原发性高血压患者血清可溶性E选择素水平与胰岛素抵抗的关系

目的:探讨高血压病患者血清可溶性E-选择素(sE-selectin)浓度与胰岛素抵抗、尿酸及血脂的关系。方法:测定186例高血压病患者(男75例,女111例)的空腹血清sE-selectin、血糖、胰岛素、尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇的浓度,稳态模式评估法计算胰岛素抵抗指数(HOMA-IR)。分析血清sE-selectin浓度与其它各项参数的相关性。结果:以HOMA-IR50%位点,作为判断胰岛素抵抗的切割点,把高血压病患者分为胰岛素抵抗组(IR)与胰岛素敏感组(IS)。男性组血清sE-selectin浓度(50.1±17.8)μg/L显著高于女性组(40.6±16.6)μg/L;男性IR组(51.6±16.8)μg/L与IS组(48.5±18.8)μg/L无显著差异;女性IR组(45.1±18.0)μg/L显著高于IS组(36.0±13.7)μg/L。逐步回归分析显示,男性组HOMA-IR非血清sE-selectin浓度的独立预测因子,但女性组HOMA-IR是血清sE-selectin浓度的独立预测因子;尿酸和血脂均非血清sE-selectin浓度的独立预测因子。结论:女性原发性高血压患者血清sE-selectin浓度与胰岛素抵抗直接相关,男性则无直接相关;尿酸及血脂与血清sE-selectin浓度均无直接相关。

Association of serum soluble E-selectin concentrations with insulin resistance in essential hypertension patients

AIM: To investigate the relationship between serum soluble E-selectin (sE-selectin) and insulin resistance, serum uric acid, serum lipid in essential hypertension patients. METHODS: Fasting serum sE-selectin concentration, plasma glucose, serum insulin, serum uric acid, total cholesterol, triglycerides, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol were determined in 186 patients with essential hypertension (75 males, 111 females). Homeostasis model assessment was applied to assess the status of insulin resistance (HOMA-IR). RESULTS: Based on the HOMA-IR, the essential hypertension patients were divided into insulin-sensitive individuals (IS) and insulin resistant subjects (IR). The serum sE-selectin concentration was significantly higher in male group than in female group (P<0.01). No difference between IR group and IS group in male, and significantly higher in IR group than in IS group (P<0.01) in female were observed. A stepwise multiple linear regression analysis showed that HOMA-IR was an independent predictor of serum sE-selectin concentrations in female group and not in male group, and both serum uric acid and serum lipid were not independent predictors of serum sE-selectin concentrations. CONCLUSION: Serum sE-selectin concentrations were directly related to insulin resistance in females with essential hypertension and not in males with essential hypertension. Both serum uric acid and serum lipid were not directly related to serum sE-selectin concentrations.