目的 研究高血压微量清蛋白尿患者血清抵抗素与胰岛素抵抗及炎症的关系.方法 选择100例无糖尿病病史的高血压痛患者,收集一般临床资料,测量血压、腰围、臀围、测定空腹血糖、空腹胰岛素、超敏C-反应蛋白(hsCRP)等生化指标,采用ELISA法测定高血压痛患者血清抵抗素水平,并用胰岛素抵抗指数(IRI)作为胰岛素敏感性评价指标.测定患者晨尿的尿清蛋白和尿肌酐,尿清蛋白/尿肌酐比(ACR)(男性:22～220mg/g;女性:31～310mg/g)定义为微量清蛋白尿阳性,其中微量清蛋白尿阳性组50例,阴性组50例.结果 高血压合并微量清蛋白尿阳性患者腰围、BMI、舒张 压、IRI、hsCRP和抵抗素水平较高血压微量清蛋白尿阴性患者高(P均＜0.05),经Logistic多因素回归分析发现腰围,IRI,hsCRP及抵抗素与是否高血压合并微量清蛋白尿密切相关(OR值分别是1.144、1.511、1.163、1.069,P均＜0.05).结论 括抗素与高血压病患者发生微量清蛋白尿密切相关,抵抗素联系炎症,胰岛素抵抗与高血压发生微量清蛋白尿之间可能发挥着重要作用.%Objective To Study on the relationship of serum resistin level with insulin resistance and inflammation in hypertensive patients with microalbuminuria. Methods The basic information was collected in 100 hypertensive patients without diabetic history. Blood pressure, waist circumference and hip circumference were measured. Then blood samples were taken from them for measurement of biochemical indicators. Fasting serum resistin was tested by enzyme linked immunosorbent assay (ELISA). Insulin resistance index(IRI)was applied to estimate insulin resistance. Urine albumin-to-creatinine ratio(ACR) was obtained in the hypertensive patients. Results The levels of waist circumferenceNBMINIRI^hsCRP and serum resistin were significantly higher among patients with microalbuminuria compared with that without microalbuminuria (P <0.05). Multiple factor Logistic regression analysis showed that waist circumference ( OR = 1. 144, P < 0.05 ) , IRI ( OR = 1. 511, P < 0. 05 ) , hsCRP ( OR =1.163 ,P <0. 05) and resistin ( OR = 1. 069,P< 0. 05) were associated with microalbuminuria. Conclusion The results suggest that the presence of resistin is associated with early renal damage and endothelial damage of hypertensive patients. Furthermore, it implies that the resistin may play pivotal roles in the target organ damage of hypertension through systemic inflammation and insulin resistance.
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