Charles M A, Pettitt D J, Hanson R L, Bennett P H, Saad M F, Liu Q Z, Knowler W C
Diabetes and Arthritis Epidemiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ.
Am J Epidemiol. 1994 Jul 15;140(2):123-31. doi: 10.1093/oxfordjournals.aje.a117223.
High blood pressure, abnormal glucose tolerance, and obesity are frequently associated with each other, but the mechanism of these associations is poorly understood. Studying them in children may help in understanding the pathogenesis of hypertension. Blood pressure, height, weight, and plasma glucose and serum insulin concentrations during a 75-g oral glucose tolerance test were measured in 1,698 Pima Indian children aged 6-17 years who participated in an ongoing epidemiologic study. Weight relative to height was used as an index of obesity. The parents of many of the children were also examined. Fasting and 2-hour glucose and insulin concentrations, adjusted for age, sex, and relative weight, were positively related to systolic blood pressure but not to diastolic blood pressure. Relative weight, 2-hour glucose, and fasting insulin concentrations were independently and significantly associated with systolic blood pressure in a stepwise regression analysis that included age and sex. After parental hypertension was taken into account, maternal but not paternal non-insulin-dependent diabetes mellitus, controlled for the child's relative weight and glucose and insulin concentrations, was significantly associated with higher blood pressure in children. The stronger association with maternal diabetes suggests a greater sharing of environmental factors between mother and child than between father and child, but familial similarities in obesity and glucose and insulin concentrations, the diabetic intrauterine milieu, and shared environmental factors probably all contribute to this association.
高血压、糖耐量异常和肥胖常常相互关联，但这些关联的机制却知之甚少。在儿童中对它们进行研究可能有助于理解高血压的发病机制。在一项正在进行的流行病学研究中，对1698名6至17岁的皮马印第安儿童进行了75克口服葡萄糖耐量试验期间的血压、身高、体重、血浆葡萄糖和血清胰岛素浓度的测量。体重与身高的比值被用作肥胖指数。许多儿童的父母也接受了检查。经年龄、性别和相对体重校正后的空腹及2小时血糖和胰岛素浓度与收缩压呈正相关，但与舒张压无关。在包含年龄和性别的逐步回归分析中，相对体重、2小时血糖和空腹胰岛素浓度与收缩压独立且显著相关。在考虑了父母的高血压情况后，在控制了儿童的相对体重、血糖和胰岛素浓度的情况下，母亲而非父亲的非胰岛素依赖型糖尿病与儿童较高的血压显著相关。与母亲患糖尿病的关联更强，这表明母子之间比父子之间共享更多的环境因素，但肥胖、血糖和胰岛素浓度方面的家族相似性、糖尿病宫内环境以及共享的环境因素可能都促成了这种关联。
