高血压患者并发氨基转移酶正常的非酒精性脂肪肝的心血管危险因素分析

Cardiovascular risk factors in hypertensives complicated with non-alcoholic fatty liver but normal aminotransferase

目的 探讨高血压合并氨基转移酶正常非酒精性脂肪肝患者心血管疾病的危险因素.方法 选择2009年10月至2010年6月我院体检中心44例单纯高血压患者（对照组）及56例高血压合并氨基转移酶正常非酒精性脂肪肝（研究组）,比较两组血压、体重指数、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、γ-谷氨酰转移酶（γ-CGT）、血尿酸、高敏C反应蛋白、同型半胱氨酸,并进行相关性分析.结果 与对照组比较,研究组舒张压（T=1898.5,P〈0.05）、体重指数（t=-5.036,P〈0.01）、空腹血糖（t=-2.026,P〈0.05）、甘油三酯（T=1923.5,P〈0.05）、γ-GGT（T=1789.0,P〈0.01）、血尿酸（T=1715.0,P〈0.01）、高敏C反应蛋白（T=1832.5,P〈0.01）增高,HDL-C降低（T=2357.0,P〈0.01）.γ-GGT与体重指数（rs=0.349,P=0.000）、甘油三酯（rs=0.413,P=0.000）、尿酸（rs=0.446,P=0.000）、高敏C反应蛋白（rs=0.350,P=0.000）呈正相关.结论 高血压合并氨基转移酶正常的非酒精性脂肪肝时,心血管危险因素更加聚集,γ-GGT亦明显升高且与多种危险因素相关,预示心血管危险增加.

Objective To explore cardiovascular risk factors in patients of hypertension （HTN） complicated with non-alcoholic fatty liver but normal aminotransferase. Methods Forty-four cases （control group） of uncomplicated hypertension and 56 cases （study group） of hypertension complicated with nonalcoholic fatty liver but normal aminotransferase were screened from those who visited physical examination center of the hospital for regular checks-up during October 2009 to June 2010. Blood pressure （ BP）, body mass index （ BMI）, fasting plasma glucose （FPG）, total serum cholesterol （TC） , triglyceride （TG）, highdensity lipoprotein-cholesterol （ HDL-C ）, low-density lipoprotein-cholesterol （ LDL-C ）, gammaglutamyltransferase （ GGT ）, uric acid （ UA ） , highly-sensitive C-reactive protein （ hs-CRP） and homocysteine （Hey） of the two groups were compared. Results Comparing with the control group, the study group had higher diastolic blood pressure （ DBP） （t = 1898. 5, P 〈 0. 05） , BMI （t = - 5. 036, P 〈 0.01）, FPG （t= -2.026, P〈0.05）, TG （t = 1923. 5, P〈0.05）, GGT （t = 1789, P 〈0.01）, UA 0 = 1715, P〈0.01）, hs-CRP （t = 1832.5, P 〈 0.01） and lower level of HDL-C （t =2357.0, P〈 0. 01）. Serum activity of GGT correlated positively with BMI （rs = 0. 349, P = 0. 000）, TG （ rs = 0.413,P =0.000）, UA （rs =0.446, P= 0.000） and hs-CRP （rs =0.350, P = 0.000）, respectively.Conclusions When patients of hypertension complicated with non-alcoholic fatty liver but normal aminotransferase, their cardiovascular risk factors clustered further, with serum activity of GGT obviously increased which correlated positively with various risk factors, indicating increase in cardiovascular risks.