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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 -IR 5 0 %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 (5 0 1± 17 8) μg/L显著高于女性组 (4 0 6± 16 6 ) μg/L ;男性IR组 (5 1 6± 16 8) μg/L与IS组 (4 8 5± 18 8) μg/L无显著差异 ;女性IR组 (4 5 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
Objective: To investigate the relationship between serum soluble E - selectin (sE - selectin) and insulin resistance, uric acid and lipids in patients with essential hypertension. Methods: The serum levels of sE-selectin, blood glucose, insulin, uric acid, total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein cholesterol in 186 hypertensive patients (75 males and 111 females) Concentration and homeostasis model assessment of insulin resistance index (HOMA-IR). Analysis of serum sE-selectin concentration and other parameters of the correlation. Results: Fifty percent HOMA-IR was used as a cut-off point for determining insulin resistance. Hypertensive patients were divided into insulin resistance group (IR) and insulin-sensitive group (IS). The concentration of sE -selectin in male group was significantly higher than that in female group (5 0 1 ± 17 8) μg / L and that in male IR group was (51 6 ± 16 8) μg / L and There was no significant difference in IS group (48 58 ± 18 8) μg / L; female IR group (451 ± 18 0) μg / L was significantly higher than IS group (36 0 ± 13 7) μg / L. Stepwise regression analysis showed that the male group was an independent predictor of non-serum sE -selectin concentrations, but the female group, HOMA-IR, was an independent predictor of serum sE -selectin concentrations; both uric acid and lipids were independent of serum concentrations of sE -selectin Predictors. CONCLUSIONS: Serum sE -selectin levels are directly related to insulin resistance in women with essential hypertension and are not directly correlated with males. Uric acid and lipids are not directly correlated with serum sE -selectin levels