Resnick L M, Gupta R K, Gruenspan H, Laragh J H
Cardiovascular Center, Cornell University Medical Center, New York, New York 10021.
J Hypertens Suppl. 1988 Dec;6(4):S199-201.
In order to study the importance of altered intracellular ion metabolism in hypertension, we used 31P nuclear magnetic resonance (NMR) spectroscopy to measure intracellular free magnesium levels in normotensive (n = 19), essential hypertensive (n = 17) and diet-controlled diabetic (n = 6) subjects given a standard 100-g oral glucose load. The intracellular Mg level was significantly lower in hypertensives compared with normotensives (183 +/- 7 versus 232 +/- 10 mumol/l, P less than 0.001), and for all subjects was closely linked to both systolic (r = -0.84, P less than 0.001) and diastolic (r = -0.76, P less than 0.001) pressure. Hypertensives also showed a significantly greater insulinaemic response to glucose loading (P less than 0.001), and intracellular Mg was also closely and inversely linked to the integrated insulin response (r = -0.78, P less than 0.001). Despite the absence of hyperinsulinaemia, diabetics had the lowest intracellular Mg levels (156 +/- 8 mumol/l). Thus, suppressed intracellular Mg is linked to hypertension and to decreased tissue insulin sensitivity, and is not consequent to the hyperinsulinaemia itself. We suggest that intracellular Mg may provide a common pathophysiological basis for understanding the clinical association of hypertension and diabetes mellitus.
为研究细胞内离子代谢改变在高血压中的重要性，我们采用31P核磁共振波谱法，对19名血压正常者、17名原发性高血压患者和6名饮食控制的糖尿病患者给予标准100克口服葡萄糖负荷后，测量其细胞内游离镁水平。与血压正常者相比，高血压患者的细胞内镁水平显著降低（183±7对232±10μmol/L，P<0.001），且在所有受试者中，细胞内镁水平与收缩压（r=-0.84，P<0.001）和舒张压（r=-0.76，P<0.001）均密切相关。高血压患者对葡萄糖负荷的胰岛素血症反应也显著增强（P<0.001），且细胞内镁与胰岛素综合反应也密切负相关（r=-0.78，P<0.001）。尽管没有高胰岛素血症，但糖尿病患者的细胞内镁水平最低（156±8μmol/L）。因此，细胞内镁水平降低与高血压及组织胰岛素敏感性降低有关，并非由高胰岛素血症本身所致。我们认为，细胞内镁可能为理解高血压与糖尿病的临床关联提供一个共同的病理生理基础。
