Vlasáková Z, Válek J
Klinika diabetologie a hepatogastroenterologie IKEM, Praha.
Cas Lek Cesk. 1997 Nov 19;136(22):693-7.
Altered insulin sensitivity is the basis for the syndrome of insulin resistance generally known as metabolic syndrome. Its importance is due to the cumulation of a number of risk factors of IHD. The familial disposition for the syndrome may be the cause of medical complications also in families of hypertensive patients. The objective of the study was to provide evidence of the possible change of insulin sensitivity in a group of middle-aged men from families with disposition for hypertension two years regime therapy and subsequent administration of angiotensin converting enzyme inhibitor (ACEI).
Using the method of hyperinsulin euglycaemic clamp a group of 15 offspring of hypertensive subjects (PHT) were examined who at the time did not differ in basic indicators from a control group of 18 men of similar age. The authors found lower values of glucose consumption (Msubmax), metabolic glucose clearance (MCRsubmax), however statistically significant differences were found in the indexes of insulin sensitivity SI (SI: 46.51% +/- 11.77% vs. 54.28% +/- 7.79%, p < 0.02) and ISI (ISI: 6.6% +/- 3.99% vs. 9.88% +/- 5.05%, p < 0.01). After six weeks of ACEI administration (enalapril 10 mg) the insulin sensitivity in PTH increased significantly in the majority of investigated parameters (MCRsubmax to 9.7 +/- 3.04 mg/kg.min-1, p < 0.05), in indexes of insulin sensitivity (SI to 54.83 +/- 12.9, p < 0.001 and ISI to 9.34 +/- 4.78 mg/kg/min-1, p < 0.01). The insulin sensitivity in PHT who were given ACEI exceeded in some indicators the coresponding values in subgroup of controls which was without medication. After ACEI administration the renin secretion increased and the levels of the plasminogen activator inhibitor (PAI-1) did not change.
ACEI administration improved the insulin sensitivity in a group of 15 men from families of hypertensive subjects. It exceeded the effect of diet and change of regime which had already influenced the symptoms of metabolic syndrome in a favourable way.
胰岛素敏感性改变是胰岛素抵抗综合征（通常称为代谢综合征）的基础。其重要性在于它累积了许多缺血性心脏病的危险因素。该综合征的家族倾向可能也是高血压患者家庭中出现医疗并发症的原因。本研究的目的是提供证据，证明一组有高血压家族倾向的中年男性在接受两年的治疗方案以及随后服用血管紧张素转换酶抑制剂（ACEI）后胰岛素敏感性可能发生的变化。
采用高胰岛素正葡萄糖钳夹技术对一组15名高血压患者的后代（PHT）进行检查，他们在基本指标上与18名年龄相仿的男性对照组没有差异。作者发现葡萄糖消耗（Msubmax）、代谢性葡萄糖清除率（MCRsubmax）的值较低，然而在胰岛素敏感性指数SI（SI：46.51%±11.77%对54.28%±7.79%，p<0.02）和ISI（ISI：6.6%±3.99%对9.88%±5.05%，p<0.01）方面发现了统计学上的显著差异。在服用ACEI（依那普利10毫克）六周后，PTH组的胰岛素敏感性在大多数研究参数中显著增加（MCRsubmax升至9.7±3.04毫克/千克·分钟-1，p<0.05），在胰岛素敏感性指数方面（SI升至54.83±12.9，p<0.001，ISI升至9.34±4.78毫克/千克/分钟-1，p<0.01）。服用ACEI的PHT组在某些指标上超过了未用药的对照组亚组的相应值。服用ACEI后肾素分泌增加，纤溶酶原激活物抑制剂（PAI-1）水平未改变。
服用ACEI改善了一组来自高血压患者家庭的15名男性的胰岛素敏感性。它超过了饮食和生活方式改变的效果，而饮食和生活方式的改变已经对代谢综合征的症状产生了有利影响。
