原发性高血压患者胰岛素抵抗与非高密度脂蛋白胆固醇的关系

摘要

目的 探讨壮族原发性高血压患者胰岛素抵抗(IR)与非HDL-C的关系,为壮族高血压综合治疗提供参考.方法 选取壮族高血压患者200例,以是否合并糖尿病分为合并组80例和未合并组120例;另选健康体检者60例为对照组.各组均测定TC、TG、LDL-C、HDL-C、空腹血糖和空腹胰岛素,计算IR指数(HOMA-IR)和非HDL-C,分析非HDL-C与1R等指标的关系.以非HDL-C水平进行四分位,分为上四分位组51例和下四分位组48例,并分析HOMA-IR等指标间的关系.结果 与对照组比较,合并组和未合并组患者空腹血糖、空腹胰岛素、TC、TG、LDL-C、非HDL-C和HOMA-IR明显升高,HDL-C明显降低(P＜0.05,P＜0.01);与未合并组比较,合并组患者空腹胰岛素、非HDL-C和HOMA-IR明显升高,HDL-C明显降低(P＜0.05).与下四分位组比较,上四分位组患者收缩压、舒张压、空腹血糖、TC、TG、LDL-C和HOMA-IR明显升高,HDL-C明显降低(P＜0.05,P＜0.01).结论 不同糖代谢状态下壮族高血压患者均存在脂代谢紊乱和IR.非HDL-C与IR密切相关,是临床上评估糖、脂代谢异常的良好指标.%Objective To investigate the relationship between the level of non-high density lipoprotein cholesterol(non-HDL-C) and insulin resistance(IR)in essential hypertensive people. Methods 200 hypertensive patients were randomly divided into hypertension group, hypertension with diabetes mellitus group and other 60 healthy persons served as control group. TC, TG, HDL-C,LDL-C,fasting plasma glucose(FPG) and insulin(FINS) were determined. Non-HDL-C and insulin resistance(HOMA-IR) were calculated and the relation between non-high density lipoprotein and HOMA-IR was analyzed. Results In hypertensive patients with or without diabetes mellitus,FPG,FINS, TC, TG, LDL-C, non-HDL-C and HOMA-IR were higher than those in control group,while HDL-C-was lower. The level of IR and non-HDL-C in hypertensive patients with diabetes mellitus were higher than those in patients without diabetes. Conclusion Dyslipidemia and IR are usually present in patients with hypertension under different sugar metabolism conditions.Non-HDL-C relates to IR closely,and its changes become more dramatic in association with worsening of IR. The blood lipid index non-HDL-C has important clinical significance for forecasting dyslipidemia and abnormal sugar metabolism.