Analysis Of Relation Of Hypertention In Obesity With Hyperinsulinism And Insulin Resistance

Objective hypertension, Which is very common in the old, accociated with seversal agents. But until now , studys indicted that Major hypertension present hyperinsulinism and insulin resistance. Meanwhile, presence of obesity and hyperinsulinism were commonly found in some studys. Obesity can be considered as an insulin-resistance which comprises a constellation of clinical, biochemical and hemodynamic abnormalities . hyperinsulinism can accumulate lipid in fatty tissue, result in obesitybesity will induce insulin-resistance state, in which precent hyperinsulinism, thereby foaming vicious cycle.furthermore hypersulinism can lead to dyslipidemia. Hyperinsulinism and insulin-resistance are major risk facters with high incidence in the obese population. These risk factors have the capacity to induce hypertension. Howere, golden standard of insulin-resistance is euglycemic insulin clamp the method are expensive and time-consuming. So it doesn't suit to clinical usage. The purpose of this study was to discuss the relation of hypertension with hyperinsulinism. In order to find envidence of a individualizing therapy and diagnosis of hypertension,this study was performed.Method Fasting insulin and C peptid (CP)were measured and 2-h oral glucose tolerace tests (OGTT)were performed in 54 obese patients and 54 controls (irobese patients). All patients come from the Third Hospital of Jilin University (2002～2004) and weren't given antihypertensive therapy after hospitalize. Meanwhile, the level of triglyceridemia , total cholesterol, blood pressure ,ratio of waist and buttock were detected.Result' standard According to suggestion of American Diabetes Association(ADA) in 1997, plasma glucose concentrations≥7.8mmol/L and <11.1mmol/L was considered as abnormality in 2-h oral glucose tolerance test; normal range of insulin is 4.2～15.8mu/L; normal range of CP is 0.4～0.8pmol/L; Triglyceridemia≥1.7mmol and total cholesterol≥5.2mmol were considered as hyperlipidemia. Results The level of insulin and CP in obese group is higer than that in irobese group(P<0.01) , oral glucose tolerance test in obese group is lower than that in irobese group(P<0.05), degree of systolic pressure and diastolic pressure in obese group is higher that of irobese group(P<0.01, P<0.05), the level of triglyceridemia and total cholesterol in obese group are higher than that in irobese group(P<0.01, P<0.05).Conclusion The center-obesity patients were selected in our study. Obese hypertension exist hyperinsulinism and insulin-resistance. Pathogenesis of obese hypertension have possible relation with hyperinsulinism and insulin-resistance. Among of these facters, hyperinsulinism is very important. Risk degress of hypertension , insulin, CP, lipid in obesity were higher than that in irobesity, indicating allo-metabolism is involved in Pathogenesis of hypertension.Suggestion This study suggested hyperinsulinism and insulin-resistance are important in pathogenesis of hypertension. Hyperinsulin makes blood pressure higher and add fat in fatty tissue. Thereby, the level of insulin and CP should be detected in hypertensive patients routinely. We should emphasize individualization in therapy of hypertension. When application of anti-hypertension decrease blood pressure, ameliorat insulin sensibility, reduce the level of insulin, Progress of risk degress of blood pressure will be prevented. Coronary heart disease and diabetes mellitus will be prevented.