Kasthuri A S, Kumar S, Somani B L, Sharma S K
Commandant, 158 Base Hospital, C/o 99 APO.
Postgraduate student, Department of Biochemistry, Armed Forces Medical College, Pune - 411 040.
Med J Armed Forces India. 2001 Oct;57(4):312-6. doi: 10.1016/S0377-1237(01)80011-3. Epub 2011 Jul 21.
All patients attending the outpatient department were screened for hypertension. An attempt was made to correlate presence of hyperinsulinaemia (HI), dyslipidaemia and anthropometric characteristics in these hypertensives. Effect of angiotensin converting enzyme inhibitor (ACEI) and beta blockers on serum insulin was also studied. 85 patients with blood pressure (BP) ≥ 160/90 mm Hg and 94 controls with a BP of < 130/85 mm Hg were studied. All underwent clinical examination, anthropometric measurements (body mass index (BMI), waist hip ratio (WHR), skin fold thickness (SFT) and laboratory investigation (serum insulin, glucose, lipid profile) and post oral glucose load (POGL) for insulin and glucose. Serum insulin was estimated by I(125) radio immuno assay. Patients were randomly divided into group A (Tab enalapril) and group B (Tab atenolol). In 51 patients who completed the study, fasting and POGL insulin and fasting lipid profile were estimated two months after treatment. Mean age of cases was 38.91 years. 50% of patients had stage II hypertension. BMI was increased in 36 cases (42.35%) as compared to 9 in (9.57%) controls. Increased WHR was found in 40 cases as compared to 26 in controls. The SFT was more in cases compared to controls. 47 (55.29%) of 85 cases had abnormal lipid profile as compared to 25 (26.60%) in 94 controls. The fasting and POGL insulin levels (13.85 and 60.05 micro u/ml respectively) in cases were significantly higher than in controls (6.87 and 16.16 micro u/ml respectively). The mean POGL insulin values were much higher in obese compared to non-obese hypertensives. The decrease in mean fasting and POGL insulin values in patients taking ACEI and beta blockers were similar. Abnormal lipid profile was significantly more in cases than controls. Increased total cholesterol (TC), Low density lipoprotein cholesterol (LDLC) and total cholesterol (TC)/high density lipoprotein (HDL) ratio were the most frequent abnormality. The mean insulin (both fasting and POGL) levels were higher in obese hypertensives and those with abnormal lipid profile. Both drugs had equal efficacy in reducing the insulin values.
所有到门诊部就诊的患者均接受了高血压筛查。研究人员试图找出这些高血压患者中高胰岛素血症（HI）、血脂异常与人体测量学特征之间的关联。同时还研究了血管紧张素转换酶抑制剂（ACEI）和β受体阻滞剂对血清胰岛素的影响。研究对象为85名血压（BP）≥160/90 mmHg的患者和94名血压<130/85 mmHg的对照者。所有研究对象均接受了临床检查、人体测量（体重指数（BMI）、腰臀比（WHR）、皮褶厚度（SFT））以及实验室检查（血清胰岛素、葡萄糖、血脂谱），并进行了口服葡萄糖负荷试验（POGL）以检测胰岛素和葡萄糖水平。血清胰岛素通过I(125)放射免疫分析法进行测定。患者被随机分为A组（服用依那普利片）和B组（服用阿替洛尔片）。在51名完成研究的患者中，治疗两个月后测定了空腹和口服葡萄糖负荷后的胰岛素水平以及空腹血脂谱。病例组的平均年龄为38.91岁。50%的患者患有II期高血压。与9名（9.57%）对照者相比，36例（42.35%）病例的BMI升高。与26名对照者相比，40例病例的WHR升高。病例组的SFT高于对照组。85例患者中有47例（55.29%）血脂异常，而94名对照者中有25例（26.60%）血脂异常。病例组的空腹和口服葡萄糖负荷后的胰岛素水平（分别为13.85和60.05微单位/毫升）显著高于对照组（分别为6.87和16.16微单位/毫升）。肥胖高血压患者的口服葡萄糖负荷后胰岛素平均水平远高于非肥胖高血压患者。服用ACEI和β受体阻滞剂的患者空腹和口服葡萄糖负荷后胰岛素平均水平的下降情况相似。病例组的血脂异常显著多于对照组。总胆固醇（TC）、低密度脂蛋白胆固醇（LDLC）升高以及总胆固醇（TC）/高密度脂蛋白（HDL）比值升高是最常见的异常情况。肥胖高血压患者和血脂异常患者的胰岛素平均水平（空腹和口服葡萄糖负荷后）均较高。两种药物在降低胰岛素水平方面疗效相当。
