中青年H型高血压患者同型半胱氨酸水平与炎症因子和瘦素的相关性分析

Correlation analysis of homocysteine level with inflammatory factors and leptin in young and middle-aged patients with H-type hypertension

目的探讨中青年H型高血压患者血浆同型半胱氨酸(Hcy)水平与炎症因子和瘦素(Leptin)水平的相关性。方法选取2017年7月至2019年6月来该院心内科住院诊断为H型高血压的中青年患者150例作为研究对象,其中男104例,女46例,平均年龄(51.21±5.71)岁。所有研究对象均在入院当天测量血压、身高和体质量等,并计算体质量指数(BMI),第2天清晨空腹抽取静脉血检测Hcy、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、白细胞介素(IL)-6、IL-10、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、Leptin水平。按照血浆Hcy水平将150例患者分为3组:Hcy<10μmol/L设为低Hcy组(42例),Hcy10~20μmol/L设为中Hcy组(54例),Hcy>20μmol/L设为高Hcy组(54例)。比较3组患者各检测指标的差异,分析Hcy与Leptin、IL-6、TNF-α、IL-10、hs-CRP的相关性,并用Logistic回归分析Hcy水平升高的危险因素。结果 3组患者FBG、HDL-C、LDL-C、TC、收缩压、舒张压、TG、BMI水平比较,差异均无统计学意义(P>0.05);3组患者IL-6、hs-CRP、TNF-α、Leptin水平随Hcy水平的升高而明显增加,差异均有统计学意义(P<0.05);而IL-10则随Hcy水平的升高而明显降低,差异有统计学意义(P<0.05)。Hcy与Leptin、IL-6、TNF-α、hs-CRP均呈正相关,(r=0.714、0.691、0.683、0.675,P<0.05),与IL-10呈负相关(r=-0.643,P<0.05)。Logistic回归分析显示,Leptin、IL-6、TNF-α、hs-CRP是中青年H型高血压患者Hcy水平升高的危险因素。结论中青年H型高血压患者Hcy水平与炎症因子和Leptin水平密切相关。

Objective To investigate the correlation between plasma homocysteine(Hcy)and inflammatory factors and leptin levels in young and middle-aged patients with H-type hypertension.Methods From July 2017 to June 2019,a total of 150 young and middle-aged patients diagnosed as H-type hypertension in the Department of Cardiology in the hospital were selected as the research objects.Among them,there were 104 males and 46 females,with an average age of(51.21±5.71)years old.Blood pressure,height,body mass and other general data of all the subjects were measured on the day of admission,and body mass index(BMI)was calculated.On the second morning,Hcy,fasting blood glucose(FBG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),cholesterol(TC),total triglyceride(TG),interleukin(IL)-6 and IL-10,tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP),leptin were measured.The patients were divided into three groups according to the plasma Hcy level:patients with Hcy<10μmol/L were set to low Hcy group(42 cases),patients with Hcy of 10-20μmol/L were set to the medium Hcy group(54 cases),and patients with Hcy>20μmol/L were set as high Hcy group(54 cases).The differences of the three groups were compared,and the correlation between Hcy and Leptin,IL-6,TNF-α,IL-10,hs-CRP was analyzed and the risk factors of increased Hcy level were analyzed by Logistic regression.Results There were no significant differences in the results of FBG,HDL-C,LDL-C,TC,systolic pressure,diastolic pressure,TG,BMI among the three groups(P>0.05),but IL-6,hs-CRP,TNF-α,Leptin levels increased significantly with the increase of Hcy in the three groups,and the differences were statistically significant(P<0.05).However,IL-10 decreased significantly with the increase of Hcy level,and the difference was statistically significant(P<0.05).Hcy was positively correlated with Leptin,IL-6,TNF-α,hs-CRP(r=0.714,0.691,0.683,0.675,P<0.05)and was negatively correlated with IL-10(r=-0.643,P<0.05).Logistic regression analysis showed that Leptin,IL-6,TNF-α,hs-CRP were risk factors for the increase of Hcy level in young and middle-aged patients with H-type hypertension.Conclusion Hcy level is closely related to inflammatory factors and leptin levels in young and middle-aged patients with H-type hypertension.