高血压患者血清脂联素与颈动脉内膜中层厚度及血压相关因素的研究

Relationship between serum adiponectin and carotid intima-media thickness,blood pressure and other related factors in patients with hypertension

目的探讨高血压患者血清脂联素与颈动脉内膜中层厚度(IMT)及血压相关因素的关系。方法选择新发高血压患者80例(1级27例,2级28例,3级25例),健康体检者(对照组)30例,测定其血清脂联素水平及相关生化指标,应用超声诊断仪测量颈动脉IMT。应用SPSS 11.5软件对其结果进行统计学分析。结果随着血压的升高,对照组、1级高血压组、2级高血压组及3级高血压组血清脂联素水平逐渐降低,胰岛素抵抗指数(HOMA-IR)、颈动脉IMT逐渐升高,组间比较差异均有统计学意义(P<0.01)。Pearson相关分析显示,血清脂联素水平与收缩压、舒张压、稳态模型胰岛素抵抗指数、高敏C反应蛋白、颈动脉IMT均呈负相关(r=-0.670、-0.561、-0.302、-0.460、-0.539,P<0.01);多元线性回归分析结果显示,收缩压、舒张压、低密度脂蛋白胆固醇、颈动脉IMT是脂联素的独立影响因素(P<0.05)。结论血清脂联素水平随血压升高而降低,颈动脉IMT与脂联素关系密切,二者均可为高血压的防治提供依据。

Objective To investigate the relationship between serum adiponectin and carotid intima-media thickness （ IMT）, blood pressure and other related factors in patients with hypertension. Methods Eighty new hypertensive patients （ including 27cases of grade 1 hypertension,28 cases of grade 2 hypertension and 25 cases of grade 3 hypertension） and 30 healthy subjects as control group were enrolled into this study. Serum adiponectin level and correlated biochemical indicator were measured, carotid IMT was estimated by ultrasonic diagnostic equipment. SPSS software was used to analyze the dala. Results With the increase of blood pressure, serum adiponectin levels in control group, grade 1 hypertension group, grade 2 hypertension group and grade 3 hypertension group decreased gradually,the differences among the groups were significant（ P 〈 0.01 ）. Homeostatic model assessment for insulin resistance（HOMA-IR） and carotid IMT in the four group increased with the increase of blood pressure, the differences among the groups were significant（ P 〈 0.01 ）. Pearson correlation analysis revealed that adipoucetin was negative correlated with systolic blood pressure （SBP）, diastolic blood pressure （DBP）, HOMA-IR, high-sensitivity C-reactive protein and carotid IMT（ r = - 0. 670, - 0. 561, - 0.302, - 0. 460, - 0. 539, P 〈 0. 01 ）. Multiple linear regression analysis indicated that SBP, DBP, low density lipoprotein cholesterol （LDL-C） and carotid IMT were independent factors associated with serum adiponectin level （ P 〈 0. 05 ）. Conclusion Level of adiponectin decreases in patients with hypertension. Carotid IMT is correlated with adiponectin, and both of them can provid evidence for prevention of hypertension.