Vlasáková Z, Válek J, Pelikánová T, Růzicková J
Klinika diabetologie a hepatogastroenterologie IKEM, Praha.
Vnitr Lek. 1997 Apr;43(4):195-200.
Hypertension which is part of the metabolic syndrome has frequently a family background. The authors investigated therefore indicators of insulin sensitivity by the method of a hyperinsulinaemic euglycaemic clamp in the offspring of hypertensive probands. In conjunction with the increased interest in the role of muscles in influencing insulin sensitivity the authors were also interested in serum amino acid levels. They examined a group of 15 healthy offspring of hypertonic subjects (PHT) and compared them with a group of 18 healthy volunteers without a family-history of hypertension. PHT had as compared with controls a higher systolic pressure (117 +/- 7.2 mm Hg vs. 106.1 +/- 11.7 mm Hg p < 0.01). In the clamp examination in PHT significantly lower indexes of tissue insulin sensitivity were recorded, SI (46.51 +/- 11.8% vs. 54.3 +/- 7.79%, p = 0.02) and ISI (6.6 +/- 3.99 vs. 9.88 +/- 5.05, p < 0.01). In the PHT group were, in addition to the different ratio of some branched chain amino acids and tyrosine, also relations between indicators of insulin sensitivity and arginine. It is thus obvious that signs of reduced insulin sensitivity are present in PHT already in the preclinical stage. Relations between the altered insulin sensitivity and arginine, the precursor of nitrogen oxide, apparent only in PHT could be a stimulus for seeking associations with endothelial damage described in insulin resistant conditions.
作为代谢综合征一部分的高血压通常具有家族背景。因此,作者采用高胰岛素正血糖钳夹技术,对高血压先证者的后代进行胰岛素敏感性指标研究。鉴于人们对肌肉在影响胰岛素敏感性方面的作用兴趣日增,作者还关注血清氨基酸水平。他们检查了一组15名高血压患者(PHT)的健康后代,并将其与一组18名无高血压家族史的健康志愿者进行比较。与对照组相比,PHT的收缩压更高(117±7.2 mmHg对106.1±11.7 mmHg,p<0.01)。在钳夹试验中,PHT的组织胰岛素敏感性指标显著降低,SI(46.51±11.8%对54.3±7.79%,p = 0.02)和ISI(6.6±3.99对9.88±5.05,p<0.01)。在PHT组中,除了一些支链氨基酸与酪氨酸的比例不同外,胰岛素敏感性指标与精氨酸之间也存在关联。因此,很明显,在临床前期PHT中就已存在胰岛素敏感性降低的迹象。胰岛素敏感性改变与一氧化氮前体精氨酸之间的关系仅在PHT中明显,这可能促使人们寻找与胰岛素抵抗状态下所描述的内皮损伤之间的关联。