Esteghamati Alireza, Khalilzadeh Omid, Abbasi Mehrshad, Nakhjavani Manouchehr, Novin Leila, Esteghamati Abdul Reza
Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
Clin Exp Hypertens. 2008 Jul;30(5):297-307. doi: 10.1080/10641960802269919.
The relationship between insulin resistance (IR) and essential hypertension (HTN) is controversial. The aim of this study was to determine the association of IR estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and HTN in a large sample of Iranian diabetic and non-diabetic population. A total of 2047 diabetic and non-diabetic individuals with or without HTN, aged 30-75 yrs, who were referred to a university general hospital between November 2004 and April 2007 were included in this study. Demographic data and anthropometric characteristics of participants were recorded. Fasting blood samples were collected, and fasting plasma glucose (FPG), serum creatinine, lipids, insulin, C-peptide and HbA1c were measured. HOMA-IR and HOMA derived Beta-cell function (HOMA-B) were also calculated. Age, sex and waist girth adjusted HOMA-IR values were compared between hypertensive and normotensive subjects. Hypertensive patients had significantly higher HOMA-IR than age-, sex-, and waist girth-adjusted normotensive individuals in both non-diabetic (2.163 +/- 0.08 and 1.75 +/- 0.03, p < 0.001) and diabetic (3.40 +/- 0.10 and 3.07 +/- 0.09, p < 0.05) groups. Multivariate logistic regression analysis showed that after adjustment for age, sex, waist girth, BMI, triglyceride, total cholesterol, FPG, and C-peptide, HOMA-IR was a significant independent predictor of HTN in all subjects (odds ratio = 1.117, CI 95% = 1.026-1.216, p < 0.05) and in diabetic and non-diabetic subjects separately (odds ratio = 1.102, CI 95% = 1.009-1.203, p < 0.05 and odds ratio = 1.328, CI 95% = 1.116-1.580, p < 0.01, respectively). In conclusion, this study showed that IR is associated with HTN in Iranian diabetic and non-diabetic subjects.
胰岛素抵抗（IR）与原发性高血压（HTN）之间的关系存在争议。本研究的目的是在一大群伊朗糖尿病和非糖尿病患者中，确定通过胰岛素抵抗稳态模型评估（HOMA-IR）估算的IR与HTN之间的关联。本研究纳入了2047例年龄在30至75岁之间、患有或未患有HTN的糖尿病和非糖尿病个体，这些个体于2004年11月至2007年4月期间被转诊至一家大学综合医院。记录了参与者的人口统计学数据和人体测量学特征。采集空腹血样，测量空腹血糖（FPG）、血清肌酐、血脂、胰岛素、C肽和糖化血红蛋白（HbA1c）。还计算了HOMA-IR和HOMA衍生的β细胞功能（HOMA-B）。比较了高血压组和血压正常组在年龄、性别和腰围调整后的HOMA-IR值。在非糖尿病组（2.163±0.08和1.75±0.03，p<0.001）和糖尿病组（3.40±0.10和3.07±0.09，p<0.05）中，高血压患者的HOMA-IR均显著高于年龄、性别和腰围调整后的血压正常个体。多因素逻辑回归分析显示，在调整年龄、性别、腰围、体重指数（BMI）、甘油三酯、总胆固醇、FPG和C肽后，HOMA-IR是所有受试者（比值比=1.117，95%置信区间=1.026-1.216，p<0.05）以及糖尿病和非糖尿病受试者中HTN的显著独立预测因子（分别为比值比=1.102，95%置信区间=1.009-1.203，p<0.05和比值比=1.328，95%置信区间=1.116-1.580，p<0.01）。总之，本研究表明，在伊朗糖尿病和非糖尿病受试者中，IR与HTN相关。
