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目的研究2型糖尿病伴原发性高血压(T2DM+EH)患者的胰岛功能及胰岛素抵抗。方法应用BA-ELISA法测定96例正常糖耐量(NGT)、132例T2DM和148例T2DM+EM三个实验组的血清真胰岛素(TI)水平,并计算出胰岛素敏感性指数(IAI)、胰岛素抵抗指数(HomalIR)和β细胞功能指数(HBCI)。结果IAI分别为-2.44±0.83,-3.46±0.99和-3.98±0.68; HBCI分别为4.23±0.18,2.39±0.11和2.41±0.14;Homa-lIR分别为-0.67±0.83,0.35±0.99和0.86±0.68。T2DM及T2DM+EH组IAI、HBCI均低于NGT组,经协方差分析,差异具有非常显著性(P<0.01),HomalIR明显高于NGT组,且差异具有非常显著性(P<0.01)。T2DM+EH组IAI低于T2DM组,差异有显著性(P<0.05),HomalIR高于T2DM组且差异有显著性(P<0.05),T2DM、T2DM+EH二组间HBCI差异无显著性(P>0.05)。结论2型糖尿病伴原发性高血压较单纯2型糖尿病胰岛素抵抗加重,胰岛素敏感性减低,而胰岛素β细胞分泌功能损害并无加重。
Objective To study the islet function and insulin resistance in type 2 diabetic patients with essential hypertension (T2DM + EH). Methods Serum True Insulin (TI) levels were measured in 96 normal glucose tolerance (NGT), 132 T2DM and 148 T2DM + EM groups using BA-ELISA. The insulin sensitivity index (IAI), insulin Resistance index (HomalIR) and beta cell function index (HBCI). Results IAI were -2.44 ± 0.83, -3.46 ± 0.99 and -3.98 ± 0.68 respectively; HBCI was 4.23 ± 0.18, 2.39 ± 0.11 and 2.41 ± 0.14 respectively; Homa-lIR was -0.67 ± 0.83, 0.35 ± 0.99 and 0.86 ± 0.68. The levels of IAI and HBCI in T2DM and T2DM + EH groups were lower than those in NGT group. The covariance analysis showed that the difference was significant (P <0.01), and the HomalIR was significantly higher than that in NGT group (P <0.01). The IAI of T2DM + EH group was lower than that of T2DM group, the difference was significant (P <0.05), HomalIR was higher than that of T2DM group (P <0.05), while there was no significant difference of HBCI between T2DM and T2DM + EH P> 0.05). Conclusions Type 2 diabetes mellitus with essential hypertension aggravates insulin resistance and insulin sensitivity in type 2 diabetes mellitus, but does not aggravate the secretory function of insulin.