Niskanen L K, Uusitupa M I, Pyörälä K
Department of Medicine, Kuopio University Central Hospital, Finland.
J Hum Hypertens. 1991 Jun;5(3):155-9.
We have carried out a 5 year follow-up study of a group of 41 originally normotensive (BP less than 160/95 mmHg) newly diagnosed Type 2 (non-insulin-dependent) diabetic patients (26 men, 15 women) and 86 non-diabetic subjects (39 men, 47 women) to assess the predictive value of serum insulin levels with regard to the development of hypertension. Hypertension (BP greater than 160/95 mmHg and/or drug treatment) developed in 14% of diabetic patients and 10% of non-diabetic subjects (NS). The baseline postglucose insulin levels tended to be higher in those diabetic and non-diabetic subjects who developed hypertension during the 5 year follow-up than in those who remained normotensive, and in non-diabetic subjects the differences were statistically significant after adjustment for age, sex and body mass index for the baseline 1 hour serum insulin (104 +/- 18 vs. 68 +/- 5 mU/l; P less than 0.05) and area under the insulin curve (138 +/- 34 vs. 85 +/- 8 mU/l.h, P less than 0.05). Both diabetic and non-diabetic subjects who developed hypertension showed elevated total- and VLDL-triglycerides at baseline compared with those subjects who remained normotensive during the follow-up. In conclusion, the results support the hypothesis that hyperinsulinaemia or insulin resistance may play a role in the pathogenesis of hypertension.
我们对一组41名初诊为2型（非胰岛素依赖型）糖尿病患者（26名男性，15名女性）和86名非糖尿病受试者（39名男性，47名女性）进行了为期5年的随访研究，这些糖尿病患者最初血压正常（血压低于160/95 mmHg），以评估血清胰岛素水平对高血压发病的预测价值。14%的糖尿病患者和10%的非糖尿病受试者（NS）出现了高血压（血压大于160/95 mmHg和/或接受药物治疗）。在5年随访期间出现高血压的糖尿病和非糖尿病受试者的基线餐后血糖胰岛素水平往往高于血压仍正常的受试者，在非糖尿病受试者中，对基线1小时血清胰岛素进行年龄、性别和体重指数校正后，差异具有统计学意义（104±18 vs. 68±5 mU/l；P<0.05）以及胰岛素曲线下面积（138±34 vs. 85±8 mU/l.h，P<0.05）。与随访期间血压仍正常的受试者相比，出现高血压的糖尿病和非糖尿病受试者在基线时的总甘油三酯和极低密度脂蛋白甘油三酯均升高。总之，结果支持高胰岛素血症或胰岛素抵抗可能在高血压发病机制中起作用这一假说。
