高血压伴肥胖患者血清脂联素水平与左心室肥厚及动脉粥样硬化的关系  

Correlation of serum adiponectin with left ventricular hypertrophy and carotid atherosclerosis in patients with hypertension and obesity

作　　者：王继萍[1] 童岚[1] 李修英[2] 张婧[2] 卢新卫[2] 冷吉燕[2] 

机构地区：[1]吉林大学第一医院放射科,长春130021 [2]吉林大学第一医院干部病房,长春130021

出　　处：《中华老年医学杂志》2012年第11期963-966,共4页Chinese Journal of Geriatrics

基　　金：吉林省发展与改革委员会项目（200906）

摘　　要：目的观察高血压伴肥胖患者血清脂联素（APN）水平变化，探讨其与左心室肥厚（LVH）、动脉粥样硬化（AS）的关系。方法选取50例原发性高血压患者分为单纯高血压组（23例）和高血压肥胖组（27例），另选45例血压正常者分为对照组（24例）和单纯肥胖组（21例）。酶联免疫吸附法（ELISA）测定血清APN水平，采用彩色多普勒超声仪测量颈总动脉内-中膜厚度（CCA—IMT）、颈总动脉内径（CADIA）及左心室各相关指数，计算左心室质量指数（LVMI）。结果对照组、单纯肥胖组、单纯高血压组和高血压肥胖组的空腹血糖（FPG）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL—C）和高密度脂蛋白胆固醇（HDL-C）差异具有统计学意义（F=81．97、8．56、25．53、15．19，均P〈0．05）；两两比较结果显示，高血压肥胖组FPG与对照组、单纯肥胖组比较差异具有统计学意义，单纯肥胖组、单纯高血压组、高血压肥胖组TG、LDL—C均较对照组升高、HDL—C较对照组降低，而高血压肥胖组TG、TC、LDI。C较单纯高血压组增高（均P〈0．05）。对照组、单纯肥胖组、单纯高血压组、高血压肥胖组中血清APN水平依次降低、CADIA逐渐减小，LVMI依次升高、CCAIMT逐渐增高（F=28．34、10．26、36．52、14．73，均P％0．01），经两两比较差异均有统计学意义（均P〈0．05）。相关分析显示，APN与LVMI、CCA—IMT呈明显的负相关（r=-0．870、-0．710，均P〈0．01），与CADIA呈正相关（r=0．742，P〈0．01）。逐步回归分析显示，APN、收缩压和体质指数（BMI）是影响左心室肥厚的主要因素（0值分别为-0．909、0．126、-0．053）。结论高血压与肥胖同时存在时，两者可能起协同作用，APN水平的降低、BMI的增加可能加速高血压伴肥胖患者LVH和AS的发生和发展。Objective To investigate the relationship of serum adiponeetin（APN） with left ventricular hypertrophy （LVH） and carotid atherosclerosis （AS）, and to observe the change of serum adiponectin levels in patients with hypertension and obesity. Methods Patients with essential hypertension （50 cases） were divided into simple hypertension group （23 cases） and hypertension with obesity group（27 cases）,and 45 normotensives were divided into control group （24 cases） and simple obesity group （21 cases） .The levels of serum adiponeetin were determined by enzyme immunoassay. Common carotid artery intima-media thickness （CCA-IMT）, carotid artery diameter （CADIA） and left ventricular relevant index were measured by color doppler ultrasonography, and left ventricular mass index （LVMI） was calculated. Results In control group, simple obesity group, simple hypertension group and hypertension with obesity group, serum APN levels were decreased by turn, CADIA reduced gradually, LVMI values were increased by turn, CCA-IMT values were increased gradually （F=28.34, 10.26, 36.52, 14.73, all P〈0.01）. Correlation analysis showed that serum APN levels were significantly negatively correlated with LVMI and CCA-IMT（r=- 0. 870,- 0. 710,both P〈0.01）, and were positively related with CADIA （r=0. 742,P〈0.00）. APN, SBP and BMI were the main influencing factors on left ventricular hypertrophy （β =- 0. 909, 0. 126, -0. 053）. Conclusions The presence of both hypertension and obesity may play a synergistic role in accelerating the process of left ventricular hypertrophy and atherosclerosis. Lower APN levds and/or rising BMI may accelerate occurrence and development of LVH and AS in aged patients with hypertension and obesity.

关 键 词：高血压 肥胖症 脂联素 动脉粥样硬化 

分 类 号：R544.1[医药卫生—心血管疾病]