摘要
目的 探讨运动性高血压（exercise hypertension,EH）与2型糖尿病（type 2 diabetes mellitus,T2DM）及胰岛素抵抗的关系。方法 选取2010年8月至2013年7月在遵义市第一人民医院内分泌科门诊和内分泌科住院部初诊的2型糖尿病（T2DM）患者109例作为病例组,匹配年龄、性别后以同期43例健康体检志愿者作为对照组。以Bruce运动方案做次级量症状限制性运动试验,比较分析T2DM患者和对照组运动性高血压的发生率;采用HOMA-IR法评估胰岛素抵抗。应用独立样本t检验和多因素Logistic回归分析,探讨T2DM患者运动性高血压与胰岛素抵抗、糖化血红蛋白、年龄、血脂等的关系。结果 病例组运动试验前后收缩压变化幅度显著高于对照组,而且运动性高血压的发生率也明显高于对照组,差异均具有统计学意义（P〈0.05）。t检验结果显示,EH组HOMA-IR指数显著高于非EH组,差异具有统计学意义（P=0.013）;多因素Logistic回归分析,结果显示HOMA-IR指数进入方程,提示胰岛素抵抗可能是运动性高血压EH发生的危险因素,OR及相应95%置信区间为1.48（1.03-2.12）。结论 T2DM可增加运动性高血压的发生风险;与无运动性高血压的T2DM患者相比,运动性高血压患者可能具有较高的胰岛素抵抗。
Objective To explore the correlation of exercise hypertension （EH） with type 2 diabetes mellitus （T2DM） and insulin resistance in the patients. Methods A total of 109 eases of in- and out- patients diagnosed with T2DM who were admitted at the department of endocrinology in the first people＇ s hospital of Zunyi from August 2010 to July 2013 were randomly recruited as the treatment group. All patients had normal resting blood pressure. Forty-three eases of age- and gender-matched healthy volunteers were taken as control group. Bruce exercise program was used for secondary symptoms of restrictive exercise test. Incidence of EH in T2DM patients and control group was compared. Insulin resistanee was assessed by homeostasis model assessment-insulin resistance （HOMA-IR） test. The correlation of EH with insulin resistance, glycosylated hemoglobin, age, and blood lipid in T2DM patients was assessed by using independent sample t test and single factor logistic regression analysis. Results Compared with control group, the systolic blood pressure changed significantly before and after the exercise test in T2DM group. Also, the incidence of EH in T2DM patients were significantly higher （P 〈 0.05）. The HOMA-IR index of the EH group was significantly higher than the non-EH group （ P = 0. 013 ） by t-test. The results of single factor logistic regression analysis showed that the HOMA-IR index was included in the equation, suggesting that insulin resistance might be a risk factor of EH occurrence, with odds ratio （OR） of 1.48 and corresponding 95% confidence interval （CI） of （1.03 - 2. 12）. Conclusion T2DM can increase the risk of developing EH. Patients with EH may have higher insulin resistance compared to those T2DM patients without EH.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第20期2279-2282,共4页
Journal of Third Military Medical University
基金
遵义市科学技术局
贵州省遵义市第一人民医院联合科技研发资金项目(遵义市科合社字[2010]020号)~~
关键词
运动性高血压
2型糖尿病
胰岛素抵抗
exercise hypertension
type 2 diabetes mellitus
insulin resistance
