新疆农村地区维吾尔族高血压患者血清游离脂肪酸与胰岛素抵抗的关系  

The relationship between serum free fatty acid and insulin resistance in Uygur hypertensive patients from a rural area of Xinjiang

作　　者：闫贻忠 木拉提[1] 牛强[1] 何佳[1] 刘佳铭[1] 张眉[1] 李述刚[1] 张景玉[1] 郭恒[1] 丁玉松[1] 马儒林[1] 芮东升[1] 郭淑霞[1] 

机构地区：[1]新疆石河子大学医学院预防医学系,新疆石河子832002

出　　处：《中华高血压杂志》2015年第9期863-867,共5页Chinese Journal of Hypertension

基　　金："十一五"国家科技支撑计划(2009BAI82B04);新疆生产建设兵团国际科技合作项目(2009YD33)

摘　　要：目的分析新疆农村地区维吾尔族高血压患者血清游离脂肪酸（FFA）与胰岛素抵抗（IR）的关系。方法将387例研究对象分为单纯IR组48例、单纯高血压组118例、高血压伴IR组52例及正常组169例共4组,比较4组间FFA的差异,分析FFA与高血压和IR的关系。结果4组间FFA水平比较,差异有统计学意义[正常组（0.40±0.18）比单纯IR组（0.57±0.21）比单纯高血压组（0.58±0.25）比高血压伴IR组（0.82±0.35）mmol/L,P〈0.01],调整年龄、体质量指数、血脂、空腹血糖及空腹胰岛素后,修正均数的差异仍有统计学意义[正常组（0.44±0.25）比单纯IR组（0.59±0.26）比单纯高血压组（0.57±0.24）比高血压伴IR（0.78±0.31）mmol/L,P〈0.01]。未发现IR和高血压对FFA水平存在交互作用。多因素Logistic回归分析发现,FFA与高血压、IR相关,与FFA〈0.40mmol/L组比较,≥0.79组发生高血压的OR值（95%CI）为6.54（1.82~23.52）;FFA 0.40~〈0.62、0.62~〈0.79和≥0.79组发生IR的OR值（95%CI）分别为4.67（1.38~15.84）、4.72（1.47~15.16）和5.40（1.71~17.06）。结论新疆农村地区维吾尔族人群中血清FFA水平与高血压和IR的发生有关,并均为独立相关。Objective To investigate the relationship between serum free fatty acid（FFA）and insulin resistance（IR）in Uygur hypertensive patients from a rural area of Xinjiang. Methods In total,118 essential hypertensive patients without IR（EH group）,48 normotensive subjects with IR（IR group）,52 essential hypertensive patients with IR（EH＋IR group）and 169 normotensive subjects without IR（N group）were enrolled in this study. Serum FFA was compared across the four groups to test whether FFA was associated with hypertension and IR. Results Serum FFA differed significantly across the four groups[N group（0.40±0.18）vs IR group：（0.57±0.21）vs EH group（0.58±0.25）vs EH＋IR group（0.82±0.35）mmol/L,P〈0.01],even after adjusting for age,body mass index,serum lipids,fasting plasma glucose and fasting insulin[N group（0.44±0.25）vs IR group（0.59±0.26）vs EH group（0.57±0.24）vs EH＋IR group（0.78±0.31）mmol/L,P〈0.01]. There was no significant interaction between IR or hypertension and serum FFA. Logistic regression analysis revealed that serum FFA was associated with hypertension and IR. Compared with patients with serum FFA of less than 0.40mmol/L,the odds of developing hypertension was 6.54（95%CI1.82-23.52）in patients with serum FFA ≥0.79mmol/L,and that of developing IR was 4.67（95% CI1.38-15.84）,4.72（1.47-15.16）and 5.40（1.71-17.06）in patients with serum FFA of 0.40-0.62,0.62-0.79 and ≥ 0.79 mmol/L,respectively. Conclusion In the rural area of Xinjiang,serum FFA was significantly associated with the presence of hypertension and IR in Uygur hypertensive patients.

关 键 词：维吾尔族 高血压 胰岛素抵抗 游离脂肪酸 

分 类 号：R544.1[医药卫生—心血管疾病]