社区肥胖型高血压和瘦素抵抗的关系

目的在浦东社区非糖尿病人群调查的基础上 ,探讨肥胖型高血压和瘦素抵抗的关系。　方法 2 6 8位非糖尿病居民 ,以标准法测量血压以及身高、体重、腰围和臀围。根据不同水平的血压分为理想血压组、正常血压组、正常血压高值组、高血压组。用放射免疫法检测空腹瘦素和空腹胰岛素浓度。　结果在社区非糖尿病人群中 ,经性别和年龄校正后显示 ,随着血压值的增高 ,体重指数、腰围和胰岛素抵抗指数 (HOMA -IR)以及瘦素水平也增高 ,高血压组与理想血压组之间有明显差异 (P <0 .0 0 0 1)。多元回归分析显示 ,高瘦素血症与体重指数、HOMA -IR及舒张压明显相关 (P <0 .0 0 3) ;在与体重指数校正后 ,瘦素和血压的相关关系消失 ,而体重指数和血压的关系即使在瘦素水平校正之后仍保持明显的相关性 (P <0 .0 0 1)。　结论肥胖与瘦素抵抗及胰岛素抵抗相关 ,瘦素与血压的关系依赖于全身肥胖 (体重指数 )指标。在社区控制肥胖型高血压的首要措施是减轻体重 ,以减轻瘦素抵抗和胰岛素抵抗 ,降低血压。

Correlation Between Obesity-Related Hypertension and Leptin Resistance

Objective To explore, in a community-based study of nondiabetic individuals, the relationship between obesity-related hypertension and leptin resistance. Methods The 268 eligible residents of Shanggang community, volunteered to participate in this cross-sectional survey. Anthropome tric measurements and blood pressure were performed according to standard methods. Serum leptin and insulin were measured by means of a radioimmunoassay. The blood pressure status was defined as: optimal, normal, high-normal, high BP. Results After adjusting for sex and age, the subjects with higher BP had a significantly higher body mass index(BMI), waist and leptin level, HOMA-IR value, as compared those with optimal BP ( P <0.0001). In multiple linear regression analysis, fasting plasma leptin was significantly correlated to BMI, waist, HOMA-IR and diastolic pressure ( P <0.003). However, the significant association between leptin and blood pressure disappeared after adjusting for BMI, whereas the association between BMI and blood pressure persisted after adjusting for leptin level ( P <0.001). Conclusion We observed a strong relationship between leptin levels and overall obesity, insulin resistance in this study population. The association between leptin and blood pressure was dependent on BMI. Weight reduction is most important for lessen leptin and insulin resistance, and lower obesity-related hypertension in community.