青春期高血压胰岛素样生长因子-1变化与心室质量指数的关系

摘要

目的 探讨血清胰岛素样生长因子-1(IGF-1)水平与青春期高血压及引起心血管损伤的关系,研究青春期高血压的发病机制.方法 选择太原市城乡部分中学生体检中筛查出的青少年高血压患者33例,其中男性18例,女性15例,年龄13~15岁;高血压前期36例,其中男性19例,女性17例,年龄13~15岁;健康对照组34名,其中男性15名,女性19名,年龄13~15岁.健康青少年及高血压前期、高血压患者均禁食12 h,检测血清IGF-1水平,采用酶联免疫吸附测定法,心脏超声检查,根据各项参数计算左心室质量指数(LVMI).统计学分析用单因素方差分析比较健康对照组、高血压前期组和高血压组空腹血糖(BFS)、LVMI、血清总胆固醇(TC)、甘油三酯(TG)、IGF-1的差别;用Pearson直线相关分析血清IGF-1与LVMI、BFS、TC、TG、收缩压(SBP)、舒张压(DBP)的相关性.结果 高血压前期组LVMI、血清IGF-1水平高于健康对照组(P＜0.05),高血压组LVMI、血清IGF-1水平高于高血压前期组和健康对照组(P＜0.05);且血清IGF-1水平与SBP、DBP、LVMI之间均存在正相关(r＝0.83,P＜0.01;r＝0.59,P＜0.01;r＝0.87,P＜0.01).结论 血清IGF-1水平与青春期高血压密切相关,其参与了青春期高血压病的发生发展,且在高血压病心肌重构过程中起到了重要作用.%Objective To investigate the relationship between insulin-like growth factor-1 (IGF-1) and left ventricular mass index(LVMI) in teenager hypertension, the role of IGF-1 in cardiovascular injury and the mechanism underlying teenager hypertension.Methods A cohort of high-school students from suburban or urban Taiyuan who underwent checkup for blood pressure were recruited in this study.The subjects comprised 33 cases of teenager hypertension (15 boys and 19 girls aged 13 to 15), 36 cases of teenager pre-hypertension (19 boys and 17 girls aged 13 to 15) and 34 normotensive teenagers (18 boys and 15 girls, aged 13 to 15).After a fasting for 12 hours, the subjects underwent enzyme-linked immunoassay of IGF-1 and echocardiography.LVMI was calculated based on parameters determined by echocardiography.ANOVA was used to determine the differences in fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG), LVMI and IGF-1 among subjects with normal controls, pre-hypertension or hypertension.Pearson’s linear correlation was employed to identify the possible relationship between serum IGF-1 and BFS, TC, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP) and LVMI.Results ①LVMI was higher in pre-hypertension than in normal controls (P＜0.05), as was in hypertension than in pre-hypertension and normal controls (P＜0.05).The serum IGF-1 level was higher in pre-hypertension than in normal controls (P＜0.05), as was in hypertension than in pre-hypertension and normal controls (P＜0.05).② The serum level of IGF-1 showed positive correlations with SBP (r= 0.83, P＜0.01), DBP(r=0.59, P＜0.01) and LVMI (r=0.87,P＜0.01).Conclusion The positive correlation between serum IGF-1 and hypertension suggests that IGF-1 may be involved in the pathogenesis of teenager hypertension, and may also plays an important role in myocardial remodeling.