【摘要】 目的观察厄贝沙坦对伴高血压的糖耐量异常患者β细胞分泌功能和胰岛素敏感性的影响。方法给予22例伴高血压的糖耐量异常患者厄贝沙坦150mg/d,分别于治疗前和治疗3个月后测定胰岛素抵抗指数和β细胞分泌功能。胰岛素抵抗指数采用稳态模式评估法(HOMA)估测:HOMA-IR=空腹胰岛素×空腹血糖/22.5;β细胞分泌功能以馒头餐(含面粉100g)试验中△I30/△G30值及HOMA-IR校正的△I30/△G30值([△I30/△G30)/HOMA-IR]表示,其中△I30为空腹胰岛素和30min胰岛素的差值,△G30为空腹血糖和30min血糖的差值。结果厄贝沙坦治疗前后空腹血糖、餐后2h血糖、空腹胰岛素、餐后2h胰岛素和糖化血红蛋白水平的变化均无统计学意义(P>0.05)。厄贝沙坦治疗后HOMA-IR降低([17.12±2.36vs.13.45±2.28)pmol·mmol,P=0.004],△I30/△G30值升高([93.61±12.34vs119.65±15.36)pmol·mmol,P=0.003],△I30/△G30/HOMA-IR值亦升高([5.43±0.61vs6.72±0.75)1/mmol2,P=0.005]。结论厄贝沙坦增加外周组织对胰岛素的敏感性,增强胰岛β细胞的功能。更多还原

【Abstract】 Objective To study the effects of irbesartan on insulin release and insulin sensitivity in patients with impaired glucose tolerance and hypertension.Methods 22 patients with impaired glucose tolerance and hypertension were treated with irbesartan for 3 months.Insulin sensitivity and cell function were evaluated before and after treatment.Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance(HOMA-IR).βcell function was quantified as the ratio of the incremental insulin to glucose response over the first 30 min during the OGTT(△I30/△G30) and was adjusted for insulin sensitivity[(△I30/△G30)/HOMA-IR].Results The decreased HOMA-IR[(17.12±2.36 vs 13.45±2.28) pmol·mmol,P=0.004] and the incresed △I30/△G30 [(93.61±12.34 vs 119.65±15.36) pmol·mmol,P=0.003] were observed in patients after 3-month-treatment with irbesartan.Increased cell secretion was also identified when adjusted by insulin sensitivity [(5.43±0.61 vs 6.72±0.75) 1/mmol2,P=0.005).Fasting blood glucose,fasting insulin,postprandial 2 h blood glucose,postprandial 2 h insulin and HbA1c remained unchanged after treatment(P>0.05).Conclusion Irbesartan can improve both insulin sensitivity and β cell secretion in patients with impaired glucose tolerance and hypertension.更多还原