老年高血压患者血清抵抗素水平的初步研究

Study of the serum resistin level in elderly patients with essential hypertension

目的 检测老年高血压患者血清抵抗素浓度 ,探讨抵抗素在老年人糖耐量降低中的意义。 方法 酶免疫测定法检测 5 5例高血压患者 (老年组 2 5例 ,非老年组 30例 )和 13例正常血压非老年者 (对照组 )的空腹血清抵抗素水平 ,口服葡萄糖耐量试验 (OGTT) ,胰岛素释放试验测定血浆葡萄糖浓度和血清胰岛素浓度 ,计算葡萄糖曲线下面积 (AUCG) ,根据Cederholm公式计算胰岛素敏感指数 (ISI)和OGTT开始 30min胰岛素和血糖变化的比值 (△I3 0 /△G3 0 ) ;测定体重指数 (BMI)及腰臀比 (WHR)。 结果 空腹血清抵抗素浓度老年组显著高于非老年组 (P <0 0 5 )和对照组 (P <0 0 5 ) ,分别为 (2 9 6± 12 4 )、(2 3 1± 8 9)和 (19 7± 5 3) μg/L ;空腹血糖 (FPG)老年组显著高于非老年组 (P <0 0 5 )和对照组 (P <0 0 5 ) ,分别为 (6 4± 1 2 )、(4 8± 0 4 )和 (4 9± 0 6 )mmol/L ;ISI老年组 (32 8± 10 8)显著低于非老年组 (4 8 8± 15 8) (P <0 0 5 ) ;△I3 0 /△G3 0 老年组 (8 6± 7 2 )显著低于非老年组 (14 0± 10 5 ) (P <0 0 5 )。年龄与抵抗素浓度呈显著正相关 ,FPG与年龄及抵抗素浓度呈显著正相关 ,年龄与ISI及△I3 0 /△G3 0 呈显著负相关 ,抵抗素浓度与ISI及△I3 0 /△G3 0

Objective To investigate the serum resistin concentration in elderly patients with essential hypertension and potential role of resisitin in the decline of glucose tolerance . Methods Fasting serum resistin concentration was measured with enzyme immunoassay in 55 patients with essential hypertension (including 25 elderly patients and 30 non elderly patients) and 13 normotensives (control group).Oral glucose tolerance test and insulin release test were performed to calculate glucose area under the curve (AUC G ), the ratio of insulin level change to glucose level change during the first 30 min after glucose ingestion (△I 30 /△G 30 ) and insulin sensitivity index (ISI) according to the Cederholm' formula. Height, body weight, waist and hip circumferencs were measured for calculating body mass index (BMI) and waist hip ratio (WHR). Results The fasting serum resistin concentrations in the elderly group was higher than those in the non elderly group 〔(29 6±12 4) vs (23 1±8 9) μg/L, P <0 05〕 and the control group 〔(29 6±12 4) vs (19 7±5 3) μg/L, P <0 05〕 Fasting plasma glucose (FPG) in the elderly group was higher than that in the non elderly group 〔(6 4±1 2) vs (4 8±0 4) mmol/L, P <0 05〕 and in the control group 〔(6 4±1 2) vs (4 9±0 6) mmol/L, P <0 05〕. The ISI in the elderly group was lower than that in the non elderly group (32 8±10 8 vs 48 8±15 8, P <0 05). △I 30 /△G 30 in the elderly group was lower than that in the non elderly group (8 6±7 2 vs 14 0±10 5, P <0 05). Pearson analysis showed that age was correlated with fasting serum resistin concentrations ( P <0 001), while FPG was correlated with both the age ( P <0 001) and the fasting serum resistin concentrations ( P <0 01). The age and the fasting serum resistin concentrations were negatively correlated with the ISI ( P <0 001, P <0 05) and △I 30 /△G 30 ( P <0 05 and P <0 05). Conclusions The increase of fasting serum resistin level in the elderly patients with essential hypertension may cause the decline in glucose tolerance. A possible mechanism is that the excessive resisitin leads to the development of insulin resistance and an impairment of β cell secretory function.