Hrnciar J, Hrnciarová M, Jakubíková K, Okapcová J
Interná klinika Nemocnice F. D. Roosevelta, Banská, Bystrica.
Vnitr Lek. 1992 May;38(5):438-47.
The authors analyze mechanism by which hyperinsulinism causes NIDDM, hypertension, hyperlipoproteinaemia and hirsutism (5H syndrome). They demonstrate on a group of their 100 patients with NIDDM and arterial hypertension that, as compared with matched pairs without arterial hypertension, they have significantly higher levels of C-peptide and less favourable parameters of dyslipoproteinaemia. Hirsutism occurs in 10-15% of the adult female population, but in 18.4% women with NIDDM. However, in a group of 48 hirsutic women with NIDDM they did not find, as compared with matched pairs (i.e. women with NIDDM of analogous age, BMI and BP) significantly higher C-peptide and lipid levels. According to the authors congenital insulin resistance modified by numerous endogenous and exogenous factors is eventually manifested in the phenotype, in particular via hyperinsulinism as NIDDM, hypertension, associated with dyslipoproteinaemia and obesity which then, as the main risk factors, condition a high cardiovascular morbidity and mortality. Although hirsutism and the polycystic ovary syndrome are associated with hyperinsulinism, their interrelation is probably less close and thus has not such a negative impact on national health.
作者分析了高胰岛素血症导致非胰岛素依赖型糖尿病、高血压、高脂蛋白血症和多毛症（5H综合征）的机制。他们在一组100例非胰岛素依赖型糖尿病和动脉高血压患者中证明，与配对的无动脉高血压患者相比，他们的C肽水平显著更高，且脂蛋白血症参数更不理想。多毛症发生在10% - 15%的成年女性人群中，但在18.4%的非胰岛素依赖型糖尿病女性中出现。然而，在一组48例非胰岛素依赖型糖尿病多毛女性中，与配对者（即年龄、体重指数和血压相似的非胰岛素依赖型糖尿病女性）相比，他们并未发现C肽和血脂水平显著更高。作者认为，由众多内源性和外源性因素改变的先天性胰岛素抵抗最终在表型中表现出来，特别是通过高胰岛素血症表现为非胰岛素依赖型糖尿病、高血压，伴有脂蛋白血症和肥胖，而后这些作为主要危险因素，导致高心血管发病率和死亡率。虽然多毛症和多囊卵巢综合征与高胰岛素血症有关，但其相互关系可能不太密切，因此对国民健康没有如此负面的影响。
