原发性高血压人群脉压水平与胰岛β细胞功能的相关性研究  

Relationship between pulse pressure levels andβ-cell function in the patients with essential hypertension

作　　者：胡珂 王宝敏 张若楠 张娜 马婧 李晓牧 Hu Ke;Wang Baomin;Zhang Ruonan;Zhang Na;Ma Jing;Li Xiaomu(Department of Endocrinology and Metabolism,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院内分泌科,上海200032

出　　处：《中华糖尿病杂志》2023年第9期814-819,共6页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金(81970695)。

摘　　要：目的探讨原发性高血压人群脉压水平和胰岛β细胞功能的相关性。方法选取2013年1月至2014年12月于复旦大学附属中山医院高血压门诊就诊的原发性高血压患者共736例。所有患者均接受临床问诊、体格检查和生化检查。采用Spearman相关分析法分析稳态模型评估胰岛β细胞功能指数(HOMA-β)与收缩压、舒张压和脉压水平的相关性。将总人群根据HOMA-β四分位数水平分为Q1组(HOMA-β<140.5%),Q2组(140.5%≤HOMA-β<212.1%)、Q3组(212.1%≤HOMA-β<311.4%)和Q4组(HOMA-β≥311.4%),采用logistic回归分析法分析脉压水平和HOMA-β之间的关系。结果高血压总人群中合并糖尿病的患者占27.0%(199/736),其中新诊断糖尿病患者占10.9%(80/736)。高血压患者的收缩压(r=-0.07,P=0.057)、舒张压(r=0.04,P=0.287)与HOMA-β无显著相关性,脉压水平和HOMA-β之间存在负相关关系(r=-0.12,P=0.001)。单因素logistic回归分析显示,Q3和Q4组患者的脉压水平为HOMA-β的影响因素(OR=0.98,95%CI 0.97~0.99,P=0.002;OR=0.98,95%CI 0.97~1.00,P=0.009)。进一步校正性别、年龄、尿酸、体重指数、血脂情况、降压药物、既往史(心功能不全、脑血管病变)后,Q3和Q4组患者的脉压水平仍为HOMA-β的影响因素(OR=0.97,95%CI 0.96~0.99,P=0.001;OR=0.98,95%CI 0.97~1.00,P=0.023)。结论高血压患者易合并糖尿病,高血压患者的脉压水平是胰岛β细胞功能的影响因素。Objective To investigate the relationship between pulse pressure levels andβ-cell function in the patients with essential hypertension.Methods From January 2013 to December 2014,736 patients with essential hypertension were continuously enrolled from the Zhongshan Hospital Hypertension Clinic,Fudan University.Clinical consultation,physical examination and biochemical analysis were collected.The correlation between homeostasis model assessment forβ-cell function(HOMA-β)and levels of systolic blood pressure,diastolic blood pressure,and pulse pressure was analyzed using Spearman′s correlation analysis.According to HOMA-βquartile level,the total population was divided into Q1 group(HOMA-β<140.5%),Q2 group(140.5%≤HOMA-β<212.1%),Q3 group(212.1%≤HOMA-β<311.4%)and Q4 group(HOMA-β≥311.4%).Logistic regression was used to analyze the relationship between pulse pressure levels and HOMA-β.ResultsThe total hypertensive population with combined diabetes was approximately 27.0%(199/736),including 10.9%(80/736)of patients with newly diagnosed diabetes.There was no significant correlation between systolic blood pressure(r=-0.07,P=0.057),diastolic blood pressure(r=0.04,P=0.287)and HOMA-βin hypertensive patients.Pulse pressure levels were negatively and significantly correlated with HOMA-β(r=-0.12,P=0.001).Univariate logistic regression analysis showed that the level of pulse pressure in patients in the Q3 and Q4 groups was an influencing factor for HOMA-β(OR=0.98,95%CI 0.97-0.99,P=0.002;OR=0.98,95%CI 0.97-1.00,P=0.009).After further adjustment for sex,age,uric acid,body mass index,blood lipid,antihypertensive drugs and past history(cardiac insufficiency and cerebrovascular disease),pulse pressure levels of patients in the Q3 and Q4 groups remained an influencing factor for HOMA-β(OR=0.97,95%CI 0.96-0.99,P=0.001;OR=0.98,95%CI 0.97-1.00,P=0.023).Conclusion Hypertensive patients are prone to comorbid diabetes,and the level of pulse pressure was an influencing factor forβ-cell function.

关 键 词：高血压 糖尿病 脉压水平 胰岛Β细胞功能 

分 类 号：R544.11[医药卫生—心血管疾病]