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論文(リポジトリ) |
論文(リポジトリ)
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中川, 理 ; 丸山, 誠太郎 ; 金子, 晋 ; 長沼, 景子 ; 浮須, 潤子 ; 相澤, 義房
概要:
It has drawn attention for some time that diabetes mellitus, hypertension, hyperlipemia and obesity are found in the same patients, and accumulation of such risk factors is liable to cause arteriosclerotic cardiac diseases. In
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recent years, involvement of insulin resistance and hyperinsulinemia has been reported in many cases as a common factor in such glucose metabolism disorder, essential hypertension, lipid metabolism disorder and obesity. In the action mechanism of insulin resistance and the resultant hyperinsulinemia to compensate insulin resistance inducing various pathological states, involvement of biological activities of insulin other than glucose metabolism are conceived. Insulin shows vasodilation, acceleration of sodium reabsorption in the kidneys, cell growth and potentiation of sympathetic nerves, and insulin resistance is considered to cause dysfunction leading to hypertension. In this study, we report insulin resistance and hypertension based on the results in our department and discussion of literature.
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| 2.
論文(リポジトリ) |
論文(リポジトリ)
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中川, 理
概要:
To examine exacerbating factors in diabetic retinopathy, we retrospectively evaluated clinical findings on long-term follow up of 183 patients with non-insulin dependent diabetes mellitus (NIDDM)(93 males, 90 females). I)
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Diabetic retinopathy was classified as no retinopathy, simple, preproliferative and proliferative retinopathy. The patients were divided into 3 groups: an exacerbated group with at least 1 stage of progression, a stable group without progression, and an improved group with at least 1 stage of improvement over the past 5 years. The mean value of hemoglobin A1c (HbA1c) and mean blood pressure during the past 5 years were examined among 3 groups. II) 45 patients with simple retinopathy (22 males, 23 females) were divided into 2 groups, an exacerbated group or a stable/improved group, and were studied as described in I). III) 23 patients (8 males, 15 females) with NIDDM in whom the onset of simple retinopathy could be specified, were divided into 2 groups, Group S with simple retinopathy without progression or Group P with progression from simple retinopathy to either preproliferative or proliferative retinopathy. The following items were retrospectively compared: 1. duration of simple retinopathy (prior to study), 2. HbA1c, 3. systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), and 4. serum total cholesterol (TC). The results are as follows: I There were 23 patients in the improvement group, 106 patients in the no change group, and 54 patients in the exacerbation group. In both the improvement group and the no change group, levels of HbA1c and mean blood pressure were significantly lower than those in the exacerbation group (p<0.001). II There were 24 patients in the improvement/no change group, and 21 patients in the exacerbation group. In the improvement/no change group, levels of HbA1c and mean blood pressure were significantly lower than those in the exacerbation group (p<0.01, p<0.001). III There were significant differences in the duration of simple retinopathy, the HbA1c value and the TC concentration between Group S and P. There was no significant difference in other items. In conclusion, degree of HbA1c level was considered to be an important exacerbating factor in diabetic retinopathy. Furthermore, involvement of hypertension before the onset of retinopathy is suggested, although we cannot over look the possibility that levels of blood pressure was due to diabetic nephropathy. In addition to control of blood glucose and serum hypercholestelonemia, early treatment for hypertension may be important to prevent progression of retinopathy.
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