老年收缩期高血压患者性别与血清双酚A和脂联素及代谢综合征的关系  

Study on the relationship among sex differential and serum bisphenol-A, adiponectin and metabolic syndrome in elderly patients with isolated systolic hypertension

作　　者：王国平[1] 吕吉元[5] 杨国庆[2] 安琴[3] 栾静[4] 乔中东[6] 冯翠萍 

机构地区：[1]山西医科大学附属长治市医院心血管内科,长治046000 [2]山西医科大学附属长治市医院超声医学科,长治046000 [3]山西医科大学附属长治市医院老年病科,长治046000 [4]山西医科大学附属长治市医院重症医学科,长治046000 [5]山西医科大学第一临床医院心血管内科,030001 [6]上海交通大学农业与生物学院,200240 [7]山西省长治市第二人民医院心血管内科,046000

出　　处：《中华老年医学杂志》2017年第3期292-296,共5页Chinese Journal of Geriatrics

基　　金：山西省自然科学基金项目支持（2010011055-1）;山西省长治市科技星火资助项目（200704009）

摘　　要：探讨老年单纯收缩期高血压（EISH）患者性别与血清双酚A、脂联素及代谢综合征的关系。方法采用回顾性研究方法，选择2010年1月至2013年12月就在诊于山西医科大学附属长治市人民医院心血管内科与老年病科及山西医科大学第一临床医院心血管内科EISH患者540例，依据性别的不同分为女性组和男性组各270例。另设560例健康老年人为对照（健康对照组），女性300例，男性260例。分别测定血清双酚A、脂联素水平变化。常规检测血脂、胰岛素抵抗指数（HOMA—IR）、血压、体质指数、心率变异性、心脏和血管超声变化。结果EISH男性组、EISH女性组血清双酚A浓度为（0．89±0．10）ng／L、（0．64±0．10）ng／L，均较对照男性组、女性组（0．57±0．04）ng／L、（0．55±0．08）ng／L增加（F值分别为23．76、23．86，均P〈0．01）；脂联素水平降低，（4．9±1．4）ng／L，比（10．5±2．7）ng／L、（6．0±1．3）ng／L比（11．5±3．3）ng／L（F值分别为13．10、16．20，均P〈0．01）；RR间期的均方根减低（F值分别为13．10、13．70，均P〈0．01）。血清双酚A与体质指数和收缩期血压呈正相关（r=0．38，0．54，P〈0．01）；与血清脂联素及RR间期的均方根呈负相关（r值分别为0．46，0．42，均P〈0.01）。结论EISH患者血清双酚A水平存在性别差异，网络细胞因子可能芪同参与肥胖相关性高血压的病理过程。Objectives To investigate the relationship of sex difference with serum bisphenol-A （BP A）, adiponectin and metabolic syndrome （MetS）in elderly patients with isolated systolic hypertension（EISH）. Methods A retrospective study of the clinical data was conducted in 540 subjects from the Cardiology and Geriatric Department in the Affiliated Hospital of Shanxi Medical University, Changzhi Municipal People, s Hospital and the Department of Cardiology of Shanxi Medical University,First Clinic Hospital from January 2010 to December 2013. Elderly patients with EISH were divided into male group（n= 270）and female group（n= 270）. Meanwhile 560 older health persons were severed as controls,including 300 females and 260 males. The changes of BP-A and adiponectin （Ad） concentration were measured. The blood lipid, insulin resistance index （HOMA IR）, blood pressure,body mass index,heart rate variability and ultrasonic change of heart and blood vessel were tested regularly. Results The level of serum BP-A[（0.89±0. 10）ng/L vs. （0.57±0.04）ng/L]and [（0.64±0.10） ng/L vs. （0.55±0.08）ng/L]were higher in male EISH vs in male control, and in female EISH than in female control （F = 23.76, 23.86, all P 〈 0.01 ）, respectively. The levels of adiponectin were lower in male EISH vs eontrol[（4.9±1.4）ng/L vs. （10.5±2.7）ng/L and in female EISH vs control（6.0±1.3）ng/L vs. （11.5±3.3）ng/L）,F=13.10,16.20,all P〈0.01. Root mean sequare of the successive normal sinus RR interval difference（rMSSD）were lower in male/ female EISH than control groups（F= 13.10.13.70, P 〈 0.01 ）. Serum BP A level was positively correlated with the bocly mass index and systolic pressure （r = 0.38, 0.54, P 〈 0.01）, and was negatively correlated with serum Ad and rMSSD（r= -0.46,-0.42,P〈0.01）. Conclusions Obvious gender difference in changes of serum BP-A exists in older patients with EISH. Network cytokines may take part in the pathophysiological process of the obesity related hype

关 键 词：高血压 脂联素 代谢综合征X 

分 类 号：R544.1[医药卫生—心血管疾病] R589[医药卫生—内科学]