宁夏农村居民血清脂联素和hs-CRP水平与高血压前期关系研究

目的 分析高血压前期人群中血清脂联素和超敏C-反应蛋白（hypersensitive C-reactive protein，hs-CRP）水平与心血管危险因素的关系，探讨血清脂联素和hs-CRP对高血压前期的影响。方法 在宁夏地区2008-2012年开展的横断面研究的基础上，将血压值按诊断标准分为正常组、高血压前期组和高血压组，收集人体测量数据和采集血液进行血清脂联素和hs-CRP水平的测定。结果 血清脂联素水平随着血压的升高呈递减趋势（Z=41.798，P<0.001），hs-CRP呈递增趋势（Z=31.213，P<0.001）。偏相关分析显示在调整年龄、性别、民族、文化程度、吸烟、饮酒和体育锻炼后，高血压前期人群中血清脂联素分别与体质指数（body mass index，BMI）、腰围、腰臀比、空腹血糖、胰岛素抵抗指数、舒张压、总胆固醇和甘油三酯呈负相关，与高密度脂蛋白胆固醇呈正相关（均有P<0.05）；血清hs-CRP分别与BMI、腰围、腰臀比、空腹血糖、收缩压和甘油三酯呈正相关（均有P<0.05）。Logistics回归分析显示，血清脂联素水平高是高血压前期的保护因素（OR=0.462，95%CI：0.263~0.811，P=0.007），血清hs-CRP与高血压前期的发生并无统计学关联（均有P>0.05）。结论 高血压前期已出现血清脂联素和hs-CRP水平的变化，并且与心血管危险因素间相互影响，同时血清脂联素是高血压前期的保护因素。

Association of serum adiponectin and hypersensitive C-reactive with pre-hypertension of rural residents in Ningxia

Objective To analyse the association of serum adiponectin and hypersensitive C-reactive protein(hsCRP) with pre-hypertension of rural residents in Ningxia,and to explore the effect of serum adiponectin and hs-CRP on pre-hypertensive.Methods On the basis of a cross-sectional study which was conducted in Ningxia during 2008-2012,subjects were classed by diagnostic criteria into three groups.Anthpometric data and blood samples were collected.Serum adiponectin and hs-CRP were measured with enzyme-linked immunosorbent assay.Results Serum adiponectin levels decreased with elevated blood pressure (Z =41.798,P ＜ 0.001),whereas an opposite pattern of differences was observed for serum hs-CRP (Z =31.213,P ＜0.001).After adjustment for confounders,serum adiponectin was inversely associated with body mass index(BMI),waist circumference(WC),waist-hip ratio(WHR),fasting blood glucose(FBG),HOMA-insulin resistance(HOMA-IR),diabolic blood pressure(DBP),total cholesterol(TC) and triglycerides(TG),and positively correlated with high density lipoprotein-cholesterol(HDL-C) (all P ＜ 0.05).A significant positive association also existed between serum hs-CRP and BMI,WC,WHR,FBG,systolic blood pressure(SBP) and TG (all P ＜ 0.05).Logistic regression analysis indicated serum adiponectin was independently associated with pre-hypertension(OR =0.462,95％ CI:0.263-0.811,P =0.007),hs-CRP may not be an independent risk factor of pre-hypertension in the rural residents in Ningxia(all P ＞ 0.05).Conclusions Serum adiponectin and serum hs-CRP levels were changed in pre-hypertensive,and related multiple cardiovascular risk factors in pre-hypertensive population.Serum adipomecin is the protective factor of prehypertensive.