Hirata A, Shimamoto K, Masuda A, Miyazaki Y, Fukuoka M, Iimura O
2nd Department of Internal Medicine, Sapporo Medical University School of Medicine, Japan.
Hypertens Res. 1995 Dec;18(4):307-11. doi: 10.1291/hypres.18.307.
Insulin resistance and hyperinsulinemia have been linked with essential hypertension. Age-associated increases in glucose intolerance and hypertension are also well established. To clarify the influence of aging on the insulin sensitivity, euglycemic hyperinsulinemic glucose clamp technique was carried out in 41 normotensive subjects and 42 patients with essential hypertension. The subjects of these groups were divided into two subgroups: young (< 40 years old) and middle-elderly (> or = 40 years old). Insulin sensitivity was assessed as M-value, the rate at which glucose must be infused to maintain a basal blood glucose level. In normotensive subjects, the young subgroup had a significantly higher M-value than did the middle-elderly subgroup. There was a significant negative correlation between age and M-value in normotensive subjects. On the other hand, there was no significant difference in M-value between the young and middle-elderly subgroups in the patients with essential hypertension. The age did not correlate with M-value in the hypertensive group. The normotensive subjects showed a significantly lower M-value than the hypertensive patients in the young group, but not in the middle-elderly group. These results indicate that 1) insulin sensitivity declines with age in normotensive subjects and that 2) insulin sensitivity is already diminished in the early stage of hypertension, and no further decrease in insulin sensitivity occurs with aging in essential hypertensive patients.
胰岛素抵抗和高胰岛素血症与原发性高血压相关。年龄相关的糖耐量异常和高血压增加也已得到充分证实。为了阐明衰老对胰岛素敏感性的影响，对41名血压正常的受试者和42名原发性高血压患者进行了正常血糖高胰岛素钳夹技术检测。这些组的受试者被分为两个亚组：年轻组（<40岁）和中老年组（≥40岁）。胰岛素敏感性以M值评估，即维持基础血糖水平所需输注葡萄糖的速率。在血压正常的受试者中，年轻亚组的M值显著高于中老年亚组。血压正常的受试者中，年龄与M值之间存在显著负相关。另一方面，原发性高血压患者的年轻和中老年亚组之间的M值无显著差异。高血压组中年龄与M值无相关性。血压正常的受试者在年轻组中M值显著低于高血压患者，但在中老年组中并非如此。这些结果表明：1）血压正常的受试者中胰岛素敏感性随年龄下降；2）高血压早期胰岛素敏感性已经降低，原发性高血压患者不会随着年龄增长而进一步降低胰岛素敏感性。
