Sheu W H, Jeng C Y, Shieh S M, Fuh M M, Shen D D, Chen Y D, Reaven G M
Division of Endocrinology and Metabolism, Tri-Service General Hospital, Taipei, Republic of China, Taiwan.
Am J Hypertens. 1992 Jul;5(7):444-8. doi: 10.1093/ajh/5.7.444.
Plasma glucose and insulin responses to an oral glucose challenge and fasting plasma lipid and lipoprotein concentration were compared in 25 normal individuals and 53 patients with high blood pressure. Patients with hypertension were further subdivided into two groups--normal electrocardiogram (EKG) (n = 24) or abnormal EKG (n = 29)--using the Minnesota code criteria. Patients with hypertension and an abnormal EKG had significantly higher plasma glucose and insulin concentrations following oral glucose than did the control population. Furthermore, plasma triglyceride (TG) concentration was higher and high density lipoprotein cholesterol concentration lower then normal in hypertensive patients with an abnormal EKG, and the ratio of total to HDL cholesterol was higher in this subgroup. Values for patients with high blood pressure and a normal EKG were intermediate. Insulin-mediated glucose uptake was also measured in a subset of patients with hypertension and either a normal (n = 18) or abnormal (n = 17) EKG. When these two subgroups were compared, those with high blood pressure and an abnormal EKG were significantly more insulin resistant than patients with hypertension and a normal EKG. In addition, they also had higher plasma glucose and insulin responses to oral glucose, higher fasting plasma triglyceride and cholesterol concentrations, and an increase in the ratio of total to HDL cholesterol. Thus, patients with high blood pressure have abnormalities of glucose, insulin, and lipid metabolism when compared to a nonhypertensive control group, and the magnitude of these metabolic defects is significantly greater in patients with high blood pressure who have EKG evidence of coronary heart disease.
对25名正常个体和53名高血压患者进行了比较，观察他们口服葡萄糖激发试验后的血浆葡萄糖和胰岛素反应以及空腹血浆脂质和脂蛋白浓度。使用明尼苏达编码标准，将高血压患者进一步分为两组——正常心电图（EKG）组（n = 24）和异常心电图组（n = 29）。高血压且心电图异常的患者口服葡萄糖后血浆葡萄糖和胰岛素浓度显著高于对照组人群。此外，心电图异常的高血压患者血浆甘油三酯（TG）浓度较高，高密度脂蛋白胆固醇浓度低于正常水平，该亚组中总胆固醇与高密度脂蛋白胆固醇的比值更高。血压高且心电图正常的患者各项数值处于中间水平。还对一部分高血压患者进行了胰岛素介导的葡萄糖摄取测量，这些患者心电图正常（n = 18）或异常（n = 17）。比较这两个亚组时发现，高血压且心电图异常的患者比高血压且心电图正常的患者胰岛素抵抗明显更强。此外，他们口服葡萄糖后的血浆葡萄糖和胰岛素反应也更高，空腹血浆甘油三酯和胆固醇浓度更高，总胆固醇与高密度脂蛋白胆固醇的比值增加。因此，与非高血压对照组相比，高血压患者存在葡萄糖、胰岛素和脂质代谢异常，并且在有冠心病心电图证据的高血压患者中，这些代谢缺陷的程度明显更大。
