肥胖高血压患者糖、脂质代谢紊乱的临床对照研究

目的观察肥胖高血压患者血脂、血糖、胰岛素指数及血清、脂肪组织中脂蛋白脂酶(LPL)含量和活性变化,探讨糖、脂质代谢紊乱与肥胖高血压及代谢综合征的发病关系。方法选取122例肥胖高血压患者及等量正常组病例进行对照研究,测定体质量指数(BMI)、腰臀围比(WHR)、血压、血脂、血糖、血胰岛素,并计算胰岛素敏感指数(ISI),部分病例测定血清及脂肪组织的LPL含量和活性。结果肥胖高血压组患者的血清甘油三脂(TG)、空腹血糖(FBS)、血胰岛素(INS)水平均显著高于对照组(P<0.01),而血清LPL含量、HDL水平、ISI显著低于对照组(P<0.01);两组间脂肪组织中LPL的含量无显著差别(P>0.05)。相关分析发现,血淸LPL含量与BMI(r=-0.64)、WHR(r=-0.59)、TG(r=-0.78)呈显著性负相关(P<0.01),与ISI(r=0.53)、HDL(r=0.46)呈正相关;脂肪组织中LPL含量及活性与上述指标均无相关性(P>0.05)。结论肥胖高血压患者多合并有糖、脂质代谢紊乱和胰岛素抵抗,血清LPL在其代谢紊乱中可能发挥重要作用。

Case-control study of abnormal glucose and lipids in obesity-related hypertensive patients

Objective To observe the changes of Lipids,FBS,ISI and lipoprotein lipase in obesity-related hypertensive patients and investigate the relationship of abnormal glucose and lipid with obesity-related hypertension as well as metabolic syndrome.Methods A total of 122 obesity-related hypertensive patients and 122 matched normal individuals were enrolled.Blood pressure,BMI,WHR and serum lipids and glucose,serum and adipose tissue LPL were measured.Results The TG,FBS and INS in obesity-related hypertensive patients were significantly higher than those in normal control group(P<(0.01));the serum LPL mass,HDL and ISI were much lower in obesity-related hypertensive patients than those in the normal control group(P<(0.01));no difference for adipose tissue LPL was found between the tow groups(P>(0.05)).Correlated analysis showed that serum LPL mass was respectively correlated with BMI(r=-0.64,P<0.01),WHR(r=-0.59,P<0.01),TG(r=-0.78,P<0.01),ISI(r=0.53,P<0.01) and HDL-c(r=0.46,P=0.01).Conclusion Obesity-related hypertension is correlated with the abnormal changes of glucose and lipid,as well as insulin resistance;and the serum LPL may play a role in its metabolic disturbance.