原发性高血压颈动脉粥样硬化与胰岛素抵抗及脂联素的相关性

Association of insulin resistance and adiponectin with carotid atherosclerosis in essential hypertension patients

目的探讨原发性高血压(EH)患者不同程度颈动脉粥样硬化(CAS)与胰岛素抵抗(IR)及脂联素(APN)的关系,观察IR指数(IRI)与血清APN水平二者的相关性。方法利用彩色多普勒超声测定各组IRI及血清APN的水平,观察CAS与IRI及血清APN水平的关系。结果 EH患者IRI高于健康对照组(P<0.05),血清APN水平低于健康对照组(P<0.05);颈动脉斑块形成组及颈动脉内膜增厚组与颈动脉内膜正常组比较,IRI均增高(P<0.05),血清APN水平均降低(P<0.05);颈动脉内膜正常组与健康对照组比较,IRI增高(P<0.05),血清APN水平降低(P<0.05)。EH伴CAS患者IRI与外周血APN水平呈负相关(r=-0.357、P<0.05)。结论 EH患者体内存在IR及APN水平的异常表达,其可能参与了EH伴CAS发生发展的过程,此为早期干预EH发生AS提供了理论依据,IRI及血清APN可作为EH的辅助诊断及治疗的指标之一。

Objective To explore the relationship between the different degrees of Carotid Atherosclerosis（CAS） in Essential Hypertension patients with Insulin Resistance（IR）and Adiponectin,and observe the correlation between IR index（IRI） and serum APN levels. Methods To check each group by color Doppler ultrasound and respectively measure IRI and serum adiponectin（APN） levels,observe the relationship between CAS with IRI and serum APN levels. Results IRI of EH patients were significantly higher than the healthy group（P0.05）,serum APN levels were significantly lower than the NC group（P0.05）,Serum leptin and LDL-C levels were significantly lower（P0.05） than the healthy group;The carotid plaque shaping group was compared with carotid artery intimal thickening group and carotid artery intimal normal group,IRI were significantly increased（P0.05） and serum APN levels were significantly decreased（P0.05）;IRI was significantly higher（P0.05） and serum APN levels were significantly lower（P0.05） in the carotid artery intimal normal group than the healthy control group.IRI and peripheral blood of APN levels were significantly negatively correlated（r =-0.357,P0.05） in EH patients with CAS. Conclusion The abnormal expression of IR and APN levels in EH patients may be involved in the development with CAS,that provides a theoretical basis of early intervention in EH patients with CAS,and IRI and serum APN can be used as one of the secondary diagnosis and treatment of EH.