高血压伴糖尿病前期患者外周血白细胞端粒长度的变化

Changes of telomere length in peripheral blood leukocytes in hypertension patients with pre-diabetes

目的观察高血压伴糖尿病前期患者外周血白细胞相对端粒长度的变化,并探讨血压、血糖控制水平与端粒长度的相关性。方法应用实时荧光定量聚合酶链式反应方法检测2015年9月至2017年9月就诊的90例高血压伴糖尿病前期患者(病例组)及86例健康对照者(对照组)外周血白细胞相对端粒长度,并测量体质指数、收缩压、舒张压、脉压、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白及高敏C反应蛋白等,计算胰岛素抵抗指数。结果高血压伴糖尿病前期组外周血白细胞端粒长度[端粒重复序列的拷贝数与单拷贝基因拷贝数的比值(T/S)]为0.93±0.43,对照组为1.30±0.35,病例组较对照组明显缩短(P<0.05)。多元线性回归分析结果显示,病例组中,年龄、脉压、糖化血红蛋白、胰岛素抵抗指数及高敏C反应蛋白与端粒长度均呈负相关(P<0.05)。结论高血压伴糖尿病前期患者外周血白细胞相对端粒长度较正常对照者明显缩短,端粒长度缩短与脉压、血糖控制情况、胰岛素抵抗程度及慢性炎症程度有关。

Objective To observe the telomere relative length changes of peripheral blood leukocytes in patients with hypertension and pre-diabetes and explore the correlation of telomere length with blood pressure control level and blood glucose control level. Methods Ninety hypertension patients with pre-diabetes （ case group ） and 86 healthy subjects （control group ） were selected. Real-time fluorescence quantitative polymerase chain reaction was used to detect the telomere relative length of peripheral blood leukocytes. The body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin and high sensitivity c-reactive protein were measured, and the insulin resistance index was calculate. Results The telomere relative length [ ratio of the telomere repeat sequence copy number to single copy gene copy number （T/S） ] of peripheral blood leukocytes in case group was significantly shorter than that in control group （0. 93 ± 0. 43 vs 1.30 ± 0. 35, P 〈 0. 05 ）. Multiple linear regression analysis showed that age, pulse pressure, glycosylated hemoglobin, insulin resistance index and high sensitivity c-reactive protein were all negatively correlated with telomere length in case group. Conclusion The telomere relative length of peripheral blood leukocytes in patients with hypertension and pre-diabetcs is significantly shorter than that in healthy people. The telomere length shortening is related to the pulse pressure, blood glucose control situation, degree of insulin resistance and degree of chronic inflammation.