Neves F de A, Mezzomo N F, Kohlmann N E, Kohlmann Júnior O, Zanella M T, Ribeiro A B
Escola Paulista de Medicina, São Paulo.
Arq Bras Cardiol. 1994 Jan;62(1):1-5.
To investigate the effects of enalapril upon glucose and insulin metabolism in patients with essential hypertension.
After 4 weeks of washout and 2 weeks of placebo therapy, 10 hypertensive patients were treated with enalapril for 12-14 weeks. Intravenous glucose tolerance test (IVGTT) during 182 minutes was performed before and after treatment. Venous blood samples were drawn for glucose and insulin determinations.
Enalapril caused a significant fall on systolic (-19 +/- 3 mmHg) and diastolic (-10 +/- 2 mmHg) blood pressure. During IVGTT, enalapril induced a small decrease in the area under the curve of glucose (placebo 18,966 +/- 732.6 mg/dl.min and enalapril 17,575 +/- 916.1 mg/dl.min) associated with a small increase in the area under the curve of insulin (placebo 3,155 +/- 446.99 mU/ml.min and enalapril 3.577 +/- 393.92 mU/ml.min). A small rise in the disappearance rate of glucose (Kg) was also observed following enalapril (placebo 2.09 +/- 0.33 and enalapril 2.56 +/- 0.53). The insulin responsiveness to glucose increased significantly from 0.16 +/- 0.020 during placebo to 0.21 +/- 0.023 during enalapril. The insulin sensitivity remained unchanged (placebo 1.97 +/- 0.24 and enalapril 1.83 +/- 0.21).
In hypertensive patients, the treatment with enalapril induced a small increase (not significant) in glucose tolerance caused by a significant rise in insulin responsiveness to glucose since no modification in insulin sensitivity was observed.
研究依那普利对原发性高血压患者糖代谢和胰岛素代谢的影响。
经过4周的洗脱期和2周的安慰剂治疗后，10例高血压患者接受依那普利治疗12 - 14周。在治疗前后进行182分钟的静脉葡萄糖耐量试验（IVGTT）。采集静脉血样测定血糖和胰岛素水平。
依那普利使收缩压（-19±3 mmHg）和舒张压（-10±2 mmHg）显著下降。在IVGTT期间，依那普利使葡萄糖曲线下面积略有下降（安慰剂组为18,966±732.6 mg/dl·min，依那普利组为17,575±916.1 mg/dl·min），同时胰岛素曲线下面积略有增加（安慰剂组为3,155±446.99 mU/ml·min，依那普利组为3,577±393.92 mU/ml·min）。依那普利治疗后还观察到葡萄糖消失率（Kg）略有升高（安慰剂组为2.09±0.33，依那普利组为2.56±0.53）。胰岛素对葡萄糖的反应性从安慰剂治疗期间的0.16±0.020显著增加到依那普利治疗期间的0.21±0.023。胰岛素敏感性保持不变（安慰剂组为1.97±0.24，依那普利组为1.83±0.21）。
在高血压患者中，依那普利治疗由于胰岛素对葡萄糖的反应性显著升高，导致葡萄糖耐量有小幅增加（不显著），因为未观察到胰岛素敏感性的改变。
