中文摘要：

目的研究腹内脂肪对高血压患者代谢指标的影响。方法将腹部脂肪螺旋CT测定的554例高血压患者排除有糖尿病史、调脂药物治疗史及严重心肺疾病、消化道疾病后的228例，根据2005年国际糖尿病联盟腹型肥胖标准分为腰围超标组（AO＋组，114例）和腰围正常组（AO一组，114例）；再将228例患者根据是否合并腰围超标和腹内脂肪堆积分4个亚组，并测量血压、体重指数（BMI）、腰围，检测血糖、血脂代谢指标，并计算胰岛素抵抗指数（HOMA—IR）。结果A0＋组舒张压、BMI、腹内脂肪面积（VA）、空腹血糖、负荷后2h血糖、糖化血红蛋白、TC、TG、空腹胰岛素和HOMAIR均显著高于AO一组（P〈0．01）；腰围与空腹血糖、负荷后2h血糖、糖化血红蛋白、HOMA—IR和空腹胰岛素均呈显著正相关（P〈0．05，P〈0．01），VA与HOMA-IR和空腹胰岛素呈显著正相关（P〈0．01）。结论高血压患者同时合并腹围超标和腹内脂肪堆积，胰岛素抵抗、血糖、血脂异常最为严重；即使腰围正常，只要合并腹内脂肪堆积，胰岛素抵抗更为严重。

英文摘要：

Objective To explore the impact of visceral fat accumulation on metabolic profiles in patients with hypertension. Methods 228 hospitalized hypertensive patients were divided into hypertensives with increased waist circumference（WC） （AO＋ group, 114 cases） and hypertensives with normal WC（AO-group, 114 cases） according to the criteria of IDF 2005. All patients were di- vided into four sub-groups according to their WC and visceral adipose area（VA）. Blood pressure, body mass index （BMI） WC, fasting plasma glucose （FPG） ,postprandial plasma glucose （2hPG）, fasting insulin （FIN）, HbAlc, and lipid profiles were measured. HOMA-IR was calculated as （FPG×FIN）/22.5. Results Compared with AO-group, diastolic blood pressure （DBP） ,BMI, VA,FPG,2hPG, HbAlc,total cholesterol （TC）,triglyceride （TG）,FIN and HOMA-IR were sig- nificantly higher in AO＋ group. Correlation analysis showed that WC was significantly positively correlated with FPG, 2hPG, HbAlc, HOMA-IR and FIN level, whereas VA was significantly posi- tively correlated with HOMA-IR and FIN. Conclusions Hypertensive patients with increased WC and visceral fat accumulation have significantly deteriorated insulin sensitivity, glucose profiles and lipid profiles. Even with normal WC,the hypertensive patients with visceral fat accumulation still show high insulin resistance.