高血压患者白细胞内源性硫化氢与糖脂代谢指标的关系

The study on the effect of leukocyte-derived hydrogen sulfide in the regulation of metabolismin people of hypertension

目的探讨高血压患者白细胞内源性H_2S水平与血脂、血糖等营养代谢指标的可能关系。方法研究2012-10至2014-02在解放军总医院国际医学中心进行查体的高血压患者212例,根据体重指数、胰岛素水平进行分组分析。所有入选对象测定白细胞H_2S产生量,并对其与血压、血脂、血糖、糖化血红蛋白、胰岛素水平、尿酸等代谢指标关系分析,比较各组研究对象白细胞内H_2S产生量的差异,并进一步采用相关及回归分析探讨之间的关系。结果超重组[(0.49±0.21)mmol/μg]及肥胖组[(0.49±0.35)mmol/μg]高血压患者5 h白细胞H_2S产生总量均明显下降,明显低于体重正常组[(0.93±0.44)mmol/μg,P<0.05]。高胰岛素水平患者白细胞内源性H_2S产生量降低(P<0.05)。相关分析发现体重指数、尿酸水平、空腹胰岛素水平均与内源性H_2S产生量存在负相关关系(P<0.01);而HDL-C水平则与H_2S产生存在正相关关系(Pearson相关性=0.205,P<0.01)。进一步回归分析显示白细胞H_2S产生量可以影响其空腹胰岛素水平,较低的H_2S水平造成空腹胰岛素水平的升高。结论高血压患者白细胞内源性H_2S水平将对其营养代谢稳态产生调节作用,H_2S产生不足将升高胰岛素水平,降低胰岛素敏感性,加重营养代谢的异常,从而进一步推动病程的进展。

Objective To investigate the effect of leukocyte-derived hydrogen sulfide on regulation of metabolism in hypertensive person. Methods 212 cases of hypertensive subjectswereenrolled,all these persons came from PLA general hospital from Oct2012 to Feb 2014. Measure theleukocytic productivity of hydrogen sulfide inhypertensive person. Then,measure the metabolism index such as fetal glucose,TC,TG,HDL-C,LDL-C,insulin and so on and analyze the relationship of the leukocyte-derived hydrogen sulfide and those plasma indexandcompare the difference according BMI or insulin level. Results The leukocytic productivity of hydrogen sulfide of overweight and obesity grouphave difference compared with that with normal BMI（ 0. 49 ± 0. 21 vs 0. 49 ± 0. 35 vs 0. 93 ± 0. 44,P〈0. 05） further analysis show that hypertension with high insulin level has significantly lower hydrogen sulfide level than those of normal（ P〈0. 05）,and the leukocytic productivity of hydrogen sulfide exists apparent negative correlation with BMI,insulin level and blood uric acid（ P〈0. 01）; positive correlation with HDL-cI（ r = 0. 205,P〈0. 01）. The leukocytic productivity of hydrogen sulfide contribute to the change of insulin. Conclusions Leukocyte-derived hydrogen sulfide play role on the regulation of metabolism in hypertension,lower speed of the leukocyte-derived hydrogen sulfide may lead to higher insulin level,which will worsen the abnormal nutrient homeostasis,speed up the process of hypertension.