高血压前期合并超重患者网膜素-1水平及其与尿微量白蛋白的相关性

The relationship between serum omentin-1 levels and microalbuminuria among prehypertensive patients with overweight

目的 观察单纯高血压前期以及合并超重患者血清网膜素-1水平及尿微量白蛋白的变化,探讨网膜素-1与尿微量白蛋白相关性.方法 选取2015年4～6月山西医科大学第二医院体检中心正常血压和高血压前期人群208例（男性98例,女性110例）.根据血压和体重指数（BMI）分成3组：正常对照组66例、单纯高血压前期组70例和高血压前期合并超重组72例.清晨空腹抽取静脉血测定血糖（FPG）、血脂、尿酸、血肌酐（SCr）、尿素氮（BUN）;采用双抗夹心ABC-ELLSA法测定网膜素-1;采用免疫透射比浊法测定尿微量白蛋白（MAU）水平.结果 与正常对照组比较,单纯高血压前期组和合并超重组网膜素-1均下降[分别为（41.02±9.02）ng/ml、（35.91±10.83）ng/ml比（54.96±8.94）ng/ml,P＜0.05],合并超重组下降更多（P＜0.05）.与正常对照组比较,单纯高血压前期组和合并超重组尿微量白蛋白均升高[分别为（17.66±9.50）mg/L、（26.19±24.97）mg/L比（5.08±0.22）mg/L,P＜0.05],合并超重组尿微量白蛋白水平升高更明显（P＜0.05）.Pearson相关分析显示,高血压前期组（包括单纯高血压前期组和合并超重组）网膜素-1与BMI、SBP、DBP、FBG、TC、MAU呈负相关,与HDL-C呈正相关.高血压前期组（包括单纯高血压前期组和合并超重组）MAU与年龄、BMI、SBP、FPG、LDL-C呈正相关,与网膜素-1呈负相关.进一步以MAU为应变量,三组人群SBP均为MAU独立影响因素,而网膜素-1均未进入回归方程.结论 网膜素-1参与高血压的发生与发展过程.高血压前期肾脏即有损害,合并超重时损害进一步加重,这为高血压管理前移提供了一定的理论依据.

Objective To observe serum omentin-1 levels and microalbuminuria among prehypertensive patients with overweight,and assess the relationship between serum omentin-1 levels and microalbuminria.Methods A total 208 subjects with normal blood pressure and prehypertension were recruited from the physical examination center of our hospital,from April 2015 to Jun 2015.They were divided to three groups：the normal group （n=66）,the prehypertension group（n=70）,and the prehypertension with overweight（n=72） according to blood pressure and body mass index （BMI）,fasting plasma glucose,dyslipidemia,plasma uric acid,creatinine and urea nitrogen were measured.Serum omentin-1 was measured and by ELLSA method and microalbuminuria by immunoturbidimetry.Results Serum omentin-1 levels were significantly lower in the prehypertension group [（41.02±9.02）ng/ml] and with overweight group [（35.91±10.83）ng/ml] than the normal control group [（54.96± 8.94）ng/ml]（P〈0.05）,in the prehypertension with overweight group was further lower （P〈0.05）.Of three groups examined,microalbuminuria was highest in the prehypertension with overweight group [（26.19±24.97）mg/L,P〈 0.05],and it was higher in the prehypertension group [（17.66±9.50）mg/L] than in the normal control group [（5.08±0.22）mg/L] （P〈0.05）.Pearson correlation analyses showed that serum omention-1 was negatively related with BMI,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,FBG,TC,MAU,while positively related with HDL-C in the total prehypertension.MAU was positively related with age,BMI,SBP,fasting plasma glucose,LDL-C,while negatively associated with omentin-1.The multivariable logistic regression analysis demonstrated MAU was independently associated with SBP,while omentin-1 was not into regression equation in every group.Conclusion Microalbuminuria existed in patients with prehypertension,and more obviously in patients with overweight.The result reflected that omentin-1 may be involved in the procession of MAU in the prehypertension group.