瘦素抵抗与老年男性肥胖高血压的关系

背景目前已经了解血清瘦素与肥胖的关系密切,血清瘦素和胰岛素与伴有肥胖的高血压关系如何? 目的研究老年男性肥胖高血压患者血清瘦素和胰岛素水平的变化,探讨瘦素抵抗与老年男性肥胖高血压的关系. 设计以诊断为依据,设立对照的回顾性研究. 单位华中科技大学同济医学院附属协和医院神经内科、核医学科. 对象 62例老年男性患者均来自 2001- 10/2002- 06华中科技大学同济医学院附属协和医院的住院和门诊患者,年龄 60～ 82岁.高血压的诊断采用 1999年世界卫生组织建议的血压判定标准收缩压≥ 140 mm Hg ( 1 mm Hg=0.133 kPa)和(或)舒张压≥ 90 mm Hg即诊断为高血压.方法用放射免疫法测定 41例高血压和 21例正常血压的老年男性患者血清瘦素和胰岛素的含量. 主要观察指标老年男性肥胖患者和非肥胖者血压、体质量指数、血清瘦素和胰岛素水平. 结果高血压肥胖者较正常血压肥胖者血清瘦素和胰岛素含量分别升高 1.8 μ g/L和 2.7 mIU/L,差异均有显著性意义( t=2.212,2.395,P< 0.01).高血压肥胖者较非肥胖者血清瘦素和胰岛素水平分别升高 2.7 μ g/L和 4.7 mIU/L,差异均有显著性意义( t=3.348,5.113,P均 < 0.001).高血压 70岁以上者较高血压 60～ 70岁者血清瘦素水平升高 1.7 μ g/L,差异均有显著性意义( t=2.767,P< 0.05). 结论 老年肥胖高血压患者存在瘦素抵抗和胰岛素抵抗,瘦素与伴肥胖的高血压有密切关系.

Relationship between leptin resistance and obesity-related hypertension in elderly men

BACKGROUND:It has been known that there exists a close relationship between leptin and obesity.Then,how are serum leptin and insulin related to obesity-related hypertension(ORH)? OBJECTIVE:To study the changes of serum leptin and insulin in elderly men with ORH,and investigate the relationship between leptin resistance and ORH in elderly men. DESIGN: Retrospective controlled study based on diagnosis. SETTINGS:The Department of Neurology and the Department of Nuclear Medicine,Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS: Altogether 62 elderly male inpatients or outpatients aged from 60 to 82 years in the Affiliated Union Hospital of Tongji Medical College from October 2001 to June 2002 were selected.The diagnosis of hypertension was based on the diagnostic criteria established by the WHO in 1999:systolic blood pressure(SBP) ≥ 140 mm Hg(1 mm Hg=0.133 kPa) and(or) diastolic blood pressure(DBP) ≥ 90 mm Hg. INTERVENTIONS:The content of serum leptin and insulin in 41 hypertensive and 21 normotensive elderly men was determined by the method of radioimmunoassay. MAIN OUTCOME MEASURES:Blood pressure,body mass index (BMI),serum leptin and insulin level. RESULTS:The content of serum leptin and insulin in the hypertensive obese men were increased significantly by 1.8 μ g/L and 2.7 mIU/L,respectively,as compared with that in the normotensives (t=2.212,2.395,P< 0.01). The level of serum leptin and insulin in the ORH patients was increased by 2.7 μ g/L and 4.7 mIU/L,respectively,as compared with that of the normotensives with significant differences (t=3.348,5.113,all P< 0.001). The level of serum leptin in the hypertensive patients older than 70 years was significantly increased by 1.7 μ g/L compared with that of those aged 60 to 70 years(t=2.767,P< 0.05). CONCLUSION:Resistance to leptin and insulin exists in obesity-related hypertension of elderly men and leptin is closely associated with obesity-related hypertension.