高血压患者空腹血游离脂肪酸组成与腰臀比、胰岛素活性的关系

Serum Free Fatty Acids Composition, Waist/Hip Ratio and insulin activity in Patients with Essential Hypertension

目的观察原发性高血压患者空腹血游离脂肪酸(freefattyacid,FFA)组成与向心性肥胖、胰岛素抗性、年龄、血清锌和饮食的关系及性别差异。方法采用社区人群整群抽样、病例对照方法,筛选出高血压患者109例,其中肥胖患者70例,非肥胖患者39例,并以饮食习惯相近的123例血压正常个体(其中肥胖个体66例,非肥胖者57人)为对照,用高效液相色谱直接衍生化法检测空腹血清各种FFA浓度,放免法测定胰岛素水平。结果(1)多元逐步线性回归和分层分析显示空腹血清FFA组成(包括n3PUFA水平、P/S比值、C20:5/C18:3、C22:6/C20:5及C20:4/C18:2比值)存在年龄和性别差异,即小于45岁年龄组高血压患者的FFA改变显著性大与超过46岁年龄组,男性高血压患者的FFA改变显著性大于女性。(2)分层、相关及回归分析显示空腹血清FFA组成与腰臀围比值、胰岛素敏感指数、血清锌水平、饮食习惯相关(均P<0.05)。(3)原发性高血压患者血清锌水平略低于非高血压个体(14.9±5.0vs非高血压组16.8±6.4)μmol/L,P=0.45。结论原发性高血压患者空腹血游离脂肪酸组成改变与向心性肥胖、胰岛素抵抗、锌缺乏、年龄和饮食有关,并存在性别差异。

Objective To investigate the relationship of fasting serum FFA composition with central obesity, hypertension, insulin resistance, levels of serum zinc and age, gender-related differences. Methods Serum FFA were determined by high performance liquid chromatogram in 232 commuity-based subjects aged between 35 and 55 years： 109 hypertensives, 123 normotensives. Results Multivariate stepwise linear regression models and correlation analysis showed that serum FFA composition （including levels of n3PUFA, P/S ratio, C20：5/C18：3, C22：6/C20：5 and C20：4/C18：2 ratio） were linearly correlated with waist/hip ratio, insulin sensitivity index, levels of serum zinc and related to the habit of diet （all P〈 0.05 or 0.01 ） with age and sex-related differences. Compared with normotensives, hypertensives had lower levels of serum zinc （14.9±5.0 vs normotensives： 16.8±6.4, P=0. 042）. Conclusion Fasting serum FFA composition of hypertensive patients was associated with visceral obesity, insulin resistance, zinc deficiency and diet.