Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
Departement of Internal Medicine, University of Medicine, Vinh University, Vinh, Vietnam.
J Clin Hypertens (Greenwich). 2021 Mar;23(3):529-537. doi: 10.1111/jch.14155. Epub 2021 Jan 7.
Insulin resistance (IR), a metabolic risk factor, is linked to the pathogenetic mechanism of primary hypertension. Detecting IR in the patients with hypertension will help to predict and stratify the added cardiovascular risk, institute appropriate IR management, and manage hypertension optimally. There are many methods for assessing IR, each with distinct advantages and disadvantages. The euglycemic insulin clamp and intravenous glucose tolerance test, gold standards for measuring IR, are used in research but not in clinical practice. Homeostatic model assessment (HOMA-IR), a method for assessing β-cell function and IR, is frequently applied presently, particularly in Asia. Besides, the triglyceride-glucose index (TyG) first published by South American authors showed a good correlation with the insulin clamp technique and HOMA-IR index. This simple, convenient, and low-cost TyG index is of research interest in many countries in Asia and can be used to screen for IR in the Asian hypertensive community.
胰岛素抵抗(IR)是一种代谢危险因素,与原发性高血压的发病机制有关。在高血压患者中检测 IR 有助于预测和分层心血管风险的增加,实施适当的 IR 管理,并优化高血压的管理。有许多评估 IR 的方法,各有优缺点。用于测量 IR 的金标准——正常血糖胰岛素钳夹和静脉葡萄糖耐量试验,仅用于研究,而不适用于临床实践。目前,常用于评估β细胞功能和 IR 的方法是稳态模型评估(HOMA-IR),尤其在亚洲。此外,由南美作者首次发表的三酰甘油-葡萄糖指数(TyG)与胰岛素钳夹技术和 HOMA-IR 指数相关性良好。这种简单、方便、低成本的 TyG 指数在亚洲的许多国家都具有研究意义,可以用于筛查亚洲高血压人群中的 IR。