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目的探讨社区非糖尿病人群血压测值与稳态模型胰岛素抵抗指数(HOMA-IR)及定量胰岛素敏感性指标(QUICKI)的相关性。方法2002年8月至2004年3月,在上海交通大学医学院附属仁济医院内分泌科对上海浦东上钢和塘桥社区居民743名(除外糖尿病和糖耐量受损、继发性高血压及有严重肝、肾功能损害者)进行研究检测。以标准法测量血压、身高、体重、腰围和臀围。根据不同血压测值分为非高血压组和高血压组。非高血压组包括:(1)理想血压组,收缩压<120mmHg(1mmHg=0.133kPa),舒张压<80mmHg;(2)正常血压组:收缩压120～<130mmHg,舒张压80～<85mmHg;(3)正常高值血压组:收缩压130～<140mmHg,舒张压85～<90mmHg。高血压组:收缩压≥140mmHg和(或)舒张压≥90mmHg。放免法测定空腹血浆胰岛素,并计算HOMA-IR及QUICKI。采用SPSS11.5软件进行统计分析。结果社区743名非糖尿病人群中,正常高值血压组和高血压组与理想血压组之间HOMA-IR及QUICKI比较差异均有显著性意义(P<0.01)。血压值与年龄、体重指数(BMI)、腰围、WHR、空腹胰岛素、血浆总胆固醇、三酰甘油及HOMA-IR呈正相关,与QUICKI呈负相关。在控制年龄及性别之后,HOMA-IR及QUICKI和血压之间仍明显相关(P<0.001)。结论HOMA-IR和QUICKI指数均是预测正常高值血压人群胰岛素抵抗的独立影响因子。治疗早期高血压,减轻胰岛素抵抗的因素可能更重要。
Objective To investigate the relationship between blood pressure measurement and steady-state insulin resistance index (HOMA-IR) and quantitative insulin sensitivity index (QUICKI) in community non-diabetic population. Methods From August 2002 to March 2004, Department of Endocrinology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, investigated 743 community residents (except diabetes and impaired glucose tolerance, secondary hypertension and Have severe liver and kidney dysfunction) to conduct research and testing. Blood pressure, height, weight, waist circumference and hip circumference were measured by the standard method. According to different blood pressure measurement is divided into non-hypertension group and hypertension group. Non-hypertension group included: (1) ideal blood pressure group, systolic blood pressure <120mmHg (1mmHg = 0.133kPa), diastolic blood pressure <80mmHg; (2) normal blood pressure group: systolic blood pressure 120 ~ <130mmHg, diastolic blood pressure 80 ~ (3) normal high blood pressure group: systolic blood pressure 130 ~ <140mmHg, diastolic blood pressure 85 ~ <90mmHg. Hypertension group: systolic blood pressure ≥ 140mmHg and (or) diastolic blood pressure ≥ 90mmHg. Fasting plasma insulin was measured by radioimmunoassay and HOMA-IR and QUICKI were calculated. Using SPSS11.5 software for statistical analysis. Results Among 743 non-diabetic patients in the community, HOMA-IR and QUICKI were significantly different between the normal high blood pressure group and the hypertensive group and the ideal blood pressure group (P <0.01). Blood pressure and age, body mass index (BMI), waist circumference, WHR, fasting insulin, total cholesterol, triglyceride and HOMA-IR were positively correlated with QUICKI was negatively correlated. After controlling for age and gender, HOMA-IR and QUICKI were still significantly correlated with blood pressure (P <0.001). Conclusions Both HOMA-IR and QUICKI index are independent predictors of insulin resistance in normal high blood pressure population. It may be more important to treat early hypertension and reduce insulin resistance.