He R H, Ding G X, Chen J W
Department of Endocrinology, First Affiliated Hospital of Nanjing Medical College.
Zhonghua Nei Ke Za Zhi. 1994 Mar;33(3):175-8.
In this study, we have measured plasma glucose and insulin levels at fasting and following an oral glucose load (75g) in 39 non-diabetic subjects (22 untreated hypertensive, 17 normotensive subjects). We also assessed plasma cholesterol (Ch), triglyceride (TG) levels and Na(+)-K(+)-pump activity in the membranes of their erythrocytes. Overall, hypertensive subjects have hypercholesterol, hypertriglyceride, glucose intolerance and hyperinsulinemia. These changes accorded with Syndrome X proposed by Reaven. In multivariant analysis, after correcting for age, BMI, diastolic pressure (DBP) was positively related to fasting, 1/2h insulin and insulin area under cure (AUC) (P < 0.05). Both systolic pressure (SBP) and DBP were negatively correlated to Na(+)-K(+)-pump (P < 0.01, 0.001), while Na(+)-K(+)-pump was negatively fasting, 1/2h, 1h, 2h insulin levels and insulin AUC (P < 0.05, 0.05, 0.01, 0.01, respectively). These results showed that insulin may affect Na(+)-K(+)-pump activity to develop hypertension independent of age and obese. We also postulated that insulin resistance was causal in the syndrome X, also one of factors developing coronary artery disease.
在本研究中,我们测量了39名非糖尿病受试者(22名未经治疗的高血压患者,17名血压正常的受试者)空腹及口服葡萄糖负荷(75克)后的血浆葡萄糖和胰岛素水平。我们还评估了他们红细胞膜中的血浆胆固醇(Ch)、甘油三酯(TG)水平以及钠钾泵活性。总体而言,高血压受试者存在高胆固醇、高甘油三酯、葡萄糖耐量异常和高胰岛素血症。这些变化与Reaven提出的X综合征相符。在多变量分析中,校正年龄、体重指数后,舒张压(DBP)与空腹、半小时胰岛素及胰岛素曲线下面积(AUC)呈正相关(P<0.05)。收缩压(SBP)和DBP均与钠钾泵呈负相关(P<0.01,P<0.001),而钠钾泵与空腹、半小时、1小时、2小时胰岛素水平及胰岛素AUC呈负相关(分别为P<0.05,P<0.05,P<0.01,P<0.01)。这些结果表明,胰岛素可能独立于年龄和肥胖影响钠钾泵活性从而导致高血压。我们还推测胰岛素抵抗是X综合征的病因,也是冠状动脉疾病的发病因素之一。