Paolisso G, Galzerano D, Gambardella A, Varricchio G, Saccomanno F, D'Amore A, Varricchio M, D'Onofrio F
Department of Geriatric Medicine and Metabolic Disease, II University of Naples, Italy.
Eur J Clin Invest. 1995 Jul;25(7):529-33. doi: 10.1111/j.1365-2362.1995.tb01740.x.
Hypertensive patients with left ventricular hypertrophy (LVH) have a higher degree of hyperinsulinaemia than hypertensive patients without LVH. Obese patients with LVH have also been demonstrated to have a very low glucose disappearance rate after an intravenous glucose bolus. No studies have investigated the difference in insulin action and substrate oxidation in hypertensive patients with and without LVH. For this reason 36 subjects were enrolled for our study: (1) healthy control subjects (n = 10); (2) hypertensive patients without LVH (n = 12); and (3) hypertensive patients with LVH (n = 14). All subjects underwent an oral glucose tolerance test (OGTT, 75 g of glucose) and a euglycaemic hyperinsulinaemic glucose clamp (insulin infusion rate, 7.1 pmol (kg min)-1 for 120 min). In this latter test indirect calorimetry allowed substrate oxidation determination. Echocardiographic methods allowed LVH assessment. Hypertensive patients with LVH had the lowest insulin-mediated nonoxidative glucose metabolism compared to hypertensive patients without LVH (P < 0.01) and to healthy subjects (P < 0.001). In the whole group of hypertensive patients (n = 26), partial correlations showed left ventricular mass index (LVMI) associated with fasting plasma insulin levels (r = 0.44 P < 0.005), insulin-mediated whole body glucose disposal (r = -0.41 P < 0.01) and nonoxidative glucose metabolism (r = -0.33 P < 0.04) independently of age, body weight, systolic blood pressure and plasma catecholamines levels. In conclusion, our data provide evidence that LVH in hypertensive patients is associated with a worsening in nonoxidative glucose metabolism.
患有左心室肥厚（LVH）的高血压患者比没有LVH的高血压患者有更高程度的高胰岛素血症。患有LVH的肥胖患者在静脉推注葡萄糖后也被证明有非常低的葡萄糖消失率。尚无研究调查有和没有LVH的高血压患者在胰岛素作用和底物氧化方面的差异。因此，我们招募了36名受试者进行研究：（1）健康对照受试者（n = 10）；（2）没有LVH的高血压患者（n = 12）；以及（3）患有LVH的高血压患者（n = 14）。所有受试者均接受了口服葡萄糖耐量试验（OGTT，75克葡萄糖）和正常血糖高胰岛素葡萄糖钳夹试验（胰岛素输注速率，7.1 pmol/（kg·min），持续120分钟）。在后者的试验中，间接测热法可测定底物氧化。超声心动图方法可评估LVH。与没有LVH的高血压患者（P < 0.01）和健康受试者（P < 0.001）相比，患有LVH的高血压患者胰岛素介导的非氧化葡萄糖代谢最低。在整个高血压患者组（n = 26）中，偏相关性显示左心室质量指数（LVMI）与空腹血浆胰岛素水平（r = 0.44，P < 0.005）、胰岛素介导的全身葡萄糖处置（r = -0.41，P < 0.01）和非氧化葡萄糖代谢（r = -0.33，P < 0.04）相关，且独立于年龄、体重、收缩压和血浆儿茶酚胺水平。总之，我们的数据提供了证据，表明高血压患者的LVH与非氧化葡萄糖代谢恶化有关。
