Falkner B, Hulman S, Kushner H
Department of Medicine, Medical College of Pennsylvania, Philadelphia 19129.
Hypertension. 1993 Jul;22(1):18-25. doi: 10.1161/01.hyp.22.1.18.
The purpose of this investigation was to determine whether there is a relation between impaired insulin-stimulated glucose utilization, or insulin resistance, and blood pressure (BP) in a young adult black population. Clinically well, young black men and women, including normotensive (BP < 135/85 mm Hg, n = 23) and borderline hypertensive (BP > or = 135/85 mm Hg, n = 27) individuals, were studied. Each subject had an oral glucose tolerance test (OGTT) and underwent a euglycemic hyperinsulinemic clamp procedure. A two-way analysis of variance demonstrated a significantly greater fasting insulin plasma concentration (P < .02) and sum of insulin levels during the OGTT (P = .04) in the borderline hypertensive compared with normotensive subjects. In both BP groups, women had significantly higher fasting plasma insulin levels than men (P < .02 and P = .009). Body mass index was a significantly covariate of the plasma insulin concentration. Data obtained from the clamp demonstrated significant insulin resistance in borderline hypertensive compared with normotensive subjects (4.69 +/- 0.50 versus 6.57 +/- 0.63 mg/kg per minute, P = .002). A stepwise multiple linear regression analysis demonstrated that there are significant multiple correlations of insulin resistance with body mass index, clamped insulin level, BP group, and systolic BP (multiple R = .7862, P < .001). Application of this analysis to the nonobese sample (n = 33) found significant correlations of insulin resistance with sex, BP group, and systolic BP (multiple R = .6817, P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定在年轻成年黑人人群中,胰岛素刺激的葡萄糖利用受损(即胰岛素抵抗)与血压(BP)之间是否存在关联。研究对象为临床状况良好的年轻黑人男性和女性,包括血压正常者(BP < 135/85 mmHg,n = 23)和临界高血压患者(BP≥135/85 mmHg,n = 27)。每位受试者均进行了口服葡萄糖耐量试验(OGTT)并接受了正常血糖高胰岛素钳夹术。双向方差分析表明,与血压正常的受试者相比,临界高血压患者的空腹胰岛素血浆浓度显著更高(P < 0.02),且在OGTT期间胰岛素水平总和更高(P = 0.04)。在两个血压组中,女性的空腹血浆胰岛素水平均显著高于男性(P < 0.02和P = 0.009)。体重指数是血浆胰岛素浓度的显著协变量。钳夹术获得的数据表明,与血压正常的受试者相比,临界高血压患者存在显著的胰岛素抵抗(4.69±0.50对6.57±0.63 mg/kg每分钟,P = 0.002)。逐步多元线性回归分析表明,胰岛素抵抗与体重指数、钳夹胰岛素水平、血压组和收缩压之间存在显著的多重相关性(多重R = 0.7862,P < 0.001)。将该分析应用于非肥胖样本(n = 33)发现,胰岛素抵抗与性别、血压组和收缩压之间存在显著相关性(多重R = 0.6817,P < 0.001)。(摘要截选至250词)