瘦素抵抗与高血压左室肥厚及动脉粥样硬化的相关性

Correlation analysis of leptin resistance,hypertensive left ventricular hypertrophy and atherosclerosis

目的探讨瘦素抵抗(LR)与高血压左室肥厚(LVH)及动脉粥样硬化(AS)之间的关系。方法选择原发性高血压(EH)患者80例及健康体检者40例,应用酶联免疫吸附法(ELISA)测受试者血清瘦素(LP)、可溶性瘦素受体(SLR)水平,行超声检查测定左室质量指数(LVMI)及颈动脉内膜-中层厚度(c IMT),依据LVMI及c IMT分别分为高血压左心室肥厚组40例(HLVH组)、EH不伴LVH组40例(non-LVH组)、健康体检者40例(对照组)及c IMT增厚组61例、c IMT正常组59例。结果 (1)non-LVH组血清LP水平高于对照组,血清SLR水平低于对照组(P<0.05),HLVH组血清LP水平高于non-LVH组及对照组,血清SLR水平低于non-LVH组及对照组(P<0.05)。(2)c IMT增厚组血清LP水平高于c IMT正常组,血清SLR水平低于c IMT正常组。(3)LP与LVMI及c IMT呈显著正相关(r=0.757,0.694,P<0.001),SLR与LVMI及c IMT呈显著负相关(r=-0.682,-0.708,P<0.001)。结论血清LP及SLR水平与LVMI及c IMT密切相关,说明LP抵抗可能参与了高血压LVH及AS的形成和发展。

Objective To analyze the correlations between leptin resistance with left ventricular hypertrophy （LVH） and atherosclerosis （AS） in hypertension. Methods Serum leptin and SLR levels of 80 patients with essential hypertension （EH） and 40 healthy subjects were assessed by enzyme -linked immunosorbent assay （ELISA）. UCG was performed in all subjects for left ventricular mass index （LVMI） and carotid intima media thickness （cIMT）. The partici- pants were divided into hypertensive left ventricular hypertrophy group （ HLVH group, n = 40 ） , essential hypertension without LVH group （non- LVH group, n = 40）, healthy subjects （control group, n = 40） based on LVMI. Meanwhile, they were divided into thickened cIMT group （n =61） and normal cIMT group （n =59） base on cIMT. Results Serum leptin level was significantly higher in non - LVH group than control group ; higher in HLVH group than non - LVH and control groups （P 〈 0. 05 ）. Serum SLR was significantly lower in non- LVH group than control group; lower in HLVH group than non - LVH and control groups （ P 〈 0. 05 ）. Serum leptin level was significantly higher in thickened cIMT group than normal cIMT group （ P 〈 0. 05 ）. Serum SLR was significantly lower in thickened cIMT group than normal cIMT group （ P 〈 0. 05 ）. Serum leptin level was positively correlated with LVMI and cIMT （ r = 0. 757 and 0. 694, P 〈 0. 001 ）, whereas serum SLR level was negatively correlated with LVMI and cIMT （r = - 0. 682 and - 0. 708, P 〈 0. 001 ）. Con- clusion Serum leptin and SLR levels are closely associated with LVMI and cIMT, indicating a possible role of leptin re- sistance closely related the development and progression of LVH and AS in hypertension.