Zavaroni I, Mazza S, Dall'Aglio E, Gasparini P, Passeri M, Reaven G M
Institute of the General Medical Clinic, Parma University, Italy.
J Intern Med. 1992 Mar;231(3):235-40. doi: 10.1111/j.1365-2796.1992.tb00529.x.
A total of 41 patients with hypertension were identified in a survey of 732 healthy factory workers. Twenty-three of these individuals were receiving antihypertensive medication, whereas 18 cases were newly discovered. Plasma glucose and insulin responses to oral glucose and fasting plasma triglyceride (TG), cholesterol, and high-density-lipoprotein (HDL) cholesterol concentrations of these 41 individuals were compared with those of 41 other factor workers, with normal blood pressure, matched with the hypertensive group in terms of gender, age, degree of obesity, job in the factory, and leisure-time activity. Patients with hypertension had significantly higher plasma glucose (P less than 0.05) and insulin (P less than 0.05) concentrations in response to oral glucose, as well as a higher plasma TG concentration (P less than 0.05). Similar findings were obtained when the treated and untreated hypertensive groups were analysed separately and compared with their respective control groups. However, there were no differences between the treated and untreated hypertensive groups. Ninety per cent of the normotensive group had a plasma insulin concentration of less than 500 pmol l-1 2 h after the glucose load. Using this value as the criterion for definition of hyperinsulinaemia, 41% of the patients with high blood pressure were hyperinsulinaemic. In addition to meeting this cut-off point, the patients with hypertension and hyperinsulinaemia were also glucose intolerant and dyslipidaemic. In conclusion, approximately 50% of an unselected group of patients with hypertension were hyperinsulinaemic. Insulin levels were comparable in treated and untreated patients with high blood pressure, and hyperinsulinaemic patients also tended to be glucose intolerant and dyslipidaemic.
在对732名健康工厂工人的调查中，共发现41名高血压患者。其中23人正在接受抗高血压药物治疗，另外18例为新发现的病例。将这41人的口服葡萄糖后血浆葡萄糖和胰岛素反应以及空腹血浆甘油三酯（TG）、胆固醇和高密度脂蛋白（HDL）胆固醇浓度，与另外41名血压正常的工厂工人进行比较，这些血压正常的工人在性别、年龄、肥胖程度、工厂工作岗位和休闲活动方面与高血压组相匹配。高血压患者口服葡萄糖后血浆葡萄糖（P<0.05）和胰岛素（P<0.05）浓度显著更高，血浆TG浓度也更高（P<0.05）。当分别分析治疗组和未治疗组高血压患者并与各自的对照组比较时，也获得了类似的结果。然而，治疗组和未治疗组高血压患者之间没有差异。血压正常组90%的人在葡萄糖负荷后2小时血浆胰岛素浓度低于500 pmol l-1。以这个值作为高胰岛素血症的定义标准，41%的高血压患者存在高胰岛素血症。除了达到这个临界值外，高血压和高胰岛素血症患者还存在葡萄糖不耐受和血脂异常。总之，在一组未经选择的高血压患者中，约50%存在高胰岛素血症。高血压治疗组和未治疗组患者的胰岛素水平相当，高胰岛素血症患者也往往存在葡萄糖不耐受和血脂异常。
