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目的 :研究原发性高血压 (EH)并发微量蛋白尿患者的胰岛素抵抗 (IR)状态。方法 :根据尿白蛋白排泄率将EH患者分为两组 :微量蛋白尿阳性组 (4 0例 )和微量蛋白尿阴性组 (35例 ) ,计算体重指数 (BMI)、腰臀比值 (WHR) ,空腹采血测血糖 (FBG)、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和空腹胰岛素(FINR)水平。按HOMA模型计算胰岛素抵抗指数 (HOMA IR) ,HOMA IR =(FBG×FINR) / 2 2 .5 ,再取其自然对数。两组进行比较。结果 :患者年龄、性别比例、高血压病程、血压水平和FBG、血脂水平在两组间差异均无显著性意义 (P >0 .0 5 ) ,但BMI、WHR、FINR和HOMA IR在微量蛋白尿阳性组显著高于阴性组 (P <0 .0 5 )。结论 :EH微量蛋白尿阳性患者存在明显的IR ,高血压肾病的发生与EH患者的胰岛素敏感状态密切相关。BMI、WHR可作为IR的初筛指标
Objective: To investigate the insulin resistance (IR) status in patients with essential hypertension (EH) complicated with microproteinuria. Methods: According to urinary albumin excretion rate, EH patients were divided into two groups: microalbuminuria group (40 cases) and microalbuminuria negative group (35 cases), body mass index (BMI) , Fasting blood glucose (FBG), triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol and fasting insulin (FINR) levels. The HOMA IR was calculated according to the HOMA model. The HOMA IR was (FBG × FINR) / 2 2 .5, and then the natural logarithm was obtained. The two groups are compared. Results: There were no significant differences in age, sex ratio, duration of hypertension, blood pressure level, FBG and lipid levels between the two groups (P> 0.05). However, BMI, WHR, FINR and HOMA IR were significantly different between the two groups Urine positive group was significantly higher than the negative group (P <0. 05). Conclusion: There is a significant IR in patients with EH microalbuminuria. The incidence of hypertensive nephropathy is closely related to the insulin sensitivity of EH patients. BMI, WHR can be used as an index of IR screening