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目的探讨农村地区人群血清脂联素(adiponectin,APN)水平及其在脑卒中发病中的作用。方法采用整群随机抽样方法对辽宁省彰武县农村人群进行脑卒中患病情况调查,并从中随机抽取脑卒中患者和健康者各120例进行病例对照研究。结果脑卒中和健康者血清APN水平比较,脑卒中患者血清APN水平(7.414±5.595)mg/L低于对照组(9.471±5.601)mg/L,差异有统计学意义(P<0.05);脑卒中组和对照组血清APN水平与是否伴高血压有关,单纯脑卒中组、脑卒中合并高血压组与无脑卒中无高血压组相比APN水平下降,差异有统计学意义(P<0.05),单纯脑卒中组与单纯高血压组相比APN水平下降,差异有统计学意义(P<0.05),单纯脑卒中组与脑卒中合并高血压组相比APN水平下降,差异有统计学意义(P<0.05)。脑卒中危险因素的非条件Logistic回归分析显示,血清APN水平下降和收缩型高血压可能是脑卒中的独立危险因素(APN:OR=4.019,95%CI:2.092～7.722;收缩压:OR=3.864,95%CI:2.106～7.087)。血清APN水平影响因素多元逐步回归分析显示,体质指数(BMI)、高密度脂蛋白(HDL)和收缩压(SBP)可能是其水平的影响因素。结论脑卒中患者血清APN水平明显降低,低APN水平可能参与了脑卒中的发病过程;BMI、HDL、SBP可以影响血清APN变化,进而调控脑卒中的发生发展,这为预测脑卒中和评价其预后提供了依据。
Objective To investigate the level of serum adiponectin (APN) in rural areas and its role in the pathogenesis of stroke. Methods The cluster random sampling method was used to investigate the prevalence of stroke in the rural population in Zhangwu County, Liaoning Province. 120 stroke patients and healthy individuals were randomly selected for case-control study. Results The levels of serum APN in stroke and healthy subjects were significantly lower than those in healthy subjects (7.414 ± 5.595 mg / L vs 9.471 ± 5.601 mg / L, P <0.05) APN levels in stroke group and control group were associated with hypertension. APN levels in stroke group, stroke complicated with hypertension group and non-stroke-free hypertension group were significantly decreased (P <0.05) (P <0.05). APN levels in simple stroke group and simple hypertension group were significantly lower than those in simple hypertension group (P <0.05), APN levels in stroke group were significantly lower than those in stroke group P <0.05). Non-conditional Logistic regression analysis of risk factors for stroke showed that serum APN levels and systolic hypertension may be independent risk factors for stroke (APN: OR = 4.019, 95% CI: 2.092-7.722; systolic blood pressure: OR = 3.864 , 95% CI: 2.106 ~ 7.087). Multiple stepwise regression analysis showed that body mass index (BMI), high density lipoprotein (HDL) and systolic blood pressure (SBP) were the influencing factors of serum APN level. Conclusions Serum levels of APN are significantly decreased in patients with stroke, and low APN levels may be involved in the pathogenesis of stroke. BMI, HDL and SBP may affect the changes of APN in serum and then regulate the occurrence and development of stroke. This is a good predictor of stroke and prognosis Provided the basis.