原发性高血压合并2型糖尿病患者肾素前体表达水平及与血管损伤的相关性

Association Between Plasma Prorenin and Vascular Damage in Essential Hypertension and Type 2 Diabetes Mellitus Patients

目的探讨原发性高血压合并2型糖尿病患者肾素前体表达水平及与血管损伤的相关性。方法入选原发性高血压患者78例,原发性高血压合并2型糖尿病患者41例。采集病史,并进行血压、颈-股动脉脉搏波传导速度的测量及生物化学指标的检查,应用酶联免疫吸附法测定患者血浆肾素前体浓度,应用SPSS 19.0统计软件进行分析,应用t检验比较两组间各指标均数是否具有统计学差异,采用Pearson相关分析肾素前体与颈-股动脉脉搏波传导速度及各指标的相关性,运用多元线性回归分析脉搏波传导速度的独立相关因素。结果两组间年龄、体质指数、舒张压、脉压、肌酐、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇的差异无统计学意义(P>0.05)。原发性高血压合并2型糖尿病组收缩压、空腹血糖、甘油三酯均高于原发性高血压组,差异有统计学意义(P<0.05)。原发性高血压合并2型糖尿病组肾素前体与原发性高血压组相比差异无统计学意义(P>0.05),原发性高血压合并2型糖尿病组颈-股动脉脉搏波传导速度值高于原发性高血压组,差异具有统计学意义(P<0.05)。对颈-股动脉脉搏波传导速度的相关因素进行分析显示,年龄、收缩压、脉压与颈-股动脉脉搏波传导速度相关(P<0.05),多元线性回归分析显示颈-股动脉脉搏波传导速度与年龄、收缩压独立相关(P<0.05)。结论 (1)原发性高血压合并2型糖尿病患者血浆肾素前体水平与原发性高血压患者无差异。(2)原发性高血压合并2型糖尿病时血管损伤加重,但与肾素前体间未见明确相关性。

Aim To investigate the level of the prorenin and the association between prorenin and vascular damage in essential hypertension and diabetes patients. Methods The cases were divided into essential hypertension （EH） group （n=78）, hypertension and type 2 diabetes mellitus （EH＋T2DM） group （n=41）. Collect the history of hypertension and diabetes. The plasma concentrations of prorenin were evaluated by enzyme-linked immunosorbent assay （ELISA） system, the carotid-femoral pulse wave velocity （cfPWV） was tested by the non-invasive vasculare testing device. SPSS 19.0 statistical software was applied to analyse the data. Unpaired independent t-test was used to analyze the comparisons between means. Pearson’s correlation coefficient was used to assess the association between prorenin and cfPWV. Multiple regression analysis was used to evaluate the independent determinants of cfPWV. Results Age, body mass index （BMI）, creatinine, total cholesterol （TC）, high density lipoprotein cholesterol （HDLC）, low density lipoprotein cholesterol （LDLC）, diastolic blood pressure and pulse pressure were not statistically different between the two groups （P〉0.05）, systolic blood pressure, triglyceride （TG） and fasting plasma glucose （FPG） in EH＋T2DM group were higher than in EH group （P〈0.05）. Prorenin were not statistically different between the two groups （P〉0.05）.cfPWV in EH＋T2DM group were higher than in EH group （P〈0.05）. Pearson’s correlation coefficient showed the age, diastolic blood pressure and pulse pressure were associated with cfPWV. Multiple regression analysis showed the age and systolic blood pressure were the independent determinants of cfPWV. Conclusions （1）Prorenin were not statistically different between EH＋T2DM group and EH group. （2）Essential hypertension in patients with type 2 diabetes increased the vascular damage, but the levels of plasma prorenin had no relationship with the vascular damage.