老年糖尿病合并高血压患者血清瘦素与肾素血管紧张素系统的关系  

Relationship between serum leptin and renin-angiotensin system in the aged diabetic patients with hypertesion

作　　者：岳伟 王红 李兆雷 刘立先 王艳玲 柴国禄[2] 

机构地区：[1]黑龙江省佳木斯市骨科医院内科,黑龙江佳木斯154002 [2]佳木斯大学第五临床医院内分泌科,黑龙江佳木斯154002

出　　处：《中国医药导报》2014年第34期47-50,共4页China Medical Herald

摘　　要：目的研究血清瘦素(leptin)水平变化在老年糖尿病(DM)合并高血压(HT)发病中的可能作用,探讨合并HT老年DM患者血清leptin水平变化与肾素血管紧张素系统(RAS)活性的关系。方法选择50例合并HT老年2型DM患者(合并HT老年DM组)、50例血压正常老年2型DM患者(血压正常DM组)以及50名血压正常老年人(对照组)为研究对象,检测各组血清leptin、血浆AngⅡ水平,观察应用血管紧张素转换酶抑制剂(ACEI)马来酸依那普利(Enaiapril)治疗后,合并HT老年DM组患者血清leptin、血浆AngⅡ水平的变化,并分析其血清leptin水平与平均动脉压(MAP)、血浆AngⅡ水平的相关性。结果合并HT老年DM组患者血清leptin、血浆AngⅡ水平分别为(25.84±5.17)μg/L、(146.87±22.04)ng/L,均明显高于血压正常老年DM组患者[(17.63±4.26)μg/L、(98.74±13.63)ng/L]和对照组[(9.16±2.07)μg/L、(57.26±9.91)ng/L],差异均有高度统计学意义(P<0.01)。合并HT老年DM组患者血清leptin水平与MAP、血浆AngⅡ水平呈明显正相关(r=0.675、0.634,P<0.01)。应用ACEI Enaiapril治疗后,合并HT老年DM组患者血清leptin、血浆AngⅡ水平明显降低(P<0.01)。结论血清leptin水平升高在老年DM合并HT的发病中可能发挥重要作用,合并HT老年DM患者血清leptin水平影响患者血浆AngⅡ水平,RAS活性影响合并HT老年DM患者血清leptin水平。Objective To study the effect of serum leptin change in the development of hypertension and to investigate the relationship between the serum leptin change and rennin-angiotensin system activity in the aged diabetic patients with hypertension. Methods The levels of serum leptin and plasma angiotensin Ⅱ were measured in 50 cases of type 2 aged diabetic patients with hypertension（aged diabetic patients with hypertension group）, 50 cases of type 2 aged diabetic patients with normal blood pressure（aged diabetic patients with normal blood pressure group） and 50 cases of normal aged individuals（control group）. The changes of serum leptin and plasma angiotensin Ⅱ level were investigated in aged diabetic patients with hypertension group after treatment with ACEI inhibitor Enaiapril, and the relationship between the serum leptin and plasma angiotensin Ⅱ level and MAP were analyzed. Results The results showed that the serum leptin level and plasma angiotensin Ⅱ level in the aged diabetic patients with hypertension group [（25.84±5.17）μg/L,（146.87±22.04） ng/L] were significantly higher than those in the aged diabetic patients with normal blood pressure group [（17.63±4.26） μg/L,（98.74±13.63） ng/L] and control group [（9.16±2.07） μg/L,（57.26±9.91） ng/L], the differences were statistically significant（P〈0.01）. A positive correlation was found between serum leptin and MAP, plasma angiotensin Ⅱ in aged diabetic patients with hypertension group（r=0.675, 0.634, P〈0.01）. The levels of serum leptin and plasma angiotensin Ⅱ were significantly decreased after treatment with ACEI inhibitor Enaiapril in the aged diabetic patients with hypertension group（P〈0.01）. Conclusion The high serum level of leptin might play an important role in the development of hypertension in the aged diabetic patients. The level of plasma angiotensin Ⅱ is influenced by the level of serum leptin and the level of serum leptin is influenced by the renin-angeotensin-system activity.

关 键 词：老年2型糖尿病 高血压 瘦素 血管紧张素Ⅱ 

分 类 号：R687[医药卫生—骨科学]