老年腹型肥胖者血清脂联素和糖脂代谢与高血压的关系

Relation between serum adiponectin,blood glucose and lipid metabolism and hypertension in the obese elderly

目的研究老年腹型肥胖患者血清脂联素、血糖、血脂代谢与高血压的关系。方法对109例年龄≥60岁的腹型肥胖者,依据血压水平分为高血压组(67例)和非高血压组(42例),抽取空腹静脉血,检测血糖、血脂、胰岛素、脂联素、瘦素等。结果高血压组血清脂联素(0.93±0.21)nmol/L显著低于非高血压组[(1.10±0.33)nmol/L,P<0.05];而TG,游离脂肪酸(FFA),血糖(FBG),均显著高于非高血压组(P<0.05),HDL显著低于非高血压组(P<0.01),瘦素未见显著差异。高血压组患者脂联素与腰围、TG、FBG之间存在显著负相关(r=-0.314,-0.204,-0.261,P<0.05),与HDL呈正相关(r=0.227,P<0.05)。多元线性回归提示,非高血压组,腰围是影响脂联素水平的重要因素,高血压组,血压对脂联素有较独立的影响因素。结论脂联素水平对伴有腹型肥胖的老年高血压患者的发病具有重要作用。脂联素水平下降可能是原发性高血压伴有糖脂代谢异常的特征性指标之一。

Objective To explore the relationships between serum levels of adiponectin（ADPN）, blood glucose, lipid metabolism and essential hypertension in the obese elderly. Methods The waist circumference（WC）,blood pressure were measured in persons over 60 years old in clinical service. The old obese persons were selected and divided into simple obesity group （control group, n =42） and obesity with essential hypertension group （ n =67） according to the levels of blood pressure. The concentration of serum adiponectin was measured by enzyme linked immunosorbent assay（ELISA） and the relationship between blood glucose and lipid metabolism and ADPN was analyzed. Results Levels of ADPN in essential hypertension group were significantly lower than those in the control group[（0.93 ± 0.21） nmol/ L vs （1. 10±0.33） nmol/L, P〈0.05]. TG[（1. 56±0. 58） mmol/L vs （1.25±0.42） mmol/ L, P G〈0.05],total FFA[（0. 95-＋- 0.25） mmol/L vs （0. 81±0. 22） mmol/ L, P 〈0. 05] and FBG[（6. 00±0. 62） mmol/L vs （5.58 ±0.45） mmol/L, P 〈0.05] were significantly increased and HDL[（1.25±0.21） mmbl/L 1 vs （1.42±0.20） mmol/ L, P〈0.05] was decreased in essential hypertension group as compared with control group. ADPN was negatively correlated with WC, TG, FBS（ r =-0. 314,-0. 204, -0. 261, P〈0.05） and positively with HDL（ r =0. 227, P〈0. 05） in hypertension group. Conclusions The serum level of ADPN in old obese patients with essential hypertension was significantly lower than that in the simple obese old subjects. Low ADPN level was related to impairment of glucose and lipid metabolism in old obese hypertension patients.