高血压前期中医辨证分型与脂联素、瘦素、抵抗素水平的相关性研究

目的]研究脂联素、瘦素、抵抗素水平对高血压前期及其中医辨证分型的影响,并探讨其水平与年龄、体重指数、收缩压、舒张压、平均动脉压的相关性。方法]纳入初诊为高血压前期组受试者79例,其中肝火亢盛型20例、阴虚阳亢型18例、痰湿壅盛型22例、阴阳两虚型19例,同时纳入理想血压健康体检组受试者15例为对照组。分别测定上述受试者空腹血清脂联素、瘦素、抵抗素水平,并进行统计分析。结果]1)高血压前期组空腹血清脂联素显著低于对照组(P0.01),空腹血清瘦素、抵抗素水平显著高于对照组(P0.01)。2)痰湿壅盛型受试者脂联素水平低于其他3个证型(P0.05),瘦素、抵抗素水平高于其他3个证型(P0.05),肝火亢盛、阴虚阳亢、阴阳两虚3个证型经两两比较差异无统计学意义(P0.05)。3)在高血压前期组中,脂联素水平与收缩压和平均动脉压呈负相关,瘦素与收缩压、舒张压和平均动脉压呈正相关,抵抗素与上述指标无相关性。在对照组中瘦素与年龄、收缩压、舒张压和平均动脉压呈正相关,脂联素、抵抗素与上述指标无明显相关性。结论]1)高血压前期组较理想血压组脂联素水平下降,并且瘦素、抵抗素水平升高,且与血压水平有不同程度的相关性,说明脂肪组织可能参与了高血压前期的发生。2)痰湿壅盛型受试者脂联素水平低于其他3个证型,而瘦素、抵抗素水平高于其他3个证型,说明脂肪组织的内分泌功能可能影响高血压前期的中医辨证分型,或可成为高血压前期中医辨证分型的客观指标之一。3)对脂肪组织内分泌功能的干预或可成为预防高血压前期发生乃至发展为临床高血压的有效途径。

Correlation research between syndromes of traditional Chinese medicine and levels of adiponectin, leptin, resistin in pre-hypertension

Objective] To study the levels of adiponectin, leptin, resistin in pre-hypertension and its impact on syndrome differentiation, and to investigate the correlation among the levels of adiponectin, leptin, resistin and age, body mass index, systolic blood pressure, diastolic blood pressure, mean arterial pressure.Methods] Inclusion diagnosed as pre-hypertensive subjects in 79 cases as the pre-hypertension group, including 20 cases of liver-fire hyperactivity type, 18 cases of Yang hyperactivity and Yin deficiency type, 22 cases of excessive of phlegm-dampness type, 19 cases of Yin-Yang deficiency type, while incorporating 15 cases of healthy subjects with the ideal blood pressure as the control group. The subjects were measured in the levels of adiponectin, leptin, resistin in fasting serum, and statistically analyzed.Results] 1)The fasting serum adiponectin in pre-hypertension group was significantly lower than that of control group (P<0.01), fasting serum leptin, resistin levels were significantly higher than that in control group (P<0.01). 2) The level of adiponectin in excessive of phlegm-dampness type was lower than the other three types (P<0.05), leptin, resistin levels higher than the other three syndromes (P<0.05), and there was no statistically significant among the types of liver-fire hyperactivity, Yang hyperactivity and Yin deficiency, and Yin-Yang deficiency by pairwise comparisons (P>>0.05). 3)In pre-hypertension group, adiponectin levels was negatively correlated with systolic blood pressure and mean arterial pressure, leptin was positively correlated with systolic, diastolic, and mean arterial pressure, resistin had no significant correlation between these indicators. Leptin in the control group was positively correlated with age, systolic blood pressure, diastolic, and mean arterial pressure, but adiponectin and resistin had no significant correlation between these indicators.Conclusion] 1) Pre-hypertension group had lower level of adiponectin and higher levels of leptin and resistin than the control group, these levels had varying degrees of correlation with the blood pressure levels, indicating that adipose tissue may be involved in the occurrence of pre-hypertension. 2) The levels of adiponectin in the excessive phlegm-dampness type subjects were lower than other three syndromes, but the levels of leptin and resistin were higher, indicating that the endocrine function of adipose tissue may affect the pre-hypertension traditional Chinese medicine (TCM) syndrome differentiation, these levels may be the objective indicators of pre-hypertension TCM syndrome differentiation. 3)Interference to the endocrine function of adipose tissue may be the effective way of preventing pre-hypertension occurrence and even development into clinical hypertension.