微量白蛋白尿及假性血友病因子与高血压代谢综合征的关系

目的:比较伴代谢综合征的高血压患者与单纯高血压患者的微量白蛋白尿(microalbuminuria, MAU)及假性血友病因子(von Willebrand factor, vWF)水平的差异,探讨二者与代谢综合征的关系.方法:连续收治的133例患者,根据2005年国际糖尿病联盟(International Diabetes Federation, IDF)代谢综合征全球定义分为伴代谢综合征(metabolic syndrome, MS)的高血压组(97例)与单纯高血压组(36例).测定血生化、血浆vWF、24 h尿白蛋白排泄率(urine albumin excretion, UAE)及晨尿白蛋白/肌苷比(albumin/creatinine ratio, ACR).应用统计学方法分析MAU、vWF与代谢综合征的关系.结果:同单纯的高血压患者相比,伴MS的高血压患者腰围、体重指数、甘油三酯(triglyceride,TG)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol, LDL-C) 升高(P<0.05或<0.01),而高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C) 降低(P<0.01);血浆vWF含量及UAE增加 (P均<0.05).]高血压患者UAE与ACR之间存在显著相关性(r=0.707, P<0.01).而vWF与UAE及ACR则未见显著的相关性(r分别为0.079及0.052,P均>0.05).Logistic回归分析显示HDL-C, TG, LDL-C, vWF及UAE与高血压患者MS的发生具有关联性 (相应的标准化回归系数分别为-0.825, 0.63, 0.339, 0.331, 0.371,P<0.05] 或<0.01).结论:相比单纯高血压,伴MS的高血压患者MAU增加,内皮损伤程度更重.UAE与ACR显著相关.vWF、UAE均与高血压患者MS的发生有关.

Association of microalbuminuria and von Willebrand factor with metabolic syndrome in hypertensive patients

Objective:To compare the difference of microalbuminuria (MAU) and von Willebrand factor (vWF) between essential hypertensives and hypertensive patients with metabolic syndrome (MS), and to explore the association of these factors with MS. Methods: According to the new definition of MS by International Diabetes Federation (IDF) for 2005, 133 consecutive essential hypertensives were divi-ded into two groups: hypertensive patients with metabolic syndrome (EH-MS group, n=97), and essential hypertensives (EH group, n=36). Biochemistry assay, plasma vWF, 24 hours urine albumin excretion (UAE) and morning urine albumin/creatinine ratio (ACR) were measured. The association of MAU and vWF with MS was analysed. Results: Waist circumference, body mass index, triglyceride (TG), low density lipoprotein cholesterol (LDL-C), plasma vWF and UAE were increased(P<0.05 or P<0.01, respectively), while high density lipoprotein cholesterol (HDL-C) was decreased (P<0.01) in EH-MS group, as compared with those in EH group. UAE was positively correlated with ACR (r=0.707, P<0.01). vWF was not correlated with UAE or ACR (r=0.079 and 0.052,P>0.05, respectively). Logistic regression showed HDL-C, TG, LDL-C,vWF and UAE were associated with the deve-lopment of MS in hypertensive patients (standardized coefficients: -0.825, 0.63, 0.339, 0.331, 0.371,P<0.05 or P<0.01, respectively). Conclusion: Compared with essential hypertensives, the hypertensive patients with MS had more MAU and serious endothelial dysfunction. UAE was correlated significantly with ACR. vWF and UAE were associated with the development of MS in patients with hypertension.