Does syndrome X exist in hypertensive elderly persons with impaired glycemic control?
Does syndrome X exist in hypertensive elderly persons with impaired glycemic control?
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血糖控制受损的高血压老年人是否存在 X 综合征？
DOI：
10.1093/gerona/54.11.m571
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Rutan,GH
中科院分区：
文献类型：
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作者：
Johnson,KC;Graney,MJ;Applegate,WB;Kitabchi,AE;Runyan,JW;Rutan,GH
背景。本文研究了一组老年高血压患者的血糖状态与胰岛素和血脂水平的关系，以估计x综合征的患病率。方法：在田纳西大学孟菲斯分校进行横断面研究。我们获得了95名同意参加一项辅助研究的老年人非药物干预试验（TONE）参与者的标准口服糖耐量试验（OGTT），包括胰岛素和c肽水平以及空腹血脂。结果：在服用降压药物的健康老年高血压参与者中，43名（45.3%）的糖耐量（NGT）正常；41例（43.2%）患有糖耐量（IGT）受损，11例（11.6%）患有未确诊的非胰岛素依赖型糖尿病（NIDDM）。只有一名IGT组的参与者出现了空腹高胰岛素血症。高甘油三酯血症和低高密度脂蛋白（HDL）发生在4人，没有人有高胰岛素血症。与NGT组相比，NIDDM组和IGT组的β细胞功能下降，但OGTT数据估计的外周胰岛素抵抗没有增加。结论：我们的数据表明，在中枢性肥胖高发的老年高血压参与者队列中，血糖控制受损很常见，但与空腹高胰岛素血症或外周胰岛素抵抗无关。此外，我们得出结论，X综合征基本上没有发生在这些参与者身上，并假设他们血糖控制受损的主要病因是β细胞功能障碍。需要进一步的研究来阐明这些关系。
Background.This report focuses on the glycemic state in relation to insulin and lipid levels of a cohort of elderly hypertensive persons to estimate the prevalence of syndrome X.Methods.A cross-sectional study was performed at the University of Tennessee, Memphis, and the General Clinical Research Center (GCRC) on 95 participants in the Trial of Nonpharmacologic Interventions in the Elderly (TONE) study who agreed to participate in an ancillary study A standard oral glucose tolerance test (OGTT) with insulin and C-peptide levels and a fasting lipid profile were obtained.Results.In this sample of healthy elderly participants with hypertension who were taking an antihypertensive medication, 43 (45.3%) had normal glucose tolerance (NGT), 41 (43.2%) had impaired glucose tolerance (IGT), and 11 (11.6%) had undiagnosed non-insulin-dependent diabetes mellitus (NIDDM). Fasting hyperinsulinemia occurred in only one participant, who was in the IGT group. Hypertriglyceridemia and low high density lipoprotein (HDL) occurred in four persons, none of whom had hyperinsulinemia. Persons in the NIDDM and IGT groups had decreased beta cell function compared to persons in the NGT group, but did not have increased peripheral insulin resistance as estimated from the OGTT data.Conclusions.Our data demonstrated that in this cohort of elderly hypertensive participants with a high prevalence of central obesity, impaired glycemic control was common, but was not associated with fasting hyperinsulinemia or peripheral insulin resistance. Furthermore, we conclude that syndrome X essentially did not occur in these participants and postulate that the primary etiology for their impaired glycemic control is beta cell dysfunction. Further research is needed to elucidate these relationships.