血清瘦素和NGAL在2型糖尿病合并不同分级高血压患者中的变化及其与左心结构和功能的关系  

Change of leptin and NGAL in type 2 diabetes with different grades of hypertension patients and their relationship with left heart structure and function

作　　者：李宝新[1,2] 郭淑芹[1] 张鑫[1] 常文龙[1] 李立琴[1] 王翯[1] 马爽[1] 张云良 LI Bao-xin;GUO Shu-qin;ZHANG Xin;CHANG Wen-long;LI Li-qin;WANG He;MA Shuang;ZHANG Yun-liang(Department of Endocrinology, Baoding NO. 1 Central Hospital, Baoding 071000, China;Hebei Medical University, Shijiazhuang 050017, China)

机构地区：[1]保定市第一中心医院内分泌科,河北省保定市071000 [2]河北医科大学,河北石家庄050017

出　　处：《现代医学》2018年第2期106-111,共6页Modern Medical Journal

基　　金：国家自然科学基金青年基金项目(81500644);河北省医学科学研究重点课题计划(20160282);保定市科学技术研究与发展计划(16ZF071)

摘　　要：目的:研究不同血压分级的2型糖尿病患者血清瘦素和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的变化,并分析其与左心结构和功能的关系。方法:收集住院的2型糖尿病患者208例,包括单纯糖尿病患者(DM组,50例),2型糖尿病合并高血压患者158例,依据血压水平又分为糖尿病高血压1级组(DH1组,53例),糖尿病高血压2级组(DH2组,51例),糖尿病高血压3级组(DH3组,54例),同期体检健康对照组(NC组,50例),ELISA检测血清瘦素和NGAL的水平,测量所有受试者超声心动图参数。对比受试者各项指标的差异,并分析其相关性。结果:与正常对照组和单纯糖尿病组相比,糖尿病合并高血压组随着血压分级的增加,超声心动图参数IVST、LVEDD、LVPWT、LAD、LVMI、血清LPN和NGAL水平均明显升高,且以DH3组最高(P<0.05);而参数LVEF和E/A随着血压分级的增加而显著降低,以DH3组最低(P<0.05)。多元逐步回归分析结果显示参数LVMI和收缩压均为LPN和NGAL的独立危险因素。结论:2型糖尿病患者随着血压分级的增高出现左心肥厚程度相应增加,而左心收缩功能随之降低,血清LPN和NGAL水平逐渐升高,表明LPN和NGAL均可能参与2型糖尿病合并高血压的发生并对其左心结构和功能产生影响。Objective：To study the levels of serum leptin（LPN）and NGAL and its correlation with left cardiac morphology and function in type 2 diabetes with different grades of hypertension patients.Methods：We chose two hundred and eight resident type 2 diabetes patients,including type 2 diabetes alone patients（DM group,n = 50）,and one hundred fifty-eight type 2 diabetes with hypertension patients（DH1 group,n = 53;DH2 group,n = 51;DH3 group,n = 54）,then fifty healthy people as NC group were enrolled in this study.The levels of serum leptin and NGAL were detected by ELISA,and the cardiac structure and function were examined.Compared the difference of each index in the groups,and index about the correlation between leptin and NGAL were analyzed.Results：The levels of IVST,LVEDD,LVPWT,LAD,LVMI,leptin and NGAL in DH1,DH2 and DH3 group were higher than those in the NC and DM groups（P 〈 0.05）,and those in the DH3 group were the highest（P 〈 0.05）,LVEF and E/A were decreased with the rising grade of hypertension,and in the DH3 group were the lowest（P 〈 0.05）.Correlation analyses showed that LPN and NGAL were positively correlated with SBP and LVMI.Further multiple linear regression analysis showed that SBP and LVMI were independent risk factors for serum LPN and NGAL levels.Conclusion：The left ventricular systolic function was decreased and left ventricular hypertrophy was increased with the rising grade of blood pressure.With the rise of blood pressure,the levels of serum LPN and NGAL were increased.LPN and NGAL might play important roles in the changes of left cardiac structure and function in T2 DM patients with hypertension.

关 键 词：2型糖尿病 高血压 瘦素 NGAL 左心功能 

分 类 号：R587.1[医药卫生—内分泌]