原发性高血压患者血浆脂联素水平与胰岛素抵抗及高敏C反应蛋白的关系

目的：检测原发性高血压（EHP）患者血浆脂联素水平，探讨其与胰岛素抵抗及高敏C反应蛋白（hs—CRP）的关系。方法：选取原发性高血压患者（EHP组）102例及血压正常者（NT组）80例，测定空腹血浆脂联素浓度、血清胰岛素水平及hs—CRP，稳态模型法（HOMA）计算胰岛素抵抗指数（HOMA—IR）。结果：①EHP组的脂联素水平[（6．82±3．41）mg／L]明显低于NT组【（9．51±2．42）mg／L]，差异有高度统计学意义（P〈0．01）。②EHP组的hs—CRP水平[9．42±2．30）me／L]明显高于NT组[（4．68±1．73）mg／L]，差异有高度统计学意义（P〈0．01）。③HOMA—IR随血压水平升高而升高，2级及3级EHP组与NT组比较差异有统计学意义（P〈0．05）。④相关分析显示脂联素与收缩压（SBP）、舒张压（DBP）、体重指数（BMI）、腰围（we）、HOMA—IR、hs—CRP之间存在负相关。脂联素、BMI、hs—CRP、HOMA—IR为影响血压的独立因素。结论：①原发性高血压患者血浆脂联素水平较血压正常者明显降低，且其hs—CRP升高，存在胰岛素抵抗。②血压与脂联素、BMI、hs—CRP、HOMA—IR之间存在独立的相关性。

Relationship of plasma adiponectin levels,Insulin resistance and hs-CRP in patients with essential hypertension

Objective： To investigate the correlation between plasma adiponectin, Insulin resistance and hs-CRP by de- tecting plasma adiponectin levels in essential hypertensive （EHP） patients. Methods： 102 patients were enrolled in the EHP group, 80 patients were enrolled in the NT group. Fasting plasma adiponectin level, insulin, hypersensitive C-reactive （hs- CRP） were measured in each patient. HOM-A-IR was used as an insulin resistant index. Results： （1）The adiponectin level in EHP group [（6.82±3.41）mg/L] was significantly lower than that in NT group [（9.51±2.42）mg/L] （P〈0.01）. （2）The hs-CRP level in EHP group [（9.42±2.30）mg/L] was significantly higher than that in NT group [（4.68＋l.73）mg/L] （P〈0.01）. （3） HOMA-IR increased with the increment blood pressure. HOMA-IR in the 2nd and 3rd grade EHP groups were signifi- cantly higher than that in NT group （P〈0.05）. （4）Person correlation analysis markers showed significantly negatively corre- lations between plasma adiponectin and WC, BMI, SBP, DBP, HOMA-IR and hs-CRP. Adiponectin, BMI, HOMA-IR hs- CRP were the most independent factors that affecting the level of blood pressure. Conclusion： （1）The plasma adiponeetin levels are lower in patients with EHP than that in NT group. In the EHP group, hs-CRP level is increase and insulin resis- tant is aggravated. （2）There is an independent correlation between the levels of adiponectin, BMI, HOMA-IR hs-CRP and blood pressure.