Sheu W H, Chin H M, Su H Y, Jeng C Y
Department of Medicine, Taichung Veterans General Hospital, Taiwan, ROC.
Clin Exp Hypertens. 1998 May;20(4):403-16. doi: 10.3109/10641969809053221.
Hyperinsulinemia and the associated increased sympathetic nervous activity have been proposed to implicate in the development of hypertension and obesity. The role of hyperinsulinemia in mediated resting energy expenditure (REE) in hypertensive obese subjects is not clear. The effect of weight loss on REE between hypertensive and normotensive obese women are also unknown. We measured fasting plasma glucose, insulin, lipids concentrations, REE and body composition by bioelectrical impedance methods before and after a weight loss program in 9 newly diagnosed hypertensive and 10 normotensive obese women. As compared with age-matched lean control women (n=14), obese subjects had higher fasting plasma glucose, insulin concentrations and REE values. However, these variables were not different between obese groups. Although REE and fasting plasma insulin concentrations correlated well in simple correlation (r=0.708, p<0.001), this relationship disappeared after adjusting for values of fat free mass (FFM). Weight loss for approximately 10% of initial weight led to significant decreases of blood pressure and fasting plasma insulin concentrations in both obese groups. Fasting plasma cholesterol, LDL cholesterol and triglyceride concentrations decreased in hypertensive obese individuals. Significant fall of REE in hypertensive group (p<0.05) and normotensive group (p<0.02) were observed following weight loss. However, the ratio of REE to FFM decreased significantly only in hypertensive subjects (114.6+/-5.2 KJ/day x Kg(-1) to 107.2+/-4.6 KJ/day x Kg(-1), p<0.05). In conclusion, obese women, either hypertensive or normotensive, had higher fasting plasma insulin concentrations and REE than those of lean controls, although these variables were not different between obese groups. No significant relation between fasting plasma insulin and REE could be found. Weight loss produced a significant decrease of REE/FFM only in hypertensive obese women. Further study to evaluate the effect of weight loss on energy expenditure in hypertensive obese subjects is necessary.
高胰岛素血症及相关的交感神经活动增加被认为与高血压和肥胖的发生有关。高胰岛素血症在介导高血压肥胖受试者静息能量消耗（REE）中的作用尚不清楚。体重减轻对高血压肥胖女性和血压正常肥胖女性的REE的影响也未知。我们通过生物电阻抗法在9名新诊断的高血压肥胖女性和10名血压正常肥胖女性进行减肥计划前后测量了空腹血糖、胰岛素、血脂浓度、REE和身体成分。与年龄匹配的瘦对照女性（n = 14）相比，肥胖受试者的空腹血糖、胰岛素浓度和REE值更高。然而，这些变量在肥胖组之间并无差异。尽管REE与空腹血浆胰岛素浓度在简单相关性分析中相关性良好（r = 0.708，p < 0.001），但在调整无脂肪体重（FFM）值后这种关系消失。体重减轻约初始体重的10%导致两组肥胖者血压和空腹血浆胰岛素浓度显著下降。高血压肥胖个体的空腹血浆胆固醇、低密度脂蛋白胆固醇和甘油三酯浓度降低。减肥后高血压组（p < 0.05）和血压正常组（p < 0.02）的REE均显著下降。然而，仅高血压受试者的REE与FFM的比值显著降低（从114.6±5.2千焦/天×千克-1降至107.2±4.6千焦/天×千克-1，p < 0.05）。总之，高血压或血压正常的肥胖女性空腹血浆胰岛素浓度和REE均高于瘦对照者，尽管这些变量在肥胖组之间并无差异。空腹血浆胰岛素与REE之间未发现显著关系。体重减轻仅使高血压肥胖女性的REE/FFM显著降低。有必要进一步研究评估减肥对高血压肥胖受试者能量消耗的影响。
