高血压患者血清脂联素水平和动脉顺应性的关系

Serum Adiponectin and Arterial Compliance in Patients of Hypertension

目的探讨高血压人群中血清脂联素浓度和动脉顺应性之间的关系。方法入选非糖尿病的高血压受试者83例,分为药物治疗组和未治疗组。常规检测受试者的坐位血压及部分血清生化指标,包括血糖、血脂、肝功能、肾功能和胰岛素水平;放射免疫法检测血清脂联素浓度;计算稳态模式胰岛素抵抗指数(HOMA-IR);用HDICVprofilor DO-2020检测大动脉弹性指数(C1)和小动脉弹性指数(C2)。结果比较药物治疗组和未治疗组,发现前者的脂联素浓度(中位数:11.9μg/mL)、C1(中位数:13.7mL/mmHg×10)、C2(中位数:4.3mL/mmHg×100)均明显高于后者(5.7μg/mL,10.7mL/mmHg×10,3.7mL/mmHg×100,P均<0.01)。对未治疗组进行相关分析发现LogC1与脂联素浓度明显正相关(r=0.54,P<0.01),与平均血压(MBP)负相关(r=-0.40,P<0.05);LogC2和脂联素浓度明显正相关(r=0.49,P<0.01),与HOMA-IR和MBP明显负相关(LogC2-HOMA-IRr=-0.40,P<0.05;LogC2-MBP,r=-0.32,P<0.01);另外还发现C1与心率(HR)负相关(LogC1-HRr=-0.41,P<0.01)。多元线性逐步回归分析发现血清脂联素浓度和HR水平以及性别是LogC1的独立影响因素(R2=0.39,P<0.01);血清脂联素水平和性别是LogC2的独立影响因素(R2=0.44,P<0.01)。结论高血压人群中C1,C2的减退与血清脂联素浓度的降低密切相关。接受抗高血压药物治疗的患者,血清脂联素浓度和动脉顺应性水平升高。

Objective To investigate the relation between serum adiponectin and arterial compliance in patients with hypertension. Methods Eighty three hypertensives without diabetes were enrolled into medication treatment group and none-medication treatment group. Serum adiponectin was detected by radioimmunology assay and arterial compliance was determined by the device of HDI CVprofilorDO-2020. Insulin resistant index was defined as HOMA-IR. Results Medication treatment group had a higher concentration of serum adiponectin and level of C1, C2（ P〈0.01）. In the untreatment group, LogC1 was correlated with adiponectin（r=0.54, P〈 0. 01）, HR （r=-0.41, P〈0. 05） and MBP （r=-0. 40, P〈0.05）; LogC2 was correlated with adiponectin（r= 0. 49, P〈0. 01 ）, HOMA-IR （r=-0.40, P〈0.05）. Multivariate linear regression analysis showed that serum adiponectin, HR and gender were independent predictors for large arterial compliance（R2 =0.39, P〈0.01） ; adiponectin in serum and gender were independent predictors for small arterial compliance（R2 = 0.44, P〈0. 01 ）. Conclusion Serum adiponectin was closely related with arterial stiffness（C1 , C2 ） in subjects with hypertension. Medication treatment for hypertensives increase serum adiponectin and level of C1 , C2.