原发性高血压分级与胰岛素抵抗、血浆内皮素-1的关系

目的探讨血浆内皮素-1(endothelin-1,ET-1)、胰岛素抵抗(insulin resistance,IR)和原发性高血压(高血压)分级之间的关系。方法入选150例门诊及体检科新发现的高血压患者,按照2010年《中国高血压防治指南》诊断标准和血压分级原则,分为高血压1级组(52例)、高血压2级组(50例)、高血压3级组(48例),分别检测患者的血浆ET-1、空腹血糖(fasting blood glucose,FBG)、空腹血清胰岛素(fasting serum insulin,FINS)浓度。IR检测采用HOMA法,计算胰岛素敏感指数(insulin sensitivity index,ISI)。结果高血压3级组ISI明显小于高血压2级组和高血压1级组,差异有统计学意义(0.31±0.07 vs.0.43±0.06 vs.0.52±0.03,P<0.05);高血压2级组ISI明显小于高血压1级组,差异有统计学意义(P<0.05)。高血压3级组血浆ET-1浓度明显高于高血压2级组和高血压1级组,差异有统计学意义(166.27±10.58)ng.L-1vs.(156.74±12.11)ng.L-1vs.(148.62±11.45)ng.L-1,P<0.05];高血压2级组血浆ET-1浓度明显高于高血压1级组,差异有统计学意义(P<0.05)。相关分析结果显示,ISI与收缩压呈负相关(r=-0.58,P<0.05),与舒张压也呈负相关(r=-0.56,P<0.05);ET-1与收缩压呈正相关(r=0.60,P<0.05),与舒张压也呈正相关(r=0.59,P<0.05)。结论 IR及血浆ET-1浓度升高与高血压血压分级有密切关系。

Relationships among insulin resistance, endothelin-1 and essential hypertension grading

Objectives To investigate the relationships among plasma concentration of endothelin-1 （ET-1）, insulin resistance （IR） and essential hypertension （EH） grading. Methods Totally 150 patients with EH newly diagnosed by physical examination were selected. They were divided into three groups based on their EH grading by 2010 Chinese Hypertension Treatment Guideline： EH grade 1 group （52 cases）, EH grade 2 group （50 cases）, EH grade 3 group （48 cases）. Plasma concentrations of ET- 1, fasting blood glucose （FBG）, fasting serum insulin （FINS） of the patients were measured. IR was detected by HOMA insulin sensitivity index （ISI）. Results ISI of EH grade 3 group was significantly lower than those of EH grade 2 group and EH grade 1 group （0.31±0.07 vs. 0.43±0.06 vs. 0.52±0.03, P〈 0.05 ） ; ISI of EH grade 2 group was significantly lower than that of EH grade 1 group （P〈0.05）. Plasma concentration of ET-1 in EH grade 3 group was significantly higher than those in EH grade 2 group and EH grade 1 group （166.27± 10.58） ng L-1 vs. （156.74±12.11） ng.L-1 vs. （148.62±11.45） ng L-1, P〈0.05] ; plasma concentration of ET-1 in EH grade 2 group was significantly higher than that in EH grade 1 group（P〈0.05 ）. ISI was negatively correlated with systolic blood pressure （r=-0.58, P〈0.05） and diastolic blood pressure （r=-0.56, P〈0.05） ;plasma concentration of ET-1 was positively correlated with systolic blood pressure （r=0.60, P〈0.05） and diastolic blood pressure （r=0.59, P〈0.05）. Conclusions Elevating of IR and ET-1 concentration has positive correlation with patients＇ blood pressure levels.