Falkner B, Kushner H, Tulenko T, Sumner A E, Marsh J B
Medical College of Pennsylvania, Philadelphia, USA.
Arterioscler Thromb Vasc Biol. 1995 Nov;15(11):1798-804. doi: 10.1161/01.atv.15.11.1798.
The purpose of this study was to determine whether insulin resistance was linked with alterations in plasma lipids in adult young blacks with borderline hypertension. Ninety-four American blacks participated (46 men, 48 women, age range 28 to 33 years). Within this group of 94 subjects, there were 60 normotensive (Nt) subjects and 36 subjects with borderline hypertension (BHt), defined as blood pressure > 135/85 mm Hg. None of the subjects were diabetic or receiving antihypertension medication. All participants had blood pressure and anthropometric measurements, a fasting lipid profile, an oral glucose tolerance test, and a euglycemic hyper-insulinemic clamp. Insulin-stimulated glucose utilization (M), determined by insulin clamp, was significantly lower in the BHt subjects compared with the Nt subjects (men, Nt 6.91 +/- 0.62 versus BHt 5.54 +/- 0.65; women, Nt 5.97 +/- 0.47 versus BHt 3.79 +/- 0.38 mg.kg-1.min-1, P = .006). When M was corrected for adiposity and expressed in milligrams per kilogram of fat free mass (M'), the difference between Nt and BHt remained significant (P = .006). There was a significant correlation of M' with systolic blood pressure (r = .393, P < .0001), HDL-C (r = .382, P < .0001), triglyceride level (r = 308, P < .001), apolipoprotein A-I (r = .190, P = .033), and apolipoprotein B stepwise multiple linear regression analysis, HDL-C emerged as the most significant lipid component in the model for insulin resistance. These data suggest that in American blacks with mild hypertension, the risk for cardiovascular disease may be augmented in the presence of insulin resistance.
本研究的目的是确定胰岛素抵抗是否与临界高血压成年年轻黑人的血浆脂质改变有关。94名美国黑人参与了研究（46名男性，48名女性，年龄范围28至33岁）。在这94名受试者中，有60名血压正常（Nt）受试者和36名临界高血压（BHt）受试者，临界高血压定义为血压>135/85 mmHg。所有受试者均无糖尿病且未接受抗高血压药物治疗。所有参与者均进行了血压和人体测量、空腹血脂谱、口服葡萄糖耐量试验以及正常血糖高胰岛素钳夹试验。通过胰岛素钳夹测定的胰岛素刺激的葡萄糖利用率（M），BHt受试者显著低于Nt受试者（男性，Nt为6.91±0.62，BHt为5.54±0.65；女性，Nt为5.97±0.47，BHt为3.79±0.38 mg·kg-1·min-1，P = 0.006）。当M校正肥胖并以每千克去脂体重的毫克数表示（M'）时，Nt和BHt之间的差异仍然显著（P = 0.006）。M'与收缩压（r = 0.393，P < 0.0001）、高密度脂蛋白胆固醇（HDL-C，r = 0.382，P < 0.0001）、甘油三酯水平（r = 0.308，P < 0.001）、载脂蛋白A-I（r = 0.190，P = 0.033）和载脂蛋白B有显著相关性。逐步多元线性回归分析显示，HDL-C是胰岛素抵抗模型中最显著的脂质成分。这些数据表明，在美国轻度高血压黑人中，存在胰岛素抵抗时心血管疾病风险可能会增加。
