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目的通过前瞻性人群观察试验,探讨深海鱼皮的酶解产物海洋胶原肽干预对高血压患者的血压以及脂肪内分泌激素表达的影响。方法从社区中招募并筛选出符合条件的高血压患者100人和正常人自愿者50人,随机分为高血压干预组(C组)、高血压对照组(D组)和正常人对照组(N组),每组各50人。对所有研究对象进行饮食和行为方式指导,同时在常规药物治疗的基础上分别给予海洋胶原肽(6.5g/次,2次/d)或安慰剂,进行为期3个月的前瞻性双盲人群对照研究。分别于干预前和干预后1.5,3.0个月时测空腹血压并抽血检测所有观察对象的游离脂肪酸、瘦素、抵抗素、脂联素等脂肪内分泌激素的浓度变化并分析比较。结果海洋胶原肽干预前,两个单纯高血压组(C组、D组)的收缩压(SBP)、舒张压(DBP)、脉压差(PPD)、平均动脉压(MAP)水平均高于正常人对照组(N组)(P>0.05或P<0.05或P<0.01)。干预后,C组、D组的SBP均呈下降趋势,且差异有统计学意义(P<0.01)。C组干预后DBP水平呈明显下降趋势,与干预前比较差异有统计学意义(P<0.01),而D组的干预后DBP水平则呈轻度上升趋势,与干预前比较有统计学意义(P<0.05);C、D组的PPD水平和C组的MAP水平均呈明显下降趋势,与干预前比较差异有统计学意义(P<0.01);其他各组干预前后比较差异无统计学意义。海洋胶原肽干预前,C组、D组的游离脂肪酸(FFA)、抵抗素和瘦素水平均显著高于N组(P<0.01),但脂联素与N组比较差异无统计学意义。海洋胶原肽或安慰剂干预后,C组的FFA水平显著低于干预前水平(P<0.01);C组干预后3.0个月的脂联素水平显著高于干预前和干预后1.5个月(P<0.05)。各组干预前后抵抗素、瘦素水平差异无统计学意义。结论游离脂肪酸、抵抗素、脂联素和瘦素等脂肪内分泌激素的异常表达是高血压合并心血管并发症的重要作用机制;海洋胶原肽可抑制或促进脂肪内分泌激素的表达而发挥降血压的作用,对其作用机制的进一步研究,将为海洋类生物活性肽在防治高血压及其心血管并发症的临床应用提供线索和依据。
Objective To investigate the effects of marine collagen peptide, a hydrolyzate of deep-sea fish skin, on the blood pressure and the expression of fat and endocrine hormones in hypertensive patients through a prospective population-based observational test. Methods A total of 100 eligible hypertensive patients and 50 normal volunteers were enrolled and screened from the community and randomly divided into two groups: hypertension intervention group (C group), hypertension control group (D group) and normal control group N group), each group of 50 people. All subjects were given diet and behavioral guidance. At the same time, they were given the marine collagen peptide (6.5g / time, twice daily) or placebo on the basis of routine drug therapy, respectively, for a prospective double-blind population of 3 months Control study. The levels of free fatty acids, leptin, resistin, adiponectin and other fat and endocrine hormones in all the subjects were measured before and after the intervention at 1.5 and 3.0 months respectively. Results The levels of SBP, DBP, PPD and MAP in two simple hypertension groups before and after intervention with marine collagen peptide were higher Normal control group (N group) (P> 0.05 or P <0.05 or P <0.01). After intervention, the SBP of C group and D group showed a decreasing trend, and the difference was statistically significant (P <0.01). The level of DBP decreased significantly in group C compared with that before intervention (P <0.01), while the level of DBP increased slightly in group D after intervention (P <0.01), which was statistically significant compared with that before intervention P <0.05). The levels of PPD in group C and group D were significantly lower than those in group C (P <0.01), but there was no significant difference in other groups . Before intervention of marine collagen peptide, the levels of free fatty acids (FFA), resistin and leptin in groups C and D were significantly higher than those in group N (P <0.01), but there was no significant difference between adiponectin and N groups. The level of FFA in group C was significantly lower than that in group C after intervention with marine collagen peptide or placebo (P <0.01). The level of adiponectin in group C at 3.0 months was significantly higher than that before intervention and 1.5 months after intervention P <0.05). The levels of resistin and leptin in each group before and after intervention had no statistical significance. Conclusion The abnormal expression of free fatty acids, resistin, adiponectin and leptin is an important mechanism of hypertension with cardiovascular complications. Marine collagen peptide can inhibit or promote the expression of fat endocrine hormones to exert antihypertensive The further study of its mechanism of action will provide clues and basis for the clinical application of marine bioactive peptides in the prevention and treatment of hypertension and its cardiovascular complications.