Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
J Atheroscler Thromb. 2010 Feb 26;17(2):148-55. doi: 10.5551/jat.2584. Epub 2010 Feb 10.
There are few data focusing on the effect of insulin resistance on a new risk category of prehypertension (120-139 mmHg systolic and/or 80-89 mmHg diastolic blood pressure) recently established by The Seventh Report of the Joint National Committee on High Blood Pressure (JNC-7). We aimed to determine whether insulin resistance was associated with a risk for prehypertension and hypertension.
Of 3,164 (34.6% of 9,133 adults aged 19 to 90 years) adults at the community-based annual medical check-up, study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina, or renal failure (567 men aged 57+/-14 (mean+/-standard deviation); range, 20-84) years and 702 women aged 59+/-12; 21-88 years) were recruited. We examined the cross-sectional relationship between insulin resistance, which was evaluated by homeostasis of minimal assessment of insulin resistance (HOMA-IR) and normotension, prehypertension, or hyper-tension using the JNC-7 criteria.
The HOMA-IR correlated significantly with systolic (r=0.171) and diastolic (r=0.170) blood pressures. Triglycerides >or=150 mg/dL, HDL-C <40 mg/dL, metabolic syndrome, serum uric acid >or=7.0 mg/dL, and HOMA-IR >or=2.5 showed the highest crude odds ratio (OR) for progression from normotension to prehypertension, and >or=65 years, FBG >or=110 mg/dL, metabolic syndrome, and HOMA-IR >or=2.5 showed the highest crude OR for progression from normotension to hypertension. Multivariate logistic regression analysis showed that HOMA-IR was independently associated with the presence of prehypertension and hypertension.
Insulin resistance was significantly associated with prehypertension as well as hypertension in the general population.
最近，第七次美国国立卫生研究院高血压联合委员会报告（JNC-7）确立了一个新的高血压前期危险类别（收缩压 120-139mmHg 和/或舒张压 80-89mmHg），目前针对胰岛素抵抗对此危险类别的影响的数据较少。我们旨在确定胰岛素抵抗是否与高血压前期和高血压有关。
在社区年度体检的 9133 名 19 至 90 岁成年人中（34.6%），选择无卒中、短暂性脑缺血发作、心肌梗死、心绞痛或肾衰竭病史的成年人（567 名男性，年龄 57+/-14（均值+/-标准差）；范围，20-84 岁；702 名女性，年龄 59+/-12；范围，21-88 岁）作为研究对象。我们使用 JNC-7 标准，检测用稳态模型评估的胰岛素抵抗（HOMA-IR）评估的胰岛素抵抗与正常血压、高血压前期或高血压之间的横断面关系。
HOMA-IR 与收缩压（r=0.171）和舒张压（r=0.170）呈显著相关。甘油三酯≥150mg/dL、HDL-C＜40mg/dL、代谢综合征、血清尿酸≥7.0mg/dL 和 HOMA-IR≥2.5 与正常血压进展为高血压前期的粗比值比（OR）最高，年龄≥65 岁、FBG≥110mg/dL、代谢综合征和 HOMA-IR≥2.5 与正常血压进展为高血压的粗 OR 最高。多变量逻辑回归分析显示，HOMA-IR 与高血压前期和高血压的存在独立相关。
在一般人群中，胰岛素抵抗与高血压前期和高血压显著相关。
