非酒精性脂肪肝与高血压病发病的关系及可能机制探讨

Relationship between serum level of myeloperoxidase and acute coronary syndrome

目的:探讨非酒精性脂肪肝(NAFLD)与高血压病发病的关系和可能机制。方法:入选NAFLD的患者125例(NAFLD组);体检正常者105例(正常对照组)。NAFLD组按血清谷丙转氨酶(ALT)水平分为两个亚组:A组(ALT≥40IU/L)60例;B组(ALT<40IU/L)65例。测定各组空腹血糖(FBG)、血尿酸(SUA)、血脂、C反应蛋白(CRP)、血清ALT水平,检测颈动脉内膜中层厚度(IMT)。结果:①与正常对照组比较,NAFLD组高血压病发病率、血清FBG、UA、CRP、TC、TG、LDL-C水平明显升高,IMT明显增加,HDL-C水平明显降低(P均<0.05);与B组相比,A组SUA[(360.2±118.3)μmol/L比(420.8±111.3)μmol/L]水平明显升高、IMT[(0.76±0.03)mm比(1.29±0.06)mm]明显增加(P均<0.05);②Pearson相关分析显示,患者ALT水平与血压(收缩压及舒张压)呈正相关(r=0.419、0.381,P<0.05)。结论:①非酒精性脂肪肝与高血压发病有关;其血谷丙转氨酶水平升高可能是促使高血压病发生的机制之一。

Objective： To explore relationship between nonalcoholic fatty liver disease （NAFLD） and occurrence of hypertension and its possible pathogenesis. Methods： A total of 125 NAFLD patients （NAFLD group） and 105 healthy subjects （normal control group） were enrolled. NAFLD group was divided into two subgroups according level of alanine transminase （ALT） ： group A （n = 60, ALT〉40 IU/L） and group B （n = 65, n〈40 IU/L）. Fasting blood glucose （FBG）, serum uric acid （SUA）, blood lipids, C reactive protein （CRP）, serum ALT level and carotid intima-medium thickness （IMT） were measured in all groups. Results： （1） Compared with normal control group, there were significant increase in incidence rate of hypertension, levels of FBG, SUA, CRP, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein-cholesterol （LDL-C） and IMT, and significant decrease in level of high density lipoprotein-cholesterol （HDL-C） in NAFLD group （P〈0.05 all）; Compared with group B, there was significant increase in SUA level [ （360. 2 ± 118. 3） umol/L vs. （420. 8 ± 111.3） umol/L] and IMT [ （0.76 ±0. 03） mm vs. （1.29 ±0. 06） mm] in group A （P〈0.05 both） ; （2）Pearson correlation analysis indicated that ALT level was positively correlated with blood pressure （systolic and diastolic blood pressure） of patients （r = 0. 419, 0. 381, P〈 0.05）. Conclusion： （1） NAFLD is related with hypertension; （2） ALT level increase is a possible pathogenesis of NAFLD occurring hypertension.