The Occurrence Of Hypoglycemia In Primary Hypertensive Patients And The Effects Of Hypoglycemia On Carotid Intima-media Thickness

Objective To research the occurrence of hypoglycemia in primary hypertensive patients and the influence factors of hypoglycemia. Explore the influence of hypoglycemia on carotid intima-media thickness in primary hypertensive patients.Methods This study included 30 primary hypertensive patients with hyperinsulinemia and 30 patients without hyperinsulinemia as experimental group, experimental group was divided into hyperinsulinemia group and non-hyperinsulinemia group, control group included 20 healthy people. All subjects underwent 75g oral glucose tolerance test (OGTT) and continuous glucose monitoring for 72 hours, detected blood glucose, lipids, insulin, C peptide and other laboratory indicators. All subjects were conducted Carotid Duplex Ultrasound and recorded laboratory indicators, carotid intima-media thickness and the results of continuous glucose monitoring. Analyze the occurrence of hypoglycemia in primary hypertensive patients.60 primary hypertensive patients were divided into hypoglycemia group and without hypoglycemia group according to the results of continuous glucose monitoring. Analyze the influence factors of hypoglycemia and the effects of hypoglycemia on carotid intima-media thickness.Results 1、16 cases occurred hypoglycemia (blood glucose<2.8mmol/1) in hyperinsulinemia group, the incidence rate of hypoglycemia was 53.33%.6 cases occurred hypoglycemia in non-hyperinsulinemia group, the incidence rate of hypoglycemia was 20.00%.1 case occurred hypoglycemia in control group, the incidence rate of hypoglycemia was 5.00%.The incidence of hypoglycemia in hypertensive patients with hyperinsulinemia was higher than without hyperinsulinemia and control group, the difference was statistically significant(P<0.05).2、The total frequency of hypoglycemia was 24 times in hyperinsulinemia group, nocturnal hypoglycemia was 13 times(54.17%), pre-dinner hypoglycemia was 8 times(33.33%), postprandial hypoglycemia was 3 times(12.50%). The total frequency of hypoglycemia was 7 times in non-hyperinsulinemia group, nocturnal hypoglycemia was 4 times(57.14%), pre-dinner hypoglycemia was 2 times(28.57%), postprandial hypoglycemia was 1 time(14.29%). The total frequency of hypoglycemia was 1 time in control group, hypoglycemia occurred before the meal. 3、14(87.50%) patients occurred symptoms of hypoglycemia when blood glucose was less than 2.8mmol/1 and 2 patients occurred asymptomatic hypoglycemia in hyperinsulinemia group. 4(66.67%) patients occurred symptoms of hypoglycemia when blood glucose was less than 2.8mmol/1 and 2 patients occurred asymptomatic hypoglycemia in non-hyperinsulinemia group. One patient occurred asymptomatic hypoglycemia in control group.4、Single factor analysis suggested that the influence factors of hypoglycemia were age, HbA1C, HOMA-1R,2-hour post-load plasma insulin and 2-hour post-load plasma C peptide.5、Logistic regression analysis suggested that HbA1C and 2-hour post-load plasma insulin were associated with hypoglycemia in primary hypertensive patients(HbA,C OR=0.247,P<0.05,OGTT2hINS OR=3.890,P<0.05).6、Age, HOMA-IR, fasting insulin, fasting C peptide,2-hour post-load plasma insulin,2-hour post-load plasma C peptide, low density lipoprotein cholesterol, hypoglycemia and the frequency of hypoglycemia were linearly associated with carotid intima-media thickness.7、Multiple linear regression results suggested carotid intima-media thickness was closely related to age,2-hour post-load plasma insulin, hypoglycemia and the frequency of hypoglycemia.Conclusion 1、There was hypoglycemia in primary hypertensive patients, the incidence and frequency of hypoglycemia in primary hypertensive patients combined with hyperinsulinemia was higher than patients without hyperinsulinemia and healthy people.2、Hypoglycemia was associated with hyperinsulinemia and insulin resistance.3、Hypoglycemia was influence factor of carotid intima-media thickness in primary hypertensive patients.