原发性高血压患者血浆瘦素与神经肽Y浓度测定的意义

目的　研究原发性高血压患者神经肽Y与瘦素的相互关系。方法　采用放免分析法测定 2 6例健康对照者和原发性高血压 1级 4 2例、2级 4 6例及 3级 2 8例患者的空腹血浆瘦素 (LE)及神经肽Y (NPY)浓度。结果　血浆LE及NPY浓度均随血压的升高而升高 (F分别为 4 0 2和31 4 ,P均 <0 0 0 1) ,在正常对照组和高血压各组间均有显著性差异。相关分析表明 ,NPY和LE均与血压呈显著正相关 ,控制LE的影响后NPY仍与血压呈正相关 (P均 <0 0 5 ) ,而控制NPY的影响后LE与血压的相关性不再有显著性 (P >0 0 5 )。NPY浓度与LE浓度呈显著正相关 (R =0 5 5 9,P<0 0 0 0 1) ,同时控制性别、血压、血脂、BMI和HOMA IR的影响后两者仍呈显著正相关 (R =0 337,P <0 0 0 0 1)。结论　高血压患者存在瘦素抵抗 ,瘦素抵抗可能是高血压患者NPY升高的主要原因 ,而NPY的升高一方面可使血压升高 ,另一方面可能进一步加重瘦素抵抗。

Relationships between Neuropeptide Y and Leptin in Patients with Essential Hypertension

Objective To study the relationships of neuropeptide Y and leptin in patients with essential hypertension. Methods Radioimmunoassay was used to detect the fasting plasma neuropeptide Y (NPY) and Leptin (LE) in 26 healthy control subjects and hypertensive patients 1 grade (n42), 2 grade (n46) and 3 grade (n28). Results Both of LE and NPY plasma concentrations were increased with the increases of blood pressure (F40.2 and 31.4; P<0.001). Correlation analyses showed that both NPY and LE were positively correlated with SBP and DBP. After adjustment for LE, NPY were still positively correlated with SBP and DBP (P<0.05). However, after adjustment for NPY, no correlation between LE and blood pressure was found(P>0.05). The plasma NPY concentrations were positively related with plasma LE (R0.559, P<0.0001). After adjustment for sex, blood pressure, blood lipid, BMI and HOMA-IR, the plasma NPY concentrations were still positively correlated with plasma LE concentrations (R0.337, P<0.0001). Conclusion There were LE resistance in hypertensive patients, and it may be contributed to the increases in NPY. The increased plasma NPY concentrations may augment blood pressure, on the other hand it many enhance the leptin resistance.