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目的 探讨瘦素、肥胖、胰岛素抵抗与血压的相互关系 ,评价瘦素在高血压发病中的作用。方法 5 6 0名非糖尿病的成年男性 ,测定空腹血脂、瘦素、真胰岛素 (TI)浓度以及空腹和餐后 2h血糖。胰岛素敏感性以稳态模型抵抗指数 (HOMA R)评价。结果 空腹瘦素水平与体重指数 (BMI)、腰臀比 (WHR)、TI和HOMA R、血压以及甘油三酯和胆固醇均显著相关 (均为P <0 0 1)。在调整年龄、BMI、WHR和HOMA R后 ,瘦素仍与收缩压呈正相关 (r=0 11,P <0 0 5 ) ,而且高血压者 (除外服用降压药者 )的瘦素水平也显著高于非高血压者 (几何均值 6 4 μg/L对 4 7μg/L ,P <0 0 0 1)。肥胖、胰岛素抵抗和高瘦素血症均能明显增加高血压的检出率。Logistic回归分析也显示瘦素水平的升高与高血压的发病密切相关。结论 瘦素与肥胖型高血压的发病相关。
Objective To investigate the relationship between leptin, obesity, insulin resistance and blood pressure and to evaluate the role of leptin in the pathogenesis of hypertension. Methods Five hundred and sixty non-diabetic adult men were tested for fasting plasma lipids, leptin, true insulin (TI) concentrations, and fasting and postprandial blood glucose 2h. Insulin sensitivity was evaluated as a steady state model resistance index (HOMA R). Results Fasting leptin levels were significantly associated with body mass index (BMI), WHR, TI and HOMA R, blood pressure and triglycerides and cholesterol (all P <0.01). After adjusting for age, BMI, WHR and HOMA R, leptin was still positively correlated with systolic blood pressure (r = 0 11, P 0 05), and leptin levels in hypertensive subjects (except for those taking antihypertensive drugs) Was significantly higher than non-hypertensive patients (geometric mean 64 μg / L vs 47 μg / L, P <0.01). Obesity, insulin resistance and high serum leptin can significantly increase the detection rate of hypertension. Logistic regression analysis also showed that the increase of leptin level is closely related to the incidence of hypertension. Conclusion Leptin is associated with the development of obesity-related hypertension.