高血压病患者血清chemerin与颈动脉粥样硬化的关系  

Relationship between serum chemerin and carotid artherosclerosis in hypertensive patients

作　　者：彭清[1] 王小洁[2] 卢建刚[1] 陈梅[3] 

机构地区：[1]泸州医学院附属医院心内科,四川省646000 [2]泸州医学院附属医院内分泌科,四川省646000 [3]泸州医学院附属医院血液内科,四川省646000

出　　处：《中国心血管病研究》2013年第11期844-847,共4页Chinese Journal of Cardiovascular Research

基　　金：四川省卫生厅科研项目（编号：100252）

摘　　要：目的 研究高血压患者血清chemerin水平与颈动脉粥样硬化的相关性.方法 选择80例无糖尿病病史的高血压病患者和40例体检正常者,收集一般临床资料,测量血压、腰围、臀围,测定空腹血糖、空腹胰岛素和超敏C-反应蛋白（hs-CRP）等生化指标,采用ELISA法测定血清chemerin水平,用胰岛素抵抗指数（IRI）作为胰岛素敏感性评价指标,颈动脉超声检测颈动脉内-中膜平均厚度（IMT）.将高血压病患者分为斑块组（IMT≥1.5 mm）40例和无斑块组（IMT＜1.5 mm）40例.结果 腰围、低密度脂蛋白、空腹胰岛素、IRI、hs-CRP、chemerin及颈动脉IMT,高血压颈动脉斑块组、无颈动脉斑块组和对照组之间差异有统计学意义（P＜0.05）.高血压斑块组及无斑块组患者血浆ehemerin水平均与hs-CRP、IRI及IMT呈正相关（P＜0.05）.经单因素及多因素分析发现,IRI、hs-CRP及ehemerin与高血压发生颈动脉粥样硬化密切相关（OR值分别是2.134、2.248、1.101,P均＜0.05）.结论 高血压病患者chemerin与胰岛素抵抗及超敏C-反应蛋白密切相关,且chemerin是高血压病患者发生颈动脉粥样硬化的危险因素,提示chemerin可能通过胰岛素抵抗及非特异性炎症在高血压颈动脉粥样硬化发病过程中起重要作用.Objective To study the relationship between serum chemerin and carotid artherosclerosis （AS） in hypertensive patients. Methods The basic information was collected in eighty hypertensive patients without diabetic history and forty normal people as control. Blood pressure,waist circumference and hip cir- cumference were measured. Then blood samples were taken from them for measurement of biochemical indi- cators. Fasting serum chemerin was tested by enzyme linked immunosorbent assay （ELISA）. Insulin resistance index （IRI） was applied to estimate insulin resistance. Carotid artery intima-media complex thickness （IMT） were detected with uhrasonie. Hypertension patients were divided into AS group （IMT≥ 1.5mm,n=40） and non AS group（IMT〈1.5 mm,n=40）. Results Univariate analysis showed that there were significant difference in waist circumference, blood pressure, low density lipoprotein （LDL）, IRI, hsCRP, IMT and chemerin among hypertensive patients with carotid AS group, hypertensive patients without carotid AS group and those in nor- real control group （P〈0.05）. Pearson relation analysis showed that the chemerin level of the hypertensive pa- tients was positively correlated with IRI, IMT and hsCRP （P〈0.05）. Multiple factor Logistic regression analysis showed that IRI （OR=2.134,P〈0.05）, hsCRP （OR=2.248,P〈0.05）and chemerin （OR=I.101 ,P〈0.05） were associated with IMT. Conclusion The results suggest that the presence of chemerin is associated with sys-temie inflammation and insulin resistance of hypertensive patients. Furthermore, chemerin is an important risk factor for the carotid artherosclemsis in hypertensive patients. It implies that the chemerin may play pivotal roles in the pathogenesis and development of carotid artherosclerosis through systemic inflammation and in- sulin resistance in hypertensive patients.

关 键 词：高血压 颈动脉粥样硬化 血清Chemerin 

分 类 号：R544.1[医药卫生—心血管疾病]