2型糖尿病合并高血压患者血清脂联素水平的变化及其意义

目的探讨2型糖尿病合并高血压患者血清脂联素水平的变化及其意义。方法随机选取2型糖尿病患者120例,肥胖者68例与非肥胖者52例,2型糖尿病患者合并高血压120例,肥胖者62例与非肥胖者58例,正常对照组50名。分别检测以上三组患者的空腹脂联素、瘦素、肿瘤坏死因子(TNF)-α、胰岛素、空腹和馒头餐后2h血糖、糖化血红蛋白(HbA1c)、体重指数(BMI)、血压、总胆固醇、甘油三酯(TG),计算胰岛素敏感指数(ISI),比较脂联素水平变化,并与其他因素进行相关分析及逐步回归分析。结果2型糖尿病合并高血压组和单纯2型糖尿病组血清脂联素水平低于正常对照组(P<0.01),2型糖尿病合并高血压组血清脂联素水平低于单纯2型糖尿病组(P<0.01)。多元线性相关分析显示,2型糖尿病合并高血压组中,脂联素与BMI、收缩压、空腹血糖、胰岛素、甘油三酯、瘦素、TNF-α之间存在显著负相关,与ISI呈独立正相关,进入回归方程的因素为脂联素、瘦素、TNF-α、BMI、TG、收缩压;2型糖尿病非高血压组中,脂联素与空腹血糖、胰岛素、甘油三酯、瘦素、TNF-α之间呈显著负相关,与ISI呈独立正相关,进入回归方程的因素为脂联素、瘦素、TNF-α、TG。结论在2型糖尿病患者中,血清脂联素水平明显降低,合并高血压者血清脂联素水平更低,脂联素水平与高血压之间存在一定的相关性。

Clinical study of adiponectin level in hypertension patients with 2 type diabetes

Objective To investigate the adiponectin level in hypertension patients with 2 type diabetes mellitus.Methods One hundred and twenty cases of type 2 diabetes,68 cases of obesity,52 cases of not obesity; 120 cases of hypertension patients with 2 type diabetes mellitus,62 cases of obesity,58 cases of not obesity and 50 normal controls were enrolled in this study.Fasting plasma adiponectin,leptin,tumor necrosis factor(TNF-α),insulin,fasting and 2 h postprandial blood glucose,glucosylated hemoglobin(HbA1c),body mass index(BMI),blood pressure,total cholesterol,triglyceride(TG) were measured in these three groups and insulin sensitivity index(ISI) was calculated to observe the changes in adiponectin levels and its relation to other factors by a multiple linear stepwise regression analysis. Results The levels of serum adiponectin in both type 2 diabetes with hypertension group and type 2 diabetic group were significantly lower than those control subjects(P<0.01).The levels of plasma adiponectin in the group which had both type 2 diabetes with hypertension group was lower than that in the type 2 diabetic group(P<0.01).Plasma adiponectin in type 2 diabetes with hypertension group was negatively related to BMI,blood pressure,fasting blood glucose,fasting insulin,TG,Leptin,TNF-α,while positively to ISI.Multiple linear regression showed that adiponectin,Leptin,TNF-α,BMI,TG,blood pressure were entered in the regression equation.Plasma adiponectin in type 2 diabetes group was negatively related to fasting blood glucose,fasting insulin,TG,Leptin,TNF-α,while positively to ISI.Multiple linear regression showed that adiponectin,Leptin,TNF-α and TG were entered in the regression equation.Conclusion The patients with type 2 diabetes have lower plasma adiponectin levels,the patients with both type 2 diabetes and hypertension have much lower levels.There was negative and significant correlation between adiponectin and blood pressure.