Insulin resistance and hypertension in Japanese.
Insulin resistance and hypertension in Japanese.
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DOI：
10.1291/hypres.19.supplementi_s1
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发表时间：
1996-06-01
期刊：
影响因子：
--
通讯作者：
Iimura, O
中科院分区：
文献类型：
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作者：
Iimura, O
在这篇文章中，我们的一些发现的流行病学和临床研究的实际状态的胰岛素抵抗的高血压发生在日本进行了描述。在流行病学研究中，在北海道的农业区的两个城镇中，观察到高血压和糖耐量受损的高患病率，并且发现血压和血糖水平之间存在显著的正相关性，即使是在低程度上。在临床研究中，胰岛素敏感性，这是衡量的M值正常血糖高胰岛素葡萄糖钳夹法，是显着低于原发性高血压患者比正常血压受试者。此外，这种胰岛素敏感性的抑制也观察到在年轻的血压正常的受试者有明显的高血压家族史，高血压的表现之前。与此同时，肥胖和衰老与胰岛素敏感性下降明确相关。假设M值的正常范围为非肥胖、非糖尿病、血压正常的年轻受试者的平均值+/- 1 SD，则本研究中原发性高血压患者中M值降低（意味着存在胰岛素抵抗）的个体患病率为45.4%，血压正常的受试者为16.3%。在葡萄糖钳夹试验产生的高胰岛素血症期间，观察到血浆去甲肾上腺素水平和血浆肾素活性增加，尿钠排泄量和钠排泄分数减少。高胰岛素血症的这些反应与正常血压受试者没有不同，因此，不是原发性高血压患者的特异性反应。从这些结果中，可以得出结论，胰岛素抵抗肯定存在于日本原发性高血压，它在原发性高血压的病理生理学中起着重要的作用。
In this article, some of our findings of epidemiologic and clinical studies on the actual state of insulin resistance in hypertension occurring in Japanese were described. In epidemiologic studies, a high prevalence of concomitant hypertension and impaired glucose tolerance was observed, and a significant positive correlation was found between blood pressure and blood glucose levels, even at a low degree, in two towns, the agricultural districts of Hokkaido. In clinical studies, insulin sensitivity, which was measured as M-values by the euglycemic hyperinsulinemic glucose clamp method, was significantly lower in essential hypertensives than in normotensive subjects. Moreover, this suppression of insulin sensitivity was also observed in young normotensive subjects with an apparent family history of hypertension, preceding the manifestation of hypertension. At the same time, obesity and aging were definitely correlated to the decrease in insulin sensitivity. On the assumed criterion that the normal range of M-values is mean +/- 1 SD of non-obese, non-diabetic young normotensive subjects, the prevalence of individuals with lowered M-value, which means existence of insulin resistance, was calculated as 45.4% in essential hypertensives and as 16.3% in normotensive subjects in this study. Increases in plasma norepinephrine levels and plasma renin activity, and decreases in urinary excretion of sodium and fractional excretion of sodium were observed during hyperinsulinemia produced by glucose clamp test. These responses to hyperinsulinemia were not different from those in normotensive subjects and, therefore, not specific to essential hypertensives. From these results, it was concluded that insulin resistance definitely exists among Japanese essential hypertensives, and that it plays an important role in the pathophysiology of essential hypertension.