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目的研究高血压病(EH)合并糖尿病(DM)患者血清瘦素(LEP)、脂联素(ADI)、胰岛素抵抗(IR)与心血管重构之间的相关性。方法选取EH患者75例,DM患者73例,EH+DM患者75例,对照组50例。分别检测上述4组患者的空腹血糖、餐后2 h血糖、胰岛素、总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、尿素氮、肌酐、谷丙转氨酶、谷草转氨酶、LEP、ADI,采用超声检查测定颈总动脉、颈内动脉、颈外动脉内-中膜厚度(IMT),心脏彩色多普勒测量左室舒张末内径、室间隔厚度、左室后壁厚度,并计算胰岛素抵抗指数(HOMA-IR)、心脏指数(LVMI)。结果 EH+DM组血清LEP水平及HOMA-IR显著高于EH组、DM组及对照组,而血清ADI水平显著低于EH组、DM组及对照组。EH+DM组左右IMT、斑块积分、LVMI高于EH、DM组,且左右IMT、斑块积分差异有统计学意义。结论 EH+DM患者心血管重构与LEP升高、IR升高以及ADI降低可能呈正相关关系。
Objective To investigate the correlation between serum leptin (LEP), adiponectin (ADI), insulin resistance (IR) and cardiovascular remodeling in patients with hypertension (EH) and diabetes mellitus (DM). Methods 75 cases of EH, 73 cases of DM, 75 cases of EH + DM and 50 cases of control group were selected. The fasting blood glucose, postprandial blood glucose, insulin, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, urea nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase, LEP, . The carotid artery, internal carotid artery, carotid artery and carotid artery intima - media thickness (IMT) were measured by ultrasonography. Left ventricular end - diastolic diameter, interventricular septum thickness and left ventricular posterior wall thickness were measured by color Doppler. Insulin Resistance index (HOMA-IR), heart index (LVMI). Results Serum LEP levels and HOMA-IR in EH + DM group were significantly higher than those in EH group, DM group and control group, while serum ADI levels were significantly lower than those in EH group, DM group and control group. The IMT, plaque score and LVMI in EH + DM group were higher than those in EH and DM group, and there were significant differences in IMT and plaque score between the two groups. Conclusions There is a positive correlation between cardiovascular remodeling and elevated LEP, elevated IR and decreased ADI in patients with EH + DM.