高血压前期与胰岛素抵抗、血清脂联素水平的相关研究

Correlation between prehypertension and insulin resistance or level of serum adiponectin

目的探讨人群胰岛素抵抗及血清脂联素水平与高血压前期的关系。方法入选160例体检人群,分为理想血压组(43例)、高血压前期组(79例)、1级高血压组(38例),分别检测受检者血清脂联素、空腹血清胰岛素水平,采用HOMA-IR法计算胰岛素抵抗指数。对理想血压是否进展为高血压前期进行二分类Lo-gistic回归分析。结果理想血压组、高血压前期组、1级高血压组胰岛素抵抗指数分别为(1.39±0.06)、(1.78±0.06)、(2.49±0.15),三组间差异有显著统计学意义(P<0.01)。高血压前期组、1级高血压组血清脂联素水平分别为(17.76±0.99)mg/L、(18.59±1.32)mg/L,两组差异无统计学意义;两组血清联素水平与理想血压组[(22.89±1.25)mg/L]比较,差异均有显著统计学意义(P均<0.01)。Logistic回归分析表明体质指数、胰岛素抵抗指数为理想血压进展为高血压前期的危险因素而脂联素为保护因素。结论高血压前期人群胰岛素抵抗水平已经升高,并伴随脂联素水平下降。

Objective To discuss the relationship between insulin resistance or the level of serum adiponectin and prehypertension in people group.Methods All 160 cases of physical examination were divided into the ideal blood pressure group（n=43）,prehypertension group（n=79） and grade 1 hypertension group（n=38）.The levels of serum adiponectin and fasting insulin（FINS） were determined,and insulin resistance index was calculated by using the method of homeostasis model assessment of insulin resistance（HOMA-IR）.The binary Logistic regression was used to analyze whether ideal blood pressure developing to prehypertension.Results The insulin resistance index was,respectively,（1.39±0.06）,（1.78±0.06） and（2.49±0.15） in the ideal blood pressure group,prehypertension group and grade 1 hypertension group,and the difference of three groups was statistically significant（P0.01）.The level of serum adiponectin was,respectively,（17.76±0.99） mg/L and（18.59±1.32） mg/L in the prehypertension group and grade 1 hypertension group,and the difference between two groups was not significant.The level of serum adiponectin in the prehypertension group,and grade 1 hypertension group compared with that in ideal blood pressure group[（22.89±1.25） mg/L]showed the difference was statistically significant（all P0.01）.The analysis of Logistic regression showed that body mass index and insulin resistance index were the risk factors in the development of ideal blood pressure to prehypertension and adiponectin was a protective factor.Conclusion The level of insulin resistance has increased accompanying by the decrease of the level of serum adiponectin in the people group of prehypertension.