Nesfatin-1和Vaspin在老年高血脂和高血压患者中的水平及临床意义

Levels and clinical significance of Nesfatin-1 and Vaspin in elderly patients with hyperlipidemia and hypertension

目的测定老年高血脂和高血压患者血清人新饱食分子蛋白1(Nesfatin-1)和人内脏脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)水平,为老年高血脂和高血压患者在诊断、治疗、疗效观察方面提供临床依据。方法随机选取2020年7月至2021年7月期间与昆明市第二人民医院住院不同类型老年代谢性疾病患者101例,其中老年高血脂(HL)组40例,老年高血压(HT)组61例。收集同期健康老年人47例作为对照组。检测和收集一般临床指标,比较不同分组之间血浆Nesfatin-1和Vaspin水平。结果各组各指标差异性比较,HL组与HT组和对照组相比,Nesfatin-1、三酰甘油(TG)、总胆固醇(TC)、载脂蛋白B(ApoB)和ApoE表达水平显著升高,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇(HDL-C)表达水平显著降低,差异有统计学意义(P<0.05)。HL组与对照组相比,空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、低密度脂蛋白胆固醇(LDL-C)、ApoA和血红蛋白(Hb)表达水平显著升高,差异有统计学意义(P<0.05)。均值图走向结果显示,在HL、HT和对照组三组间,Nesfatin-1、Vaspin和ApoB表达水平趋势是一样的,而各组年龄层段的走势、HDL-C表达水平和Nesfatin-1、Vaspin和ApoB正好相反;FINS、HOMA-IR、Hb的走势一致;TG、TC、LDL-C、APOE几乎是一致的。Pearson相关性分析,Nesfatin-1与空腹血糖(FPG)、脂蛋白a(Lpa)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)呈显著负相关性(r=-0.168,-0.139,-0.221,-0.151;P=0.016,0.046,0001,0.031);Vaspin只和收缩压呈显著负相关(r=-0.145,P=0.033)。多元线性回归分析结果显示,ApoB、C反应蛋白(CRP)(β=0.571、-0.249,P<0.05)为血清Nesfatin-1的影响因素。结论在老年人群中,随着高血脂的发生,血清中Nesfatin-1的表达水平升高,调节血脂并参与了胰岛素抵抗的发生,血清Nesfatin-1与ApoB和CRP相关。Vaspin与血管收缩有关,可能与Nesfatin-1在调节糖脂代谢上有共同的作用。

Objective To determine serum Nesfatin-1 and Vaspin levels in elderly patients with hyperlipidemia and hypertension.This would provide a clinical basis for elderly patients with hyperlipidemia and hypertension in terms of diagnosis,treatment and efficacy observation.Methods A total of 101 elderly patients with different types of metabolic diseases,including 40 hyperlipidemia and 61 hypertension,hospitalized in The Second People′s Hospital of Kunming from July 2020 to July 2021 were randomly selected.Forty seven healthy elderly patients were selected as control group.Plasma Nesfatin-1 and Vaspin levels were compared between different groups.Results Comparing the differences of each index in each group.The expression levels of Nesfatin-1,TG,TC,ApoB and APOE were significantly higher in HL(hypertension)compared with HT(hyperlipidemia)and NP(normal person)groups,the difference was statistically significant(P<0.05).HDL-C expression levels were significantly lower,the difference was statistically significant(P<0.05).The expression levels of FINS,HOMA-IR,LDL-C,APOA and Hb were significantly higher in HL groups compared with NP groups,the difference was statistically significant(P<0.05).The mean plot trend results showed that the trend of Nesfatin-1,Vaspin and ApoB expression levels were the same among HL,HT and NP groups,while the trend of age strata,HDL-C expression levels and Nesfatin-1,Vaspin and ApoB were opposite in each group.The trend of FINS,HOMA-IR and Hb were similar.TG,TC,LDL-C and APOE were almost the same.For Pearson correlation analysis,Nesfatin-1 showed a significant negative correlation with FPG,HLa,HbAlc,and HOMA-IR(r=-0.168,-0.139,-0.221,-0.151;P=0.016,0.046,0.001,0.031).Vaspin was only significantly negatively correlated with systolic blood pressure(r=-0.145,P=0.033).Multiple linear regression analysis showed that ApoB and CRP(β=0.571,-0.249,P<0.05)were the influencing factors of serum Nesfatin-1.Conclusion In the elderly population,with the occurrence of hyperlipidemia,the expression level of Nesfatin-1 in serum increases,regulating blood lipids and participating in the occurrence of insulin resistance.Serum Nesfatin-1 is associated with ApoB and CRP.Vaspin is related to vasoconstriction and may have a common role with Nesfatin-1 in regulating glucose and lipid metabolism.