Grandi A M, Gaudio G, Fachinetti A, Zanzi P, Bianchi L, Ceriani L, Guasti L, Venco A
Department of Clinical and Biological Sciences, II Faculty of Medicine, University of Pavia, Varese, Italy.
Eur J Clin Invest. 1997 Sep;27(9):774-9. doi: 10.1046/j.1365-2362.1997.1700725.x.
We evaluated the influence of family history of hypertension on insulin sensitivity in lean and obese hypertensive subjects (H): 40 lean [body mass index (BMI) < or = 25 kg m-2] H with normotensive parents (F-), 50 lean H with one or two parents hypertensive (F+), 30 obese HF- (BMI > or = 30 kg m-2) and 35 obese HF+. The four groups were comparable in terms of age, sex and ambulatory blood pressure values. We evaluated glucose, insulin and C-peptide before and 30, 60, 90 and 120 min after an oral glucose load, insulin sensitivity index (ISI, fasting glucose/insulin ratio), fasting insulin/C-peptide ratio (I/Cp). Glucose, fasting and during test, and I/Cp were similar among the four groups; insulin and C-peptide, fasting and stimulated, were significantly higher and ISI lower in obese H than in lean H; at similar BMI, insulin and C-peptide were significantly higher in F+ than in F-. Insulin directly correlated with night-time blood pressure only in lean HF-. The correlation between insulin and BMI was significantly closer in F-than in F+. In conclusion, family history of hypertension appears to play a relevant role in insulin sensitivity in hypertensive subjects also in the presence of obesity.
我们评估了高血压家族史对瘦型和肥胖型高血压患者（H）胰岛素敏感性的影响：40名瘦型[体重指数（BMI）≤25kg/m²]高血压患者，其父母血压正常（F-）；50名瘦型高血压患者，其父母一方或双方患有高血压（F+）；30名肥胖型高血压患者，父母血压正常（HF-）（BMI≥30kg/m²）；35名肥胖型高血压患者，父母患有高血压（HF+）。四组在年龄、性别和动态血压值方面具有可比性。我们在口服葡萄糖负荷前以及负荷后30、60、90和120分钟评估了血糖、胰岛素和C肽，胰岛素敏感性指数（ISI，空腹血糖/胰岛素比值），空腹胰岛素/C肽比值（I/Cp）。四组之间的血糖、空腹及测试期间的血糖以及I/Cp相似；肥胖型高血压患者空腹及刺激后的胰岛素和C肽显著高于瘦型高血压患者，而ISI则较低；在BMI相似的情况下，F+组的胰岛素和C肽显著高于F-组。仅在瘦型HF-组中，胰岛素与夜间血压直接相关。F-组中胰岛素与BMI的相关性显著高于F+组。总之，高血压家族史似乎在高血压患者的胰岛素敏感性中起相关作用，即使在存在肥胖的情况下也是如此。
