糖代谢紊乱对原发性高血压患者血脂及同型半胱氨酸异常的影响

Effect of impaired glucose metabolism on the level of blood lipid and serum homocysteine in essential hypertensive patients

目的:研究糖代谢紊乱(IGM)对原发性高血压(EH)患者血脂及同型半胱氨酸(Homocysteine,Hcy)浓度的影响,从而探讨EH患者血糖、血脂代谢紊乱与血清Hcy的关系。方法:对46例单纯EH患者,平均年龄(77.0±9.6)岁与33例合并2型糖尿病(T2DM)EH患者平均年龄(78.2±7.7)岁的血糖代谢、血脂代谢、体质指数(BMI)及血清同型半胱氨酸(Hcy)浓度进行测定、比较,并分析合并DM的EH患者的血清Hcy与血糖、血脂及BMI之间的相关性。结果:与单纯EH患者相比,合并DM的EH患者的BMI、空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c)、血甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apo-B)及血清Hcy均显著增高;在合并DM的EH患者中,血清Hcy水平分别与BMI(r=0.688,P<0.01)、FBG(r=0.667,P<0.01)、HbA1c(r=0.692,P<0.01)、LDL-C(r=0.906,P<0.01)及apo-B(r=0.774,P<0.01)显著正相关。结论:合并糖代谢异常增加EH患者的血清Hcy水平,而这与血糖代谢异常及血脂紊乱的程度密切相关,改善血糖代谢及调脂治疗可减轻EH患者的血管内皮损伤,进而延缓心血管疾病的病理进展。

Objective To study the effect of impaired glucose metabolism（IGM） on thr level of blood lipid and serum homocysteine in essential hypertensive（EH） patients,and to investigate the relationship between homocysteine and IGM along with dyslipidaemia in EH patients.Methods Comparation on body mass index（BMI）,blood glucose,blood lipidogram and serum homocysteine（Hcy） was made between 46 simple EH and 33 EH patients with Type 2 diabetes mellitus（T2DM）.Then,the correlation analysis was performed between blood lipidogram and BMI,serum Hcy and glucose metabolism level in the EH patients combined with T2DM.Results In comparation to those patients with simple EH,the EH patients with T2DM had more higher level of BMI,FBG,PBG,HbA1c,TG,LDL-C,apo-B and serum Hcy（P 〈 0.05,respectively）.Correlation analysis showed that serum Hcy was positively related with BMI（r = 0.688,P 〈 0.01）,FBG（r = 0.667,P 〈 0.01）,HbA1c（r = 0.692,P 〈 0.01）,LDL-C（r = 0.906,P 〈 0.01） and apo-B（r =0.774,P 〈 0.01）.Conclusions Impaired glucose metabolism may increase serum Hcy level in EH patients,which is associated with the degree of impaired glucose metabolism and dyslipidaemia.Therefore,improvement of glucose metabolism and modification of blood lipidogram could delay the pathological progress of cardiovascular disease in EH patients.