高血压患者血清抵抗素水平与大动脉弹性的关系

目的 探讨高血压患者血清抵抗素水平与大动脉弹性改变的关系.方法 将入选的271例受试者分为正常对照组和高血压组,均检测血压、身高、体重、腰围、臀围、体质指数(BMI).用酶联免疫吸附法检测空腹血清抵抗素水平,放射免疫法检测血清肿瘤坏死因子-α(TNF-α)和胰岛素水平,用胰岛素抵抗指数(HOMA-IR)评价胰岛素抵抗.应用VP-1000动脉硬化分析仪测定受试者臂踝脉搏波传导速度(baPWV).结果 (1)高血压组血清抵抗素水平、baPWV和TNF-α均高于正常对照组[(0.65±0.12)μg/L比(0.59±0.13)μg/L;(1513.24±182.30)cm/s比(1301.69±151.15)cm/s;(5.69±1.98)μg/L比(3.83±2.38)μg/L;均P<0.01].(2)Pearson相关分析显示:高血压组血清抵抗素水平与baPWV、TNF-α、HOMA-IR呈正相关(r=0.219,r=0.212,r=0.183,P均<0.05);偏相关分析显示:血清抵抗素水平仍与baPWV、TNF-α呈正相关(r=0.238,P<0.01;r=0.207,P<0.05),而与HOMA-IR无关.(3)多元逐步回归分析显示:高血压组收缩压、年龄、TNF-α、血清抵抗素水平是影响baPWV的独立因素(R2=0.368,P<0.01).结论 高血压患者的大动脉弹性随着血清抵抗素水平的升高而降低.

Relationship between serum resistin level and large arterial elasticity in patients with essential hypertension

Objective To investigate the association between serum resistin concentration and large arterial elasticity in patients with essential hypertension (EH). Methods 271 recruited subjects were divided into the control group (n=134) and EH group (n=137). Blood pressure, waist circumference, hip, body mass index (BMI) were measured. Serum resistin concentration was assessed by enzyme was evaluated by insulin resistance index (HOMA-IR). Brachial ankle pulse wave velocity (baPWV) was tested by the full-automatic arteriosclerosis diagnostic instrument. Results (1) The serum resistin [(0.65±0.12)μg/L vs (0.59±0.13)μg/L; (1513.24±182.30) cm/s vs (1301.69±151.15) cm/s; (5.69±1.98) μg/L vs (3.83±2.38) μg/L;all P<0.01]. (2) Pearson correlation analysis showed that resistin was positively correlated with baPWV, TNF-α. and HOMA-IR in EH group(r=0.219,r=0.212, r=0.183, P<0.05 respectively) ; partial correlation analysis revealed that resistin was positively correlated with baPWV and TNF-α (r=0.238, P<0.01 ;r=0.207, P<0.05), but not with HOMA-IR. (3) Multivariate regression analysis showed that SBP, age, TNF-α, resistin were risk factors of impaired baPWV in EH group (R2=0.368, P<0.01). Conclusion Large arterial elasticity was decreased in proportion to increasing serum resistin level in hypertensive patients.