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目的:观察原发性高血压患者血清高分子质量(high molecular weight,HMW)脂联素水平,探讨其与血压、肥胖、糖脂代谢、胰岛素抵抗及超敏C反应蛋白(hs-CRP)的关系。方法:纳入76例研究对象,以有无原发性高血压分为对照组和高血压组(各38例)。所有研究对象均行口服75g葡萄糖耐量试验(OGTT),检测空腹血糖、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、餐后2 h胰岛素(2 h INS)及血脂水平,并以稳态模型评估胰岛素抵抗指数(HOMA-IR)。采用化学发光法检测血清hs-CRP水平,酶免法检测HMW脂联素水平。结果:高血压组血清HMW脂联素质量浓度为0.82(0.46~1.46)ng/L,明显低于对照组[2.53(1.70~5.75)ng/L,P<0.01]。相关分析显示血清HMW脂联素与收缩压、舒张压、平均动脉压(MAP)、体质量指数(BMI)、腰臀比、三酰甘油、空腹血糖、2 h PG、HOMA-IR、hs-CRP呈负相关,与高密度脂蛋白胆固醇(HDL-C)呈显著正相关。多元逐步回归分析提示收缩压、三酰甘油是血清HMW脂联素水平的独立影响因素(P<0.05)。二分类Logistic回归分析表明,HMW脂联素是高血压的保护因素(P<0.01)。结论:原发性高血压人群血清HMW脂联素水平明显降低,且与血压、肥胖、糖脂代谢、胰岛素抵抗及hs-CRP密切相关,提示低HMW脂联素血症可能参与了原发性高血压的发生发展。
OBJECTIVE: To observe the level of serum adiponectin (HMW) in patients with essential hypertension and to explore its relationship with blood pressure, obesity, glucose and lipid metabolism, insulin resistance and high-sensitivity C-reactive protein (hs-CRP) relationship. Methods: A total of 76 subjects were enrolled in this study. The patients with primary hypertension were divided into control group and hypertension group (38 cases each). All subjects were given oral 75g glucose tolerance test (OGTT), fasting blood glucose, 2 h postprandial blood glucose (2 h PG), fasting insulin (FINS), 2 h postprandial insulin (2 h INS) Insulin resistance index (HOMA-IR) was assessed using a steady-state model. The level of hs-CRP in serum was detected by chemiluminescence and the level of HMW adiponectin was detected by enzyme immunoassay. Results: The serum HMW adiponectin concentration of hypertension group was 0.82 (0.46-1.46) ng / L, which was significantly lower than that of control group [2.53 (1.70-5.75) ng / L, P <0.01]. Correlation analysis showed that serum HMW adiponectin correlated with systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), body mass index (BMI), waist-hip ratio, triglyceride, fasting blood glucose, 2 h PG, HOMA-IR, hs- CRP was negatively correlated with high-density lipoprotein cholesterol (HDL-C) was significantly positively correlated. Multiple stepwise regression analysis showed systolic blood pressure. Triglyceride was an independent predictor of serum HMW adiponectin level (P <0.05). Logistic regression analysis showed that HMW adiponectin was the protective factor of hypertension (P <0.01). CONCLUSIONS: The serum levels of HMW adiponectin in essential hypertension patients were significantly lower and closely related to blood pressure, obesity, glucose and lipid metabolism, insulin resistance and hs-CRP, suggesting that low HMW adiponectin may be involved in the primary Hypertension occurs.