Minh H V, Thanh L C, Ngoc P T, Trinh T D, Tho T D, Valensi P
Ecole de médecine de Hué, Viêtnam.
Arch Mal Coeur Vaiss. 1997 Aug;90(8):1143-5.
Several epidemiological and experimental studies suggest that essential arterial hypertension is associated with hyperinsulinism and insulin resistance in obese subjects and also in subjects with normal body weight. Undernutrition remains frequent in adult Vietnamese people and mean body mass index is around 18.5 kg/m2 in Vietnam. The aim of this study was to look for insulin resistance in hypertensive Vietnamese subjects, despite a markedly lower BMI in Vietnam than in occidental countries. One hundred and eight hypertensive patients (51 men and 57 women) over 40 years (mean = 65.4 years) were compared with 36 healthy subjects (23 men and 13 women) over 40 years (mean = 63.8 years). Hypertensive patients had significantly higher BMI (20.5 +/- 0.3 (SEM) kg/m2 vs 18.4 +/- 0.4 kg/m2; p < 0.01), thicker triceps skinfold (1.26 +/- 0.07 cm vs 0.71 +/- 0.07 cm; p < 0.001) and not significantly different waist/hip ratio (0.88 +/- 0.01 vs 0.85 +/- 0.01). Blood glucose at fasting and 2 hours after 75 g glucose taken orally were similar in hypertensive and normotensive subjects. Plasma insulin at fasting and 2 hours after glucose were significantly higher in hypertensive patients (44.4 +/- 5.1 pmol/L vs 21.6 +/- 3.2 pmol/L; p < 0.05 and 271.1 +/- 21.6 pmol/L vs 139.1 +/- 15.2 pmol/L; p < 0.001). Thus, despite under-nutrition, hypertensive Vietnamese patients have a moderate but significant increase in BMI and fat mass without predominant abdominal localization, and a state of insulin-resistance, compared with normotensive healthy subjects.
多项流行病学和实验研究表明，原发性动脉高血压与肥胖受试者以及体重正常的受试者的高胰岛素血症和胰岛素抵抗有关。成年越南人营养不良现象仍然常见，越南人的平均体重指数约为18.5kg/m²。本研究的目的是在越南高血压患者中寻找胰岛素抵抗，尽管越南人的体重指数明显低于西方国家。将108名40岁以上（平均65.4岁）的高血压患者（51名男性和57名女性）与36名40岁以上（平均63.8岁）的健康受试者（23名男性和13名女性）进行比较。高血压患者的体重指数显著更高（20.5±0.3（标准误）kg/m²对18.4±0.4kg/m²；p<0.01），肱三头肌皮褶更厚（1.26±0.07cm对0.71±0.07cm；p<0.001），腰臀比无显著差异（0.88±0.01对0.85±0.01）。高血压和血压正常的受试者空腹血糖以及口服75g葡萄糖后2小时的血糖相似。高血压患者空腹和葡萄糖负荷后2小时的血浆胰岛素显著更高（44.4±5.1pmol/L对21.6±3.2pmol/L；p<0.05以及271.1±21.6pmol/L对139.1±15.2pmol/L；p<0.001）。因此，尽管存在营养不良，但与血压正常的健康受试者相比，越南高血压患者的体重指数和脂肪量有适度但显著的增加，且无主要的腹部脂肪分布，同时存在胰岛素抵抗状态。
