伴代谢综合征高血压患者微量白蛋白尿和血清高分子量脂联素的变化

Changes of microalbuminuria and serum high molecular weight-adiponectin in hypertensive patients with metabolic syndrome

目的比较伴代谢综合征(MS)高血压患者与单纯高血压患者的微量白蛋白尿(MAU)及高分子量脂联素(HMW-ADP)水平的差异,探讨MAU与HMW-ADP的相关性及二者与伴MS高血压的关系。方法68例原发性高血压患者,根据有无MS分为伴MS高血压组(33例)与单纯高血压组(35例)。采用放射免疫分析法测定尿白蛋白/肌酐比(ACR),双抗体夹心ELISA法测定血清HMW-ADP。结果同单纯高血压组相比,伴MS高血压患者的尿ACR增高,血清HMW-ADP降低(P<0.01);Pearson相关分析显示,血清HMW-ADP与尿ACR差异无统计学意义(P>0.05);多因素BinaryLogistic回归分析显示,空腹血糖(FPG)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、ACR及HMW-ADP与高血压患者MS的发生具有关联性(P<0.05或0.01)。结论MS加重高血压患者肾功能损害;尿ACR与血清HMW-ADP没有明显相关性;尿ACR增高及血清HMW-ADP降低可促进高血压患者MS的发生。

Objective To compare the differences of microalbuminuria（MAU） and serum high molecular weight-adiponectin（ HMW-ADP） between essential hypertensive patients and hypertensive patients with metabolic syndrome （MS）,and to explore the association of MAU and HMW-ADP in hypertensive patients with MS. Methods 68 essential hypertensive patients were enrolled and divided into two groups by the definition of MS： the MS and hypertension group （n = 33） and the pure hypertension group （n = 35）. The urine albumin-to-creatinine ratio（ACR） was measured by radioimmunoassay. Serum HMW-ADP was determined by sandwich ELISA. Results The MAU level was higher and the level of serum HMW-ADP was lower in the MS and hypertension group than in the hypertension group（P〈0. 01）. Pearson correlation analysis showed that HMW-ADP was not correlated with ACR（P〉0. 05）. Binary logistic regression showed that fasting plasma glucose,high density lipoprotein cholesterol,triglyceride,low density lipoprotein cholesterol,ACR and HMW-ADP were associated with the development of MS in hypertensive patients（ P〈0. 05-0. 01）. Conclusions MS aggravates kidney damage in hypertensive patients. HMW-ADP is not correlated with ACR. Increase of ACR and decrease of HMW-ADP promote development of MS in patients with hypertension.