组（NIDDM1）和有高血压的正常白蛋白尿组（NIDDM2），无微白蛋白尿的微白蛋白尿组（NIDDM3）和有高血压的微白蛋白尿组（NIDDM4）。通过示踪剂稀释技术（连续输注6,6 - 2H2葡萄糖示踪剂）计算正常血糖高胰岛素钳夹试验（胰岛素输注速度为40 mU/m2/min）期间的全身葡萄糖利用率，有微白蛋白尿的高血压患者的全身葡萄糖利用率显著低于无微白蛋白尿的患者（H2与H1与对照组相比：3.41±0.51对6.52±0.62对7.03±0.48 mg/kg/min；均值±标准误）。NIDDM患者的全身葡萄糖利用率——NIDDM4与NIDDM3与NIDDM2与NIDDM1与对照组相比——分别为：1.86±0.31对2.21±0.39对2.01±0.40对5.98±0.77对5.52±0.92 mg/kg/min（均值±标准误）。前三个亚组之间无差异，但与无微白蛋白尿的血压正常的NIDDM1患者和非糖尿病对照组相比，其葡萄糖利用率显著降低（P<0.01）。有微白蛋白尿的高血压患者红细胞中钠-锂逆向转运（Na/Li CTT）的Vmax高于无微白蛋白尿的高血压患者和对照组。还观察到，有微白蛋白尿的NIDDM患者的Na/Li CTT的Vmax高于无微白蛋白尿的NIDDM患者和对照组。（摘要截短于250字）
