原发性高血压患者合并非酒精性脂肪肝与脂联素及颈动脉粥样硬化的关系
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摘要
目的:探讨原发性高血压患者合并非酒精性脂肪肝(NAFLD)与脂联素(APN)及颈动脉粥样硬化的关系。方法:选取2015年5月-2016年6月收治的65例原发性高血压患者作为研究对象,根据是否合并有NAFLD分为脂肪肝组33例和非脂肪肝组32例。用酶联免疫吸附测定(ELISA)法检测两组患者血清APN浓度、彩色超声检测颈动脉内膜-中层厚度(IMT),并进行比较。结果:脂肪肝组的IMT高于非脂肪肝组[(0.98±0.38)mm vs(0.86±0.27)mm,P<0.05],而APN水平脂肪肝组低于非脂肪肝组[(5.27±1.46)mg/L vs(10.46±2.24)mg/L,P<0.01]。多元逐步回归分析显示TG、MBI是影响APN的独立危险因素(P<0.05);LDL-C是影响IMT的独立危险因素(P<0.05)。结论:原发性高血压患者合并非酒精性脂肪肝与脂联素(ANP)及颈动脉粥样硬化密切相关。
Objective:To investigate the relationship among the degree of carotid artery atherosclerosis,adiponectin(APN)and non-alcoholic fatty liver disease in patients with essential hypertension(EH).Method:A total of 65 patients with essential hypertension from May 2015 to June 2016 were divided into two groups:NAFLD group(with non-alcoholic fatty liver disease,n=33)and without NAFLD group(n=32).The APN and carotid artery intima-media thickness(IMT)were determined in two groups.Result:The level of IMT was higher in NAFLD group than that of without NAFLD group[(0.98±0.38)mm vs(0.86±0.27)mm,P<0.05].But the level of adiponectin was lower in NAFLD group than that of without NAFLD group[(5.27±1.46)mg/L vs(10.46±2.24)mg/L,P<0.01].Multiple stepwise regression analysis showed that TG and BMI were the independent factors influencing APN,LDL-C were the independent factors influencing IMT.Conclusion:Nonalcoholic fatty liver disease in patients with essential hypertension is closely related to APN and IMT.
Objective:To investigate the relationship among the degree of carotid artery atherosclerosis,adiponectin(APN)and non-alcoholic fatty liver disease in patients with essential hypertension(EH).Method:A total of 65 patients with essential hypertension from May 2015 to June 2016 were divided into two groups:NAFLD group(with non-alcoholic fatty liver disease,n=33)and without NAFLD group(n=32).The APN and carotid artery intima-media thickness(IMT)were determined in two groups.Result:The level of IMT was higher in NAFLD group than that of without NAFLD group[(0.98±0.38)mm vs(0.86±0.27)mm,P<0.05].But the level of adiponectin was lower in NAFLD group than that of without NAFLD group[(5.27±1.46)mg/L vs(10.46±2.24)mg/L,P<0.01].Multiple stepwise regression analysis showed that TG and BMI were the independent factors influencing APN,LDL-C were the independent factors influencing IMT.Conclusion:Nonalcoholic fatty liver disease in patients with essential hypertension is closely related to APN and IMT.
引文
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[23]Czyzewska M,Wolska A,Cwiklinska A,et al.Disturbances of lipoprotein metabolism in metabolic syndrome[J].Postepy Hig Med Dosw(On line),2010,64(8):1-10.
[2]张同梅.脂联素与多种疾病关系的研究进展[J].实用心脑肺血管病杂志,2015,23(2):4-6.
[3]中国高血压防治指南修订委员会.中国高血压防治指南2010[J/OL].中国医学前沿杂志(电子版),2011,3(5):42-93.
[4]中华医学会肝脏病学分会脂肪肝和酒精性肝病学组.非酒精性脂肪性肝病诊疗指南(2010年修订版)[J].胃肠病学和肝病学杂志,2010,19(6):483-487.
[5]谢子一,冉慧,丁艳霞.2型糖尿病伴非酒精性脂肪肝患者血清脂联素水平的变化[J].河南医学研究,2014,23(5):37-39.
[6]王丹,刘晓芳,张莹.瘦素和脂联素检测对非酒精性脂肪肝的临床意义[J].实用医技杂志,2014,21(5):518.
[7]Wang F S,Fan J G,Zhang Z,et al.The global burden of liver disease:the major impact of China[J].Hepatology,2014,60(6):2099-2108.
[8]Milic S,Stimac D.Nonalcoholic fatty liver disease/steatohepatitis:epidemiology,pat-hogenesis,clinical presentation and treatment[J].Dig Dis,2012,30(2):158-162.
[9]Targher G,Arcaro G.Non-alcoholic fatty liver disease and increase drisk of cardiovascular disease[J].Atherosclerosis,2007,191(2):235-240.
[10]吴奋,黄静,陈湘清.非酒精性脂肪肝临床特征分析[J].中国实用内科杂志,2016,36(增刊1):38-39.
[11]白志冬,王煜,许芳,等.行为干预模式对非酒精性脂肪肝患者生活质量的影响[J].中国健康教育,2016,32(5):465-468.
[12]Li Y L,Yang M,Fu B Y,et al.The changes and significance of serum cholesterol in patients with nonalcoholic fatty liver disease[J].Shanxi Med J,2011,40(7):705-706.
[13]王中丽,夏冰.非酒精性脂肪肝与血清脂联素的关系[J].现代消化与介入诊疗,2007,12(4):244-247.
[14]刘春兰.利拉鲁肽对2型糖尿病患者主要生理指标的影响[J].中国药业,2015,24(20):30-31.
[15]Villarreal-Molina M T,Antuna-Puente B.A diponectin:antiinflammatory and cardioprotective effects[J].Biochimie,2012,94(10):2143-2149.
[16]Shehzad A,Lqbal W,Shehzad O,et al.A diponectin:regulation of its production and its role in human disease[J].Hormones,2012,11(1):8-20.
[17]杜晓娅,吕莉娜,魏磊,等.老年维持性血液透析患者脂联素水平与心脑血管事件及生存率的相关性[J].中华老年心脑血管病杂志,2014,16(9):932-934.
[18]Kim H C,Kim D J,Huh K B,et al.Association between nonalcololic fatty liver disease and carotid intima-media thickness according to the presence of metabolic syndrome[J].Atheroscl Erosis,2009,204(2):521-525.
[19]Choi S Y,Kim D,Kim H J,et al.The relation on between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans[J].Am J Gastroenterol,2009,104(8):1953-1960.
[20]Defronzo R A.Insulin resistance,lipotoxicity,type 2 diabetes and atherosclerosis:the missing links.The Claude Bernard Lecture,2009[J].Diabetologia,2010,53(7):1270-1287.
[21]韩召展,董会文,任会远,等.氧化应激产物、炎症因子与颈动脉粥样硬化的关系探讨[J].中西医结合心脑血管病杂志,2010,8(2):244-245.
[22]王燕,殷镜海,李会庆,等.氧化LDL抗体对颈动脉粥样硬化斑块发生影响[J].中国公共卫生,2009,25(2):179-180.
[23]Czyzewska M,Wolska A,Cwiklinska A,et al.Disturbances of lipoprotein metabolism in metabolic syndrome[J].Postepy Hig Med Dosw(On line),2010,64(8):1-10.