高血压合并代谢综合征患者血清脂联素与游离脂肪酸谱等代谢参数关系研究

Serum adiponectln and free fatty acid profile in essential hypertensive patients with or without metabolic syndrome

目的研究原发性高血压合并代谢综合征和未合并代谢综合征患者血清脂联素水平、游离脂肪酸谱特征及与其他糖脂代谢参数间关系。方法用放射免疫分析法测定128例高血压合并或未合并代谢综合征患者与43例正常对照组血清脂联素，同时用气相色谱／质谱测定其游离脂肪酸成分。结果高血压合并代谢综合征患者血清脂联素低于未合并代谢综合征组和正常对照组（P〈0．05或P〈0．01），总脂肪酸、不饱和脂肪酸（亚油酸、油酸、花生四烯酸、二十二碳六烯酸、花生三烯酸）、多不饱和脂肪酸（PUFA）和n6PUFA高于未合并代谢综合征组和正常组，差异有统计学意义（P〈0．05或P〈0．01）。在研究对象中，脂联素与体重指数、腰围、腰臀比、甘油三酯呈负相关（r=-0．222，-0．235，-0．179，-0．194，P〈0．01或P〈0．05），与高密度脂蛋白胆固醇呈正相关（r=0．336，P〈0．01）。总脂肪酸、多不饱和脂肪酸与体重指数、腰围、空腹血糖、平均血压呈正相关（r=0．241和0．280，0．198和0．188，0．226和0．298，0．274和0．334，P〈0．01或P〈0．05）。结论脂联素与游离脂肪酸代谢紊乱、n6系多不饱和脂肪酸升高，可能在原发性高血压合并代谢综合征的发病中起重要作用。

Objective To observe serum adiponectin, free fatty acid （FFA） profile and other glucose and lipid metabolic parameters in essential hypertensive patients with metabolic syndrome（HPMS） or without metabolic syndrome （HP）. Methods The serum adiponectin was measured with the radioimmunoassay, FFA profile measured with the gas chromatography and mass spectrometer in 72 HPMS, 56 HP and 43 normal control subjects. Results Serum adiponectin were significantly lower in HPMS group than those in the HP and Control group （ P 〈 0. 05 or P 〈 0.01 ）. Serum total free fatty acid （ TFA ）, unsaturated fatty acid （UFA, linoleic acid, oleic acid, arachidonic acid, docosahexaenoic acid, eicosatrienoic acid ）, polyunsaturated fatty acid （PUFA） and n6PUFA were significantly higher in HPMS group than those in the HP and control groups （ P 〈 0. 05 or P 〈 0.01 ）. Adiponectin was negatively correlated with body mass index, waist circumferences, waist hip ratio, triglycerides （ r = - 0. 222, -0. 235, -0. 179, - 0. 194, P 〈 0.01 or P 〈 0. 05, respectively） and positively correlated with high- density lipoprotein cholesterol （ r = 0.336, P 〈0.01） ; TFA and PUFA were positively correlated with body mass index, waist circumferences, fasting blood glucose, mean arterial pressure （ r = 0. 241 and 0. 280, 0. 198 and 0. 188,0. 226 and 0. 298,0. 274 and 0. 334 ,P 〈 0. 01 or P 〈 0. 05, respectively） in all subjects. Conclusion Our data suggest that changes in serum adiponectin, FFA and n6PUFA might promote the development of metabolic syndrome in essential hypertensive patients.