血清脂联素水平与胰岛素抵抗、高血压的关系

Independent relationship between serum adiponectin level and Hypertension,Insulin Resistance

目的探讨血清脂联素水平是高血压病的独立危险因素还是因胰岛素抵抗造成的伴随关联,以了解脂联素水平在高血压病的发生发展中的作用,并为高血压病乃至代谢综合征的预防和治疗提供依据。方法将170例研究对象分为单纯高血压(47例)、单纯胰岛素抵抗(41例)、高血压伴胰岛素抵抗(41例)和正常对照(41例)4组,运用协方差分析等统计分析方法比较4组间脂联素水平的差异,推断脂联素水平与高血压病和胰岛素抵抗的关联方式。结果 4组间脂联素水平的差异无统计学意义(P>0.05);按性别分组后,男性中,单纯高血压组、单纯胰岛素抵抗组和高血压伴胰岛素抵抗组的脂联素水平分别为3.070 mg/L、2.964 mg/L和2.604 mg/L,均显著低于正常对照组(4.757 mg/L,P=0.000;P=0.001;P=0.002);未发现胰岛素抵抗和高血压病与脂联素水平存在交互作用。结论血清脂联素水平存在着性别差异;在男性研究对象中,胰岛素抵抗及高血压与低脂联素水平均独立相关。

Objective To investigate that adiponectinemia in hypertension patients is the result of an increase in blood pressure itself or the accompanying condition of insulin resistance（IR）,to study its role in the onset and development of hypertension,then provide the basis for prevention and treatment of hypertension and metabolic syndrome.Methods Forty-seven essential hypertensive patients without IR,41 normotensive subjects with IR,41 essential hypertensive pa-tients with IR and 41 normotensive subjects without IR were enrolled in the research.Analysis of covariance we used to compare the plasma adiponectin concentrations among the four groups in order to find the association of adiponectin con-centration with hypertension and IR.Results There was no significant difference of adiponectin concentration among the four groups（P 0.05）;adiponectin concentrations in normotensive subjects without the IR male group（4.757 mg / L） were significantly higher than that of the other three groups,which were 3.070 mg /L,2.964 mg /L,2.604 mg /L（P =0.000;P =0.001;P =0.002）.No significant interaction was detected between insulin resistance and hyperten-sion to adiponectin concentration.Conclusion There is a gender difference in serum adiponectin levels.Insulin resist-ance and hypertension are independent factors for adiponectinemia in male subjects.