[The relationship between insulin resistance and postprandial abnormal serum triglyceride metabolism in essential hypertension].

OBJECTIVE

To investigate the relationship between insulin resistance (IR) and postprandial abnormal metabolism of serum triglyceride-rich lipoprotein in essential hypertension (EH).

METHODS

In 44 patients with EH and 22 normal subjects (NS). Total cholesterol, HDL cholesterol, LDL cholesterol, apoliprotein AI and apoliprotein B in fasting serum and serum triglyceride before and 2, 4, 6, 8 hours after a standardized fat loading were measured. Triglyceride peak response (TGPR) and the area under triglyceride curve (TG-AUC) over 8 hours were taken as the index of abnormal TG metabolism. Standardized 75 g oral glucose tolerance test was carried, the area under insulin curve (IS-AUC) over 3 hours and insulin sensitivity index were taken as the index of insulin sensitivity.

RESULTS

TGPR and TG-AUC were higher in EH than those in NS (TGRP: 4.14 mmol/L +/- 3.0 mmol/L vs 2.06 mmol/L +/- 1.32 mmol/L, P < 0.01; TG-AUC: 20 mmol/L +/- 6 mmol/L vs 10 mmol/L +/- 4 mmol/L, P < 0.05). 65.9% of EH had postprandial abnormal serum triglyceride metabolism. IS-AUC was higher in EH than that in NS, and ISI was lower in EH than that in NS. The incidence of IR in EH was 61%. 44 EH were categorized into 2 groups according to insulin sensitivity: EH with IR (n = 27) and EH with normal insulin sensitivity (NIS, n = 17). TGPR and TG-AUC in EH with IR were significantly higher than those in EH with NIS (TGPR: 5.25 mmol/L +/- 3.03 mmol/L vs 3.16 mmol/L +/- 1.46 mmol/L, P < 0.05; TG-AUC: 25 +/- 13 mmol/L vs 13 +/- 7 mmol/L, P < 0.01). No significant difference was found between EH with NIS and NS (P > 0.05). TG-AUC and TRPG was positively related to IS-AUC and negatively related to ISI.

CONCLUSIONS

Patients with EH had postprandial abnormal serum triglyceride metabolism, insulin resistance may aggravate postprandial triglyceride metabolism in EH.