Ishibashi K, Kageyama S, Sakurai T, Murakawa Y, Aihara K, Yokota K, Taniguchi I, Hashimoto Y, Fujita T, Tajima N
Department of Internal Medicine (III), Jikei University School of Medicine, Tokyo, Japan.
Hypertens Res. 1997 Sep;20(3):225-31. doi: 10.1291/hypres.20.225.
To determine the effects of insulin on intracellular calcium and platelet aggregatory responses in hypertensive subjects with insulin resistance, we measured insulin sensitivity in terms of glucose disposal rate (GDR) by the hyperinsulinemic euglycemic clamp technique (GC) in 14 non-diabetic untreated hypertensive subjects, and determined basal ([Ca2+]i) and thrombin-stimulated (T-[Ca2+]i) platelet-free calcium concentrations and thrombin-stimulated platelet aggregatory response (AG) before (PRE[Ca2+]i, T-PRE[Ca2+]i, and PRE AG, respectively) and during (POST[Ca2+]i, T-POST[Ca2+]i, and POST AG, respectively) GC. As a control for GC, vehicle (normal saline) was infused on another day. No significant difference was observed between PRE[Ca2+]i and POST[Ca2+]i, T-PRE[Ca2+]i and T-POST[Ca2+]i, or PRE AG and POST AG, GDR inversely correlated with delta[Ca2+]i (POST [Ca2+]i-PRE[Ca2+]i, r = -0.75, p < 0.02), delta T-[Ca2+]i, (T-POST[Ca2+]i-T-PRE[Ca2+]i, r = -0.63, p < 0.02) and delta AG (POST AG-PRE AG, r = -0.67, p < 0.01). No significant changes were observed in these variables during vehicle infusion. [Ca2+]i, T-[Ca2+]i, and AG decreased during GC as compared with baseline in hypertensive subjects with normal insulin sensitivity, but were unchanged in those with insulin resistance, suggesting that the vasodilatory and anti-platelet aggregatory effects of insulin are impaired in patients with insulin-resistant hypertension.
为了确定胰岛素对胰岛素抵抗的高血压患者细胞内钙及血小板聚集反应的影响，我们采用高胰岛素正葡萄糖钳夹技术（GC），通过葡萄糖处置率（GDR）来测定14例未经治疗的非糖尿病高血压患者的胰岛素敏感性，并分别在钳夹前（分别为PRE[Ca2+]i、T-PRE[Ca2+]i和PRE AG）及钳夹期间（分别为POST[Ca2+]i、T-POST[Ca2+]i和POST AG）测定基础（[Ca2+]i）和凝血酶刺激的（T-[Ca2+]i）无血小板钙浓度以及凝血酶刺激的血小板聚集反应（AG）。作为GC的对照，在另一天输注溶媒（生理盐水）。PRE[Ca2+]i与POST[Ca2+]i、T-PRE[Ca2+]i与T-POST[Ca2+]i或PRE AG与POST AG之间未观察到显著差异，GDR与Δ[Ca2+]i（POST [Ca2+]i-PRE[Ca2+]i，r = -0.75，p < 0.02）、ΔT-[Ca2+]i（T-POST[Ca2+]i-T-PRE[Ca2+]i，r = -0.63，p < 0.02）以及ΔAG（POST AG-PRE AG，r = -0.67，p < 0.01）呈负相关。在输注溶媒期间，这些变量未观察到显著变化。与胰岛素敏感性正常的高血压患者的基线相比，GC期间[Ca2+]i、T-[Ca2+]i和AG降低，但在胰岛素抵抗患者中则无变化，提示胰岛素抵抗的高血压患者胰岛素的血管舒张和抗血小板聚集作用受损。
