Grandi A M, Gaudio G, Fachinetti A, Piantanida E, Zanzi P, Ceriani L, Guasti L, Venco A
Department of Clinical and Biological Sciences, II Faculty of Medicine, University of Pavia, Varese, Italy.
Int J Obes Relat Metab Disord. 1998 Sep;22(9):910-4. doi: 10.1038/sj.ijo.0800693.
To evaluate the influence of family history of hypertension on insulin sensitivity in obese normotensive adults, comparing them with lean subjects.
136 normotensives (N)(mean 24 h blood pressure < 130/80 mmHg; age range 35-45 y): 32 lean (body mass index, BMI < or = 25 kg/m2) N with normotensive parents (F-), 37 lean N with one or two parents hypertensive (F+), 32 obese (BMI > or = 30 kg/m2) NF- and, 35 obese NF+.
24 h ambulatory blood pressure monitoring; glucose, insulin and C-peptide before and 30, 60, 90 and 120 min after an oral glucose load; index of insulin peripheral activity (Ia: 10(4)/insulin x glucose values at glucose peak); fasting insulin/C-peptide ratio (I/Cp).
The four groups were comparable for age, gender and blood pressure values throughout the 24 h. 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 Ia lower in obese N than in lean N; at similar BMI, insulin and C-peptide were significantly higher and Ia lower, in F+ than in F-. The correlation between insulin and BMI was significantly closer in F- than in F+.
Family history of hypertension appears to be significantly associated with insulin sensitivity in both lean and obese normotensive adults; moreover, overweight and a genetic predisposition to hypertension may have additive adverse effects on insulin sensitivity in normotensive adult subjects.
评估高血压家族史对肥胖血压正常成年人胰岛素敏感性的影响，并将其与瘦人进行比较。
136名血压正常者（N）（平均24小时血压<130/80 mmHg；年龄范围35 - 45岁）：32名瘦人（体重指数，BMI≤25 kg/m²）且父母血压正常（F-）的N，37名有一位或两位父母患高血压（F+）的瘦人N，32名肥胖（BMI≥30 kg/m²）的NF-，以及35名肥胖的NF+。
24小时动态血压监测；口服葡萄糖负荷前及负荷后30、60、90和120分钟的血糖、胰岛素和C肽；胰岛素外周活性指数（Ia：10⁴/葡萄糖峰值时胰岛素×葡萄糖值）；空腹胰岛素/C肽比值（I/Cp）。
四组在24小时内的年龄、性别和血压值具有可比性。四组之间的血糖、空腹及试验期间的血糖以及I/Cp相似；肥胖N组的空腹及刺激后的胰岛素和C肽显著高于瘦人N组，而Ia则较低；在相似BMI水平下，F+组的胰岛素和C肽显著高于F-组，而Ia较低。F-组中胰岛素与BMI的相关性比F+组更密切。
高血压家族史似乎与瘦人和肥胖血压正常成年人的胰岛素敏感性显著相关；此外，超重和高血压遗传易感性可能对血压正常成年受试者的胰岛素敏感性产生叠加的不利影响。
