Helgeland A, Leren P, Foss O P, Hjermann I, Holme I, Lund-Larsen P G
Am J Med. 1984 May;76(5):802-5. doi: 10.1016/0002-9343(84)90990-2.
Serum glucose levels, triglyceride levels, and body weight are reported from a controlled drug trial in men, aged 40 to 49, with uncomplicated mild hypertension. The drug treatment started with hydrochlorothiazide alone, and methyldopa was added when necessary. If side effects occurred, methyldopa was replaced by propranolol. No detailed advice about diet, smoking, or weight reduction was given to any group. The untreated control subjects had a small increase in serum glucose levels during five years, from 6.08 to 6.21 mmol/liter. Those treated with hydrochlorothiazide alone and those treated with hydrochlorothiazide plus methyldopa had a small increase in serum glucose levels of the same order as that in the control subjects. However, those receiving the thiazide/propranolol combination experienced a sizeable increase in glucose levels, from 5.96 to 6.53 mmol/liter (p less than 0.001). This increase was significantly greater than the increase in the other groups (p less than 0.001). The thiazide/propranolol group also showed a significant increase in serum triglyceride levels (p less than 0.05). There was no difference in serum potassium levels in the different drug groups. The results indicate that moderate thiazide doses do not have significant effects on serum glucose levels in this age group. Propranolol in combination with thiazide seems to increase the level of serum glucose.
在一项针对40至49岁患有单纯性轻度高血压男性的对照药物试验中,报告了血清葡萄糖水平、甘油三酯水平和体重情况。药物治疗开始时仅使用氢氯噻嗪,必要时添加甲基多巴。若出现副作用,则用普萘洛尔替代甲基多巴。未对任何组提供关于饮食、吸烟或减重的详细建议。未经治疗的对照组受试者在五年间血清葡萄糖水平有小幅升高,从6.08毫摩尔/升升至6.21毫摩尔/升。仅接受氢氯噻嗪治疗的受试者以及接受氢氯噻嗪加甲基多巴治疗的受试者,其血清葡萄糖水平的升高幅度与对照组受试者相同。然而,接受噻嗪类/普萘洛尔联合治疗的受试者,其葡萄糖水平有显著升高,从5.96毫摩尔/升升至6.53毫摩尔/升(p小于0.001)。这一升高幅度显著大于其他组(p小于0.001)。噻嗪类/普萘洛尔组的血清甘油三酯水平也有显著升高(p小于0.05)。不同药物组的血清钾水平无差异。结果表明,中等剂量的噻嗪类药物对该年龄组的血清葡萄糖水平无显著影响。噻嗪类与普萘洛尔联合使用似乎会升高血清葡萄糖水平。