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目的:了解2型糖尿病合并高血压患者血清脂联素和内脏脂肪素的变化,探讨脂联素和内脏脂肪素与2型糖尿病合并高血压的相关性.方法:选取高血压患者40例,2型糖尿病患者38例,2型糖尿病合并高血压患者40例,健康对照者40例作为研究对象,测定其血清脂联素和内脏脂肪素水平,同时测定血压、血糖、血脂和体质量指数等指标,并分析以上指标与脂联素和内脏脂肪素的关系.结果:单纯2型糖尿病组和单纯高血压组内脏脂肪素水平明显高于正常对照组,分别为(18.26±1.22)ng/mL,(17.31±1.26)ng/mL和(13.32±1.31)ng/mL(p<0.05);2型糖尿病合并高血压组(24.99±1.36)ng/mL又明显高于单纯2型糖尿病组和单纯高血压组.2型糖尿病组和高血压组脂联素水平明显低于正常对照组,分别为(8.75±1.29)μg/mL,(9.71±1.28)μg/mL和(12.67±1.48)μg/mL(p<0.05);2型糖尿病合并高血压组(5.73±1.23)μg/mL又明显低于单纯2型糖尿病组和单纯高血压组.2型糖尿病组和高血压组的脂联素和内脏脂肪素水平差异不具有统计学意义(p>0.05).相关分析显示2型糖尿病合并高血压患者空腹血清内脏脂肪素与腰臀比、甘油三酯和体质量指数呈正相关(r=0.431,0.371,0.501,p<0.05),与高密度脂蛋白呈负相关(r=-0.610,p<0.05);血清脂联素与腰臀比、体质量指数、收缩压和甘油三酯呈负相关(r=-0.6 1 2,-0.3 9 3,-0.4 5 5,-0.3 9 1,p<0.0 5).多元逐步回归分析显示,腰臀比是内脏脂肪素水平的独立相关因素(t=2.0 9 0,p<0.0 5);腰臀比、高密度脂蛋白是脂联素水平独立相关因素(t=-2.7 4 1,3.9 6 8,p<0.0 5).结论:2型糖尿病组和高血压组血清内脏脂肪素水平升高,而脂联素水平降低.2型糖尿病合并高血压组血清内脏脂肪素水平更高,脂联素水平更低.该结论提示脂联素和内脏脂肪素的表达可能与高血压和2型糖尿病的发生发展有密切的关系.
Objective: To investigate the changes of serum adiponectin and visfatin in patients with type 2 diabetes mellitus complicated with hypertension and to explore the correlation between adiponectin and visfatin and type 2 diabetes complicated with hypertension.Methods: Forty patients with hypertension, 2 38 cases of type 2 diabetes mellitus, 40 cases of type 2 diabetes mellitus with hypertension and 40 cases of healthy control. Serum levels of adiponectin and visfatin were measured, blood pressure, blood glucose, blood lipid and body mass index , And analyzed the relationship between the above indexes and adiponectin and visceral fat.Results: The levels of visfatin in simple type 2 diabetes mellitus group and simple hypertension group were significantly higher than those in normal control group (18.26 ± 1.22) ng / mL, (17.31 ± 1.26) ng / mL and (13.32 ± 1.31) ng / mL, respectively (p <0.05); Type 2 diabetic patients with hypertension (24.99 ± 1.36 ng / mL) were significantly higher than those with type 2 diabetes mellitus In the blood pressure group, the levels of adiponectin in type 2 diabetes mellitus group and hypertension group were significantly lower than those in control group (8.75 ± 1.29 μg / mL, 9.71 ± 1.28 μg / mL and 12.67 ± 1.48 μg / mL, respectively) (P <0.05). The type 2 diabetic patients with hypertension (5.73 ± 1.23) μg / mL were significantly lower than those with type 2 diabetes The levels of adiponectin and visfatin in type 2 diabetes mellitus group and hypertension group were not statistically different (p> 0.05) .Relationship analysis showed that fasting serum visfatin and type 2 diabetes mellitus patients with type 2 diabetes mellitus (R = 0.431,0.371,0.501, p <0.05), negatively correlated with high density lipoprotein (r = -0.610, p <0.05), serum adiponectin And waist-hip ratio, body mass index, systolic blood pressure and triglyceride were negatively correlated (r = -0.612, -0.393, -0.455, -0.391, p <0.05) .Multiple stepwise regression Analysis showed that waist-hip ratio was an independent predictor of visfatin (t = 2.09 0, p <0.0 5); waist-hip ratio and high density lipoprotein were independent predictors of adiponectin level (t = -2.74 1,3,9 6 8, p <0.0 5) .Conclusion: Serum visfatin levels are elevated and adiponectin levels are lower in type 2 diabetes mellitus patients and those in hypertension group.Serum visfatin levels in type 2 diabetes mellitus patients with hypertension are more High and low level of adiponectin.The conclusion suggests that the expression of adiponectin and visfatin may be closely related to the occurrence and development of type 2 diabetes and hypertension.