Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Diabetes Res Clin Pract. 2011 Oct;94(1):71-6. doi: 10.1016/j.diabres.2011.05.039. Epub 2011 Jul 13.
To investigate the correlation between serum visfatin and insulin resistance (IR) in non-diabetic essential hypertensive (EH) patients with and without IR, and to evaluate the effect of antihypertensive treatment on serum visfatin and IR in these patients.
A total of 81 non-diabetic EH patients, including 54 with IR and 27 without IR, were enrolled. After two weeks wash-out, patients with IR were randomly assigned to telmisartan (group T) or amlodipine (group A) for 6 months. Blood samples were taken before and after treatment for measurement of routine biochemical parameters, visfatin and insulin resistance (measured by HOMA-IR).
Visfatin was independently correlated with HOMA-IR (r=0.845, P=0.000). After 6 months of treatment, both drugs lowered HOMA-IR, more significantly so in group T than group A (P=0.010). Serum visfatin levels increased in group T but decreased in group A.
Serum visfatin levels were higher in non-diabetic EH patients with IR compared with those without IR. Visfatin is independently correlated with HOMA-IR. Telmisartan lowers HOMA-IR to a greater extent than amlodipine. Interestingly, serum visfatin increased with telmisartan yet decreased with amlodipine treatment.
探讨非糖尿病原发性高血压（EH）伴或不伴胰岛素抵抗（IR）患者血清内脏脂肪素与胰岛素抵抗的相关性，并评估降压治疗对这些患者血清内脏脂肪素和胰岛素抵抗的影响。
共纳入 81 例非糖尿病 EH 患者，其中 54 例伴有 IR，27 例不伴有 IR。IR 患者洗脱 2 周后，随机分为替米沙坦（T 组）或氨氯地平（A 组）治疗 6 个月。治疗前后采集血样，检测常规生化参数、内脏脂肪素和胰岛素抵抗（HOMA-IR 法）。
内脏脂肪素与 HOMA-IR 独立相关（r=0.845，P=0.000）。治疗 6 个月后，两种药物均降低了 HOMA-IR，T 组降低更为显著（P=0.010）。T 组血清内脏脂肪素水平升高，A 组则降低。
非糖尿病 EH 伴 IR 患者血清内脏脂肪素水平高于不伴 IR 者。内脏脂肪素与 HOMA-IR 独立相关。替米沙坦降低 HOMA-IR 的作用强于氨氯地平。有趣的是，替米沙坦治疗时血清内脏脂肪素升高，而氨氯地平治疗时则降低。
