Ward K D, Sparrow D, Landsberg L, Young J B, Vokonas P S, Weiss S T
Department of Veterans Affairs Outpatient Clinic, Boston, MA, USA.
J Hypertens. 1996 Mar;14(3):301-8. doi: 10.1097/00004872-199603000-00005.
To examine the association of insulin and sympathetic nervous system activity with blood pressure elevation in a cross-sectional study of 752 nondiabetic male participants of the Normative Aging Study, aged 43-90 years.
Testing included a physical examination, medical history, fasting and post-carbohydrate insulin and glucose levels determinations, an anthropometric examination, and 24 h urine collection for catecholamine level determination. Total obesity was represented by body mass index, central obesity by the abdomen circumference:hip circumference ratio, and sympathetic nervous system activity by 24 h urinary excretion of norepinephrine.
Systolic and diastolic blood pressure (SBP and DBP, respectively) were positively related to body mass index, abdomen:hip ratio, norepinephrine excretion, and insulin levels in univariate analyses. The relationship between insulin level and SBP and DBP persisted after adjustment for body mass index, abdomen:hip ratio, norepinephrine, age, smoking, physical activity level, and antihypertensive medication use. The norepinephrine level was related to SBP and DBP after adjustment for insulin level, age, smoking, physical activity level, and antihypertensive medication use, and these relationships remained marginally significant after further adjustment for body mass index and abdomen:hip ratio. In contrast, neither body mass index nor abdomen:hip ratio were related to blood pressure after adjustment for insulin level. Among participants in the lowest tertiles both of insulin and of norepinephrine levels, 10% were hypertensive, compared with 35% in the highest tertiles of these variables. In a multiple logistic regression model, insulin level, norepinephrine level, and an interaction term for insulin level with norepinephrine excretion were independent predictors of hypertension.
The results suggest that insulin level and sympathetic nervous system activity are associated with hypertension among middle-aged and elderly men.
在一项针对752名年龄在43 - 90岁的非糖尿病男性参与者的规范性衰老研究横断面研究中，检验胰岛素和交感神经系统活动与血压升高之间的关联。
测试包括体格检查、病史、空腹及碳水化合物摄入后胰岛素和葡萄糖水平测定、人体测量检查以及24小时尿儿茶酚胺水平测定。总体肥胖以体重指数表示，中心性肥胖以腹围：臀围比表示，交感神经系统活动以24小时尿去甲肾上腺素排泄量表示。
在单变量分析中，收缩压和舒张压（分别为SBP和DBP）与体重指数、腹臀比、去甲肾上腺素排泄量和胰岛素水平呈正相关。在对体重指数、腹臀比、去甲肾上腺素、年龄、吸烟、身体活动水平和抗高血压药物使用进行调整后，胰岛素水平与SBP和DBP之间的关系依然存在。在对胰岛素水平、年龄、吸烟、身体活动水平和抗高血压药物使用进行调整后，去甲肾上腺素水平与SBP和DBP相关，在进一步对体重指数和腹臀比进行调整后，这些关系仍具有边缘显著性。相比之下，在对胰岛素水平进行调整后，体重指数和腹臀比均与血压无关。在胰岛素和去甲肾上腺素水平处于最低三分位数的参与者中，10%患有高血压，而在这些变量处于最高三分位数的参与者中，这一比例为35%。在多元逻辑回归模型中，胰岛素水平、去甲肾上腺素水平以及胰岛素水平与去甲肾上腺素排泄量的交互项是高血压的独立预测因素。
结果表明，胰岛素水平和交感神经系统活动与中老年男性的高血压有关。
