1st Department of Cardiology, Medical University of Gdansk, Poland.
Kardiol Pol. 2013;71(1):47-52.
Elevated values of heart rate (HR) and insulin resistance (IR) reflect enhanced sympathetic nervous system activity and may be connected to the development of coronary artery disease (CAD) and diabetes.
To evaluate the relationship between HR, blood pressure (BP), double product and IR in nondiabetic hypertensive patients with stable CAD.
There were 73 patients included in the study. Ambulatory BP monitoring was recorded in all patients by a Spacelabs 90207 device. Homeostasis model assessment (HOMA-IR) was used to estimate IR. Double product was calculated by multiplying systolic BP and HR.
In the study population (mean age 67.1 ± 8.4 years, 52% males) there was a positive correlation between HOMAIR and 24-h double product (r = 0.35, p < 0.01) and body mass index (BMI) (r = 0.45, p < 0.001). The receiver operating characteristic analysis of 24-h double product and BMI as predictive markers of IR did not reveal statistical differences between AUC (0.72 ± 0.09 vs. 0.72 ± 0.08, 24-h double product and BMI, respectively, p = NS). The best cut-off points in predicting IR were 8,978 mm Hg/min for 24-h double product and 33.02 kg/m2 for BMI. There were differences between the non obese (n = 44, mean age 67.9 ± 9.2 years) and obese (n = 29, mean age 65.8 ± 6.9 years) groups in: serum insulin level (7.3 ± 2.3 µU/mL vs. 12.0 ± 7.3 µU/mL, p < 0.01), HOMA-IR (1.8 ± 0.7 µU/mL × mmol/L vs. 3.0 ± 2.0 µU/mL × mmol/L, p < 0.01), and day systolic BP (128.0 ± 10.8 mm Hg vs. 134.1 ± 10.1 mm Hg, p < 0.02).
24-h double product and BMI may be complementary parameters in the prediction of IR in hypertensive nondiabetics with CAD confirmed by percutaneous coronary interventions in history and/or at least one coronary artery stenosis ? 70% in elective coronary angiography.
心率（HR）和胰岛素抵抗（IR）升高反映了交感神经系统活动增强，可能与冠状动脉疾病（CAD）和糖尿病的发展有关。
评估稳定型 CAD 合并高血压的非糖尿病患者中 HR、血压（BP）、双乘积与 IR 的关系。
共纳入 73 例患者。所有患者均采用 Spacelabs 90207 设备进行动态血压监测。采用稳态模型评估法（HOMA-IR）评估 IR。双乘积通过乘积收缩压和 HR 计算得出。
在研究人群（平均年龄 67.1 ± 8.4 岁，52%为男性）中，HOMA-IR 与 24 h 双乘积（r = 0.35，p < 0.01）和体重指数（BMI）（r = 0.45，p < 0.001）呈正相关。24 h 双乘积和 BMI 作为 IR 预测标志物的受试者工作特征分析显示 AUC 之间无统计学差异（0.72 ± 0.09 与 0.72 ± 0.08，分别为 24 h 双乘积和 BMI，p = NS）。预测 IR 的最佳截断点分别为 24 h 双乘积 8,978 mm Hg/min 和 BMI 33.02 kg/m2。非肥胖（n = 44，平均年龄 67.9 ± 9.2 岁）和肥胖（n = 29，平均年龄 65.8 ± 6.9 岁）组之间存在以下差异：血清胰岛素水平（7.3 ± 2.3 µU/mL 与 12.0 ± 7.3 µU/mL，p < 0.01）、HOMA-IR（1.8 ± 0.7 µU/mL × mmol/L 与 3.0 ± 2.0 µU/mL × mmol/L，p < 0.01）和日间收缩压（128.0 ± 10.8 mm Hg 与 134.1 ± 10.1 mm Hg，p < 0.02）。
在历史上经皮冠状动脉介入治疗和/或选择性冠状动脉造影证实至少有一条狭窄≥70%的冠状动脉狭窄的合并 CAD 的高血压非糖尿病患者中，24 h 双乘积和 BMI 可能是预测 IR 的补充参数。
