原发性高血压患者血清脂联素水平及与血压、胰岛素抵抗的关系

Relationship of serum adiponectin and insulin resistance in patients with essential hypertension

目的探讨原发性高血压患者血清脂联素水平及其与血压、胰岛素抵抗之间的关系。方法选取原发性高血压患者65例及健康对照者40名,用酶联免疫吸附法检测各组空腹血清脂联素浓度,同时测定各组的血压、体重指数、腰围、血糖、胰岛素等指标,采用稳态模型法计算胰岛素抵抗指数(IRI)和胰岛素敏感指数(ISI),并分析血清脂联素与各指标间的相关性。结果原发性高血压组血清脂联素水平显著低于健康对照组[(10.30±0.93)μg/ml比(12.83±1.66)μg/ml),P=0.000]。Pearson相关性分析显示,原发性高血压组血清脂联素与收缩压(r=-0.304,P=0.032)、体重指数(r=-0.496,P=0.000)、腰围(r=-0.539,P=0.000)、空腹胰岛素(r=-0.291,P=0.040)、IRI(r=-0.334,P=0.018)之间呈负相关,与ISI呈正相关(r=0.297,P=0.037)。多元逐步回归分析显示,收缩压、腰围是影响脂联素水平的独立危险因素。结论原发性高血压患者血清脂联素水平下降,且与收缩压、胰岛素抵抗具有一定的相关性。

Objective To observe the levels of serum adiponectin in patients with essential hypertension, and the relationships between adiponectin and blood pressure （BP）, insulin resistance. Methods Sixty-five patients with essential hypertension and forty normotensive healthy subjects were studied.Fasting plasma adiponectin was assayed by ELISA technique,and related parameters such as BP, body mass index （BMI）, waist circumference （WC） ,fasting blood glucose ,and insulin were measured.According to the typical HOMA model ,insulin resistance index（HOMA-IR） and insulin sensitivity index（ISI ） were calculated. Results The level of serum adiponectin was significantly lower in essential hypertension group than that in normotensive healthy subjects [ （ 10.30±0.93 ）μg/ml vs （12.83 ±1.66）μg/ml,P=0.000 ]. Plasma adiponectin in essential hypertension group was negatively related to systolic blood pressure （ SBP, r=-0.304, P=0.032 ）, BMI （r=-0.496, P=0.000）, WC （r =-0.539, P=0.000）, fasting insulin （r=-0.291 ,P=0.040）, HOMA- IR（r=-0.334,P=0.018）,while positively to ISI（r=0.297,P=-0.037）. Multiple regression analysis showed that SBP and WC were the independent risk factors of serum adiponectin in patients with essential hypertension. Conclusion The serum adiponectin was significant lower in patients with essential hypertension, and there were significant negative correlations between adiponectin and systolic blood pressure and insulin resistance.