平均动脉压水平与血清脂联素浓度相关性研究

目的探讨不同平均动脉压水平与血清脂联素浓度的相关性。方法入选187例受试者,按不同血压水平以及治疗情况分为正常血压组、正常高值血压组、高血压未治疗组以及高血压正规药物治疗组。用放射免疫法检测血清脂联素浓度与尿微量白蛋白含量;计算胰岛素抵抗指数HOMA—IR和尿微量白蛋白与肌酐比（ACR）。结果（1）比较正常血压组和正常高值血压组发现,两组间平均动脉血压水平（89±6）mmHg比（102±7）mmHg,1mmHg=0.133kPa]和脂联素浓度（中位数值：15．58μg／ml比9．06μg/ml）均有统计学意义（P〈0．01）;高血压治疗组的脂联素浓度明显高于未治疗组（11．89μg/ml比5．37μg/ml,P〈0．01）。（2）Pearson相关分析也发现脂联素浓度与平均动脉血压呈负相关（r=-0.479,P〈0．001）;按性别分层分析也得到类似的结果（r=-0．441,P〈0．001）。（3）多元线性逐步回归分析发现平均动脉血压和胰岛素抵抗指数是血清脂联素的独立影响因素,两者解释了57％的血清脂联素浓度的变异。结论平均动脉血压对脂联素浓度的影响独立于胰岛素抵抗状态和肾脏排泄功能;平均动脉血压水平高的患者,其血清脂联素浓度相对偏低。

Association between serum adiponectin and mean blood pressure

OBJECTIVE: To investigate the relationship between serum adiponectin and mean blood pressure (BP). METHODS: A total of 187 subjects were devided into four groups according to BP levels: optimal blood pressure group (n = 38), high normal blood pressure group (n = 50), treated hypertension group (n = 54) and untreated hypertension group (n = 45). Serum adiponectin and microalbuminuria were detected by radioimmunology assay. Insulin resistant index defined as HOMA-IR and urinary concentration of microalbuminuria/urinary concentration of creatinine defined as albumin creatinine ratio (ACR) were calculated. RESULTS: (1) Serum adiponectin decreased in proportion to BP increase and the serum adiponectin level was significantly higher in treated hypertension group than untreated hypertension group. (2) Correlation analysis showed that adiponectin concentration was negatively correlated with mean blood pressure (P < 0.01). (3) Multivariate regression analysis revealed that mean blood pressure and HOMA-IR were independent predictors of serum adiponectin level. CONCLUSIONS: Mean blood pressure was the main determinant of serum adiponectin level and negatively correlated to serum adiponectin level.