高血压患者血清脂联素与游离脂肪酸、糖及脂代谢  

Serum Adiponectin, Free Fatty Acid and Glucose & Lipid Metabolism in Patients with Essential Hypertension

作　　者：李嘉强[1] 戴颖秀 刘玉敏[2] 郑基 刘文斌 

机构地区：[1]上海市杨浦区疾病预防控制中心,上海200090 [2]上海交通大学分析测试中心 [3]上海市杨浦区平凉社区卫生服务中心 [4]上海市杨浦区五角场社区卫生服务中心

出　　处：《高血压杂志》2006年第5期352-355,共4页Chinese Journal of Hypertension

基　　金：上海市杨浦区卫生局科研基金资助(2002AA001-005)

摘　　要：目的 研究不同糖耐量原发性高血压患者（EH）血清脂联素水平、游离脂肪酸（FFA）谱特征及与其他糖脂代谢参数阀关系。方法用放射免疫分析法测定122例EH患者与43例正常对照组血清脂联素水平，同时用气相色谱／质谱（GC／MS）联用法测定其血清FFA成分水平。结果EH患者血清脂联素水平[（7．2±4．7）mg／L]低于正常对照组[（9．2±4．3）mg／L，P〈0．053，伴有糖耐量受损（IGT）、伴有糖尿病（DM）亚组病人血清脂联素均显著下降（P〈0．05～0．01）。EH患者血清总脂肪酸[TFA（1291．6±503．7 vs 1064．6±470．3）μmot／L]和多不饱和脂肪酸[PUFA（712．5±284．3vs517．3±216．3）μmol／L，P〈0．05～0．01]水平显著高于正常对照组。IGT和DM组的TFA和PUFA也显著高于正常对照组和单纯高血压糖耐量正常亚组（P〈0．01）。脂联素与BMI、腹围（WC）、腹／臀围比（WHR）、TG呈负相关（r=-0．217，-0．227，-0．172，-0．193，P〈0．01～0．05），与HDL-C呈正相关（r=0．361，P〈0．01）。结论脂联素水平与游离脂肪酸代谢紊乱，可能在原发性高血压、特别是在伴有糖代谢异常的高血压发病中起重要作用。血清脂联素水平下降可能是原发性高血压伴有糖代谢异常的特征性生化指标之一。Objective To explore the relationship between serum adiponectin（ADPN） , free fatty acid（FFA）, glucose and lipid metabolism in patients with essential hypertension （EH） with abnormal glucose metabolism. Methods Serum ADPN was determined using the radioimmunoassay, and FFA profile was measured by gas chromatography and mass spectrometer（GC/MS） in 122 EH and 43 control subjects. Results Levels of ADPN in EH were significantly lower than those in the control group （7.2±4. 7 vs 9.2±4. 3 mg/L, P〈0. 05）. ADPN in EH with impaired glucose tolerance （IGT） and diabetes mellitus （DM） were significantly decreased （P〈0. 05-0. 01）. Total FFA （TFA, 1291.6±503.7 vs 1064. 6± 470. 3 /μmol/L, P 〈 0.05） and polyunsaturated fatty acid （ PUFA, 712.5 ± 284. 3 vs 517.3 ± 216.3 /μmol/L, P〈0. 01） in EH were significantly increased as compared with normal subjects. TFA and PUFA in EH with IGT and DM were increased remarkably than that in the healthy controls and EH with normal glucose tolerance（P〈0. 01）. ADPN was negatively correlated with BMI, WC, WHR, TG （ r= -0.217, -0.227, -0.172, -0.193, P〈0.01-0.05） and positively with HDL-C（r=0.361, P〈0.01 ） . Conclusion These data suggest that serum adiponectin levels and the FFA metabolic abnormality was associated with EH with glucose metabolic abnormality （GMA）. Low adiponectin level was related to impairment of glucose metabolism in hypertension patients.

关 键 词：原发性高血压 游离脂肪酸谱 气相色谱/质谱联用技术 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]