宁夏农村居民血清脂联素和hs-CRP水平与高血压前期关系研究

Association of serum adiponectin and hypersensitive C-reactive with pre-hypertension of rural residents in Ningxia

目的分析高血压前期人群中血清脂联素和超敏C-反应蛋白(hypersensitive C-reactive protein,hsCRP)水平与心血管危险因素的关系,探讨血清脂联素和hs-CRP对高血压前期的影响。方法在宁夏地区2008-2012年开展的横断面研究的基础上,将血压值按诊断标准分为正常组、高血压前期组和高血压组,收集人体测量数据和采集血液进行血清脂联素和hs-CRP水平的测定。结果血清脂联素水平随着血压的升高呈递减趋势(Z=41.798,P<0.001),hs-CRP呈递增趋势(Z=31.213,P<0.001)。偏相关分析显示在调整年龄、性别、民族、文化程度、吸烟、饮酒和体育锻炼后,高血压前期人群中血清脂联素分别与体质指数(body mass index,BMI)、腰围、腰臀比、空腹血糖、胰岛素抵抗指数、舒张压、总胆固醇和甘油三酯呈负相关,与高密度脂蛋白胆固醇呈正相关(均有P<0.05);血清hs-CRP分别与BMI、腰围、腰臀比、空腹血糖、收缩压和甘油三酯呈正相关(均有P<0.05)。Logistics回归分析显示,血清脂联素水平高是高血压前期的保护因素(OR=0.462,95%CI:0.263~0.811,P=0.007),血清hs-CRP与高血压前期的发生并无统计学关联(均有P>0.05)。结论高血压前期已出现血清脂联素和hs-CRP水平的变化,并且与心血管危险因素间相互影响,同时血清脂联素是高血压前期的保护因素。

Objective To analyse the association of serum adiponectin and hypersensitive C-reactive protein（hsCRP） with pre-hypertension of rural residents in Ningxia,and to explore the effect of serum adiponectin and hs-CRP on pre-hypertensive.Methods On the basis of a cross-sectional study which was conducted in Ningxia during 2008-2012,subjects were classed by diagnostic criteria into three groups.Anthpometric data and blood samples were collected.Serum adiponectin and hs-CRP were measured with enzyme-linked immunosorbent assay.Results Serum adiponectin levels decreased with elevated blood pressure （Z =41.798,P 〈 0.001）,whereas an opposite pattern of differences was observed for serum hs-CRP （Z =31.213,P 〈0.001）.After adjustment for confounders,serum adiponectin was inversely associated with body mass index（BMI）,waist circumference（WC）,waist-hip ratio（WHR）,fasting blood glucose（FBG）,HOMA-insulin resistance（HOMA-IR）,diabolic blood pressure（DBP）,total cholesterol（TC） and triglycerides（TG）,and positively correlated with high density lipoprotein-cholesterol（HDL-C） （all P 〈 0.05）.A significant positive association also existed between serum hs-CRP and BMI,WC,WHR,FBG,systolic blood pressure（SBP） and TG （all P 〈 0.05）.Logistic regression analysis indicated serum adiponectin was independently associated with pre-hypertension（OR =0.462,95% CI：0.263-0.811,P =0.007）,hs-CRP may not be an independent risk factor of pre-hypertension in the rural residents in Ningxia（all P 〉 0.05）.Conclusions Serum adiponectin and serum hs-CRP levels were changed in pre-hypertensive,and related multiple cardiovascular risk factors in pre-hypertensive population.Serum adipomecin is the protective factor of prehypertensive.