胰岛素样生长因子-1和原发性高血压的关系

Insulin-like growth factor-1 and essential hypertension

目的探讨血清胰岛素样生长因子-1(insulin-like growth factor,IGF-1)浓度与原发性高血压(高血压)及左心室肥厚(left ventricular hypertrophy,LVH)的关系,为高血压的诊断和治疗提供理论依据和新思路。方法选择高血压患者100例为研究对象,按照高血压分级分为1、2、3级,计算左心室质量指数(left ventricular massindex,LVMI),分为LVH组和无LVH组;另外,选择30名健康体检者作为对照组。分别用放射免疫法测定血清IGF-1浓度。高血压患者降压治疗3个月后测定血压与血清IGF-1浓度,然后进行统计学分析。结果高血压患者血清IGF-1浓度明显高于正常对照组,且高血压1～3级组间血清IGF-1浓度比较,差异有统计学意义[(412.34±41.45)ng/mL vs.(329.41±32.76)ng/mL vs.(257.56±45.32)ng/mL vs.(142.47±41.32)ng/mL,P<0.05]。高血压伴LVH患者血清IGF-1浓度[(387.45±35.76)ng/mL vs.(296.57±40.23)ng/mL,P<0.05]、左心室质量指数[(148.25±18.14)g/m2 vs.(109.43±17.68)g/m2,P<0.05]高于无伴LVH患者,差异有统计学意义。高血压患者血清IGF-1浓度与左心室质量指数呈正相关(r=0.83,P<0.05)。高血压组经药物治疗3个月后血压达标患者的血清IGF-1浓度显著低于血压未达标患者,差异有统计学意义[(259.17±42.64)ng/mL vs.(324.65±37.17)ng/mL,P<0.05]。结论高血压患者血清IGF-1浓度升高,并随着血压水平和病情严重程度更加明显,提示IGF-1在高血压LVH的发生发展过程中发挥重要作用,可能参与高血压LVH的调节。

Objectives To investigate the relationship of IGF-1 with essential hypertension （EH） and left ventricular hypertrophy （LVH） for providing a new method for the diagnosis of EH. Methods One hundred patients with EH were recruited and divided into 3 subgroups of EH 1 to 3. The value of left ventricular mass index （LVMI） of all these cases were evaluated by eehocardiography. Patients were divided into non-LVH group and LVH group by LVMI. Besides, 30 healthy subjects were included as control group. Serum concentration of IGF-1 were measured by radioimmunoassay using nitrate reduetase. Serum concentration of IGF-1 in 100 patients with EH were measured after treatment for 3 months. Statistical analysis was done. Results Serum concentration of IGF-1 in patients with EH was significantly higher than that in control group, and there were significant differences of serum concentrations of IGF-1 among the 3 clinical grading EH groups [ （412.34±41.45）ng/mL vs. （329.4132.76）ng/mL vs. （257.56±45.32）ng/mL vs. （ 142.47 ±41.32）ng/mL, P 〈0.05]. Serum concentration of IGF-1 [ （387.45 ±35.76）ng/mL vs. （296.57 ±40.23）ng/ mL,P〈0.05], LVMI[ （ 148.25±18.14）g/m2 vs. （ 109.43±17.68）g/m2,p〈0.05] in LVH group was significantly higher than that in non-LVH group. Serum concentration of IGF-1 in patients with EH positively correlated with LVMI（r=0.83, P〈0.05 ）. After 3 months＇ treatment, serum concentration of IGF-1 decreased more significantly in patients with normal blood pressure than that in patients with abnormal blood pressure [ （ 259.17 ±42.64） ng/mL vs. （ 324.65 ± 37.17 ） ng/mL, P〈0.05]. Conclusions Serum concentration of IGF- 1 increased in patients with EH, and serum concentration of IGF- 1 closely correlated with the clinical severity of hypertension, indicating that IGF-1 may play an important role in the occurrence and development of LVH.