血清脂联素水平与原发性高血压患者肾脏损害的关系

摘要

Objective To investigate the relationship between serum adiponectin and kidney function in pa-tient ofessential hypertension(EH). Methods We conducted a case-eontroul study of 60 EH patient(EH group) and 60 normal subjects of the same body mass index(BMI)、sxe and age (control group). Serum adiponectin levels was assessed by enzyme linked immunosorbent assay (ELISA) and microalbumin was detected by radioimmunoassay (RIA), 24-hour urinary albumin excretion(UAE) was calculated. Ambulatory blood pressure monitoring were re-corded and other routine parameters about clinical and laboratory were assessed. According to UAE, we divided EH group into MA(-)/EH groups who had normal albuminuria(n=40, UAE<30 mg/24 h) and MA(+)/EH group who had microalbuminuria(n=20,30≤UAE<300 mg/24 h). Results The 1g(adiponectin) values in EH group is significantly lower than control group (t=2.934,P<0.01). In EH group, there was a negative correlation be-tween lg(adiponectin) and UAE(r=-0.532,P<0.01). Subjects who had microalbminuria in EH group had ab-normal circadian rhythm of blood pressure. There was a significantly difference between non-dipper EH group and dipper EH group regarding the UAG (t=2.280, P<0.05). Conclusion The hypo-adiponectinemia is one of the risk factors for EH. There is a correlation between hypo-adiponectinemia and the microalbuminuria, therefore adi-ponectin may be a protective factor of renal dysfunction. The abnormality of rhythm of blood pressure can induce mi-croalbuminuria in patient with EH.%目的 探讨血清脂联素水平与原发性高血压(EH)患者肾脏损害的关系.方法 选择我院确诊为EH的门诊及住院患者60例(EH组33,以及体质指数(BMI)、年龄、性别匹配的健康体检者60例(对照组).用酶联免疫吸附(ELISA)法检测其血清脂联素浓度;用放射免疫法(RIA)测定尿微量白蛋白(MA)浓度,计算24 h尿白蛋白排泄量(UAE);进行24 h动态血压监测(ABPM)及常规的临床和实验室指标的检测.EH组以UAE值为基础,分为MA(-)/EH亚组和MA(+)/EH亚组.采用SPSS 11.5统计软件进行统计分析.结果 EH组脂联素浓度不呈正态分布,取其对数值进行统计学分析.EH组1g(脂联素浓度)为(0.96±0.21)mg/L,对照组为(1.06±0.16)mg/L,组间比较差异有统计学意义(t=2.934,P<0.01).EH组UAE<30 mg/24h 20例,30～300 mg/24h 40例,2组1g(脂联素浓度)与UAE呈显著负相关(r=-0.532,P<0.01),校正各因素后仍呈显著负相关(偏相关系数r=-0.279,P=0.036).EH组中动态血压节律杓形34例,非杓形26例,UAE分别为(21.17±11.08)mg/24 h和(28.20±12.48)mg/24 h,差异有统计学意义(t=2.280,P<0.05),2组1g(脂联素浓度)差异无统计学意义.结论 EH患者血清脂联素浓度低于正常对照者,低脂联素血症与EH的发生、发展有一定关系.EH患者中,MA伴有血清脂联素浓度的降低.低脂联素血症与EH患者MA的发生密切相关,脂联素可能有保护EH患者肾脏以及血管内皮功能的作用.血压昼夜节律异常促进了MA的发生.