依那普利对老年糖尿病合并高血压患者血清APN、血浆Ang Ⅱ和Leptin水平的影响

Effect of enalapril on adiponectin,Ang Ⅱ and Leptin in patients with diabetes mellitus complicated with hypertension

目的观察老年糖尿病(DM)合并高血压(HT)患者血清脂联素(APN)、血浆血管紧张素Ⅱ(AngⅡ)及血浆瘦素(Leptin)水平的变化,并探讨血管紧张素转换酶抑制剂依那普利对其影响。方法选择2013年12月至2015年12月在我院门诊就医的老年DM血压正常患者(A组)和老年DM合并HT患者(B组)各50例,以体检健康老年人50例作为对照组(C组),测定并比较三组受检者的血清APN和血浆AngⅡ和Leptin水平,并观察依那普利对老年DM合并HT患者血清APN和血浆AngⅡ和Leptin水平的影响。结果与C组[APN(7.79±1.28)mg/L、AngⅡ(55.62±8.98)ng/L、Leptin(9.18±2.13)ng/m L]相比,A组[APN(5.25±1.27)mg/L、AngⅡ(92.51±14.79)ng/L、Leptin(16.88±2.97)ng/m L]和B组[APN(3.21±1.53)mg/L、AngⅡ(152.12±21.56)ng/L、Leptin(24.89±4.96)ng/m L]DM患者血清APN明显降低、血浆AngⅡ升高、Leptin水平明显升高,差异均具有统计学意义(P<0.05)。B组患者血清APN与其MAP呈负相关(r=-0.56,P<0.05);血浆AngⅡ与患者MAP呈明显正相关(r=0.69,P<0.05);Leptin水平与MAP呈明显正相关(r=0.59,P<0.05);血清APN与血浆AngⅡ则呈现显著负相关(r=-0.55,P<0.05)。老年DM合并HT患者应用依那普利治疗后,患者在血压降低的同时其血清APN明显升高[治疗前(3.21±1.53)mg/L,治疗后(6.53±0.91)mg/L],AngⅡ[治疗前(152.12±21.56)mg/L,治疗后(106.32±18.94)mg/L]和Leptin水平[治疗前(24.89±4.96)mg/L,治疗后(18.33±3.28)mg/L]明显降低,差异均具有统计学意义(P<0.05)。结论血清APN降低、血浆AngⅡ和Leptin水平升高可能是老年DM发生HT的重要原因;依那普利可使老年DM合并HT患者血清APN水平明显降低,AngⅡ和Leptin水平明显升高。

Objective To observe the changes of serum adiponectin(APN),plasma angiotensin Ⅱ(Ang Ⅱ)and Leptin levels in elderly patients with diabetes mellitus(DM) complicated with hypertension(HT).Methods Fifty elderly DM patients with normal blood pressure(group A) and 50 elderly patients with DM complicated with HT(group B) in our hospital from December 2013 to December 2015 were selected.At the same time,50 healthy elderly subjects of physical examination were enrolled as the control group(group C).The levels of serum APN,plasma Ang Ⅱ and Leptin were measured and compared between the three groups.The effect of enalapril on levels of serum APN,plasma Ang Ⅱ and Leptin were observed.Results Compared with group C [APN(7.79±1.28) mg/L,AngⅡ(55.62±8.98) ng/L,Leptin(9.18 ± 2.13) ng/m L],the APN level were significantly decreased,Ang Ⅱ level were increased,and Leptin levels were significantly increased in group A [(5.25 ± 1.27) mg/L,(92.51 ± 14.79) ng/L,(16.88 ± 2.97) ng/m L] and group B[(3.21±1.53) mg/L,(152.12±21.56) ng/L,(24.89±4.96) ng/m L],P<0.05.The levels of serum APN were negatively correlated with MAP in group B(r=-0.56,P<0.05);Plasma Ang Ⅱ was significantly positively correlated with MAP(r=0.69,P<0.05);The level of Leptin was significantly positively correlated with MAP(r=0.59,P<0.05);Serum APN and plasma Ang Ⅱ showed significant negative correlation(r=0.55,P<0.05).After treatment with enalapril for elderly DM patients complicated with HT,with the decrease of blood pressure,the serum APN significantly increased [(3.21±1.53) mg/L vs(6.53±0.91) mg/L],while AngⅡ [(152.12±21.56) mg/L vs(106.32±18.94) mg/L] and Leptin levels [(24.89±4.96) mg/L vs(18.33±3.28) mg/L] were significantly decreased,with statistically significant difference(P<0.05).Conclusion Level decrease in APN and increase in Ang Ⅱ and Leptin may be the important reasons for the occurrence of HT in elderly DM.Enalapril can significantly reduce the serum APN levels in elderly patients with DM complicated with HT,and increase the Ang Ⅱ and Leptin levels.