Objective To study change of insulin resistance and beta-cell function of the patients in hyper-tension with normal glucose tolerance(NGT) to phthogonesis of type 2 diabetes mellitus(T2DM). Methods 84 pa-tients with hypertension were divided into NGT group,and groups of impaired glucose tolerance(IGT) with groups of T2DM. The blood pressure, height, weight, waist circumference, hip circumference, high-density lipoproteins (HDL-C)and total cholesterol(TC) ,fasting plasma glucose(FPG) and fasting plasma insulin(FINS) were measured to deter-mine the body mass index(BMI) ,waist/hip ratio(WHR) ,insulin secretion function[ including Homa β-cell function index(HBCI) and fasting β-cell function index(FBCI)] and insulin resistance level [ including Homa model insulin resistance index(IR) and insulin action index(IAI)] ,statistic comparison were measured between the groups of dif-ferent glucose tolerances. Results The BMI, WHR, diastolic blood pressure ( DBP), TC in IGT group and T2DM group were bigger or higher than those in NGT group ( P<0.05, P<0.01 ), the IAI, HOMA-IS and FBCI in T2DM group were lower than those in NGT group with these in NGT group were lower than those in NGT group( P<0.05 ,P<0.01 ). The HOMA-IR in IGT group and T2DM group were higher than those in NGT group with these in T2DM group were higher than those in NGT group. Conclusion T2DM group and IGT group had more insulin resistance level,sensitivity of insulin and islet β-cell function decrease than those in IGT group,the IGT group and T2DM group are analogous at the body weight is heavier, with waist/hips ratio, triglyceride level and DBP are higher than those in the NGT group in clinic.

Objective To compare the incidence of metabolic disorders and uric acid (UA) levels between patients with primary aldosteronism (PA) and essential hypertension (EH),and to explore factors associated with UA levels in these patients.Methods A total of 117 PA and 117 EH patients individually matched by sex,age,blood pressure and duration of hypertension were recruited from in-hospital patients who were hospitalized in our department because of suspicion of secondary hypertension from January 2008 to December 2014.Clinical data including metabolic disorders and UA levels were analyzed.Results (1) Body mass index (BMI),waist circumference,plasma triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),free fatty acid (FFA) were significantly higher in EH than in PA group (all P ＜ 0.05).Prevalence of diabetes mellitus or impaired glucose tolerance (DM + IGT) was significantly higher in EH than in PA group (41.9％ (49/117) vs.17.1％ (20/117),P ＜0.01).The prevalence of metabolic syndrome (MS) was also significantly higher in EH than in PA group (51.3 ％ (60/117) vs.24.8％ (29/117),P ＜ 0.01).(2) EH patients had higher homeostasis model assessment for insulin resistance (HOMA-IR) and lower insulin sensitivity index composite (ISI comp) than PA patients,but basic insulin secretion index (HOMA-β) and modified β cell function index (MBCI) were significantly lower in PA than in EH group (P ＜ 0.05).(3) With regard to target organs damages,PA patients revealed higher 24-hour urinary protein,urinary albumin excretion rate (UAER),urinary IgG,urinary α-1 microglobulin,left ventricular mass index and lower urine specific gravity than EH patients (all P ＜ 0.05).There was no significant difference in estimated glomerular filtration rate (eGFR) between two groups (P =0.103).(4) UA level was significantly lower in PA group than in EH group ((314.00 ±89.52) μmol/L vs.(379.16 ± 101.25) μmol/L,P ＜ 0.01).Higher plasma aldosterone concentration and lower plasma renin activity were associated with lower UA level in PA group.Conclusions Compared with sex,age and hypertension duration matched EH patients,PA patients revealed lower UA level and less severe abnormalities of glucose and lipid metabolism,but are associated with severer renal and cardiac damages.The reduced UA level in PA patients is possibly due to the high plasma aldosterone concentration and low plasma renin activity.