| | | | | 新发高血压病人游离脂肪酸与动脉弹性变化 | | | 王顺;马爱群;宋少武;泉青海;郑晓晖;赵新锋 | | | 目的观察一个人群中新发高血压病人和未发生高血压者基线空腹血清游离脂肪酸(FFA)与2年内动脉弹性的变化的相关性,探索血清FFA、动脉弹性及高血压之间的关系。方法一纵向研究。社区筛选128例健康非高血压者(年龄33～60岁),随访2年。记录新发高血压例数,采用CVProfilorDO-2020型动脉弹性功能测定仪检测两组2年前后大、小动脉弹性指数(C1和C2),测定基线空腹血FFA、血脂、血糖、胰岛素等。随访期间,有12人失访。结果1)与未发生高血压者(n=97)相比,新发高血压病人(n=19)基线空腹血清饱和脂肪酸水平增高[(217±68)μmol/L比未发生高血压组:(186±46)μmol/L,P=0.04],而多不饱和与饱和脂肪酸比值(P/S)降低(1.60±0.37比未发生高血压组:1.90±0.46,P=0.009);2)与未发生高血压者相比,新发高血压者2年的收缩压和舒张压水平增高(P均<0.01),而其大、小动脉弹性指数改变值(ΔC1和ΔC2)有降低趋势(P均>0.05);3)逐步线性回归模型分析显示:全部参与者2年的ΔC1与基线空腹血清P/S正相关(标准回归系数0.201,P=0.041),独立于基线收缩压水平和经典的心血管危险因素。4)Logistic回归模型分析显示新发高血压者的基线空腹血清P/S的优势比(OR值)和95%可信区间为0.412(0.172～0.991,P=0.048)(在调整了经典的高血压危险因素后)。结论空腹血FFA组成异常是中青年非高血压人群大动脉弹性年龄相关改变和发生高血压的危险因素之一。
【作者单位】：西安交通大学医学院第一附属医院心内科环境与疾病相关基因卫生部重点实验室心血管离子通道病研究室 陕西西安710061(王顺;马爱群);金堆城钼业集团有限公司职工总医院内科 陕西华县710061(宋少武;泉青海);西安交通大学药学院中药现代化教研室 陕西西安710061(郑晓晖;赵新锋)
【关键词】：动脉弹性;中青年高血压;游离脂肪酸组成
【基金】：西安交通大学博士学位论文基金(DFXJTU2004-13)
【分类号】：R544.1;R543.5
【DOI】：CNKI:SUN:ZGGZ.0.2007-12-009
【正文快照】：
原发性高血压患者常伴有一组心血管危险因素,包括脂肪酸代谢紊乱和动脉弹性降低,但脂肪酸与动脉弹性的关系尚不完全清楚。脂肪酸代谢异常在高血压的发病机制中发挥作用[1]。此外,给正常体重健康志愿者通过静脉注射脂肪乳剂和肝素升高循环游离脂肪酸(free fatty acid,FFA)浓度,可削弱内皮依赖性血管舒张和增强血管平滑肌α1受体敏感性,这些均可增加血管紧张度[2-3]。而动脉僵硬度增加是高血压患者的全因死亡率和心血管病死亡率的独立预测因素,且在老年单纯收缩期高血压的发病中起决定性作用[4-5]。弹力动脉硬化为年龄相关的过程,在高血压存… | | |  推荐 CAJ下载  PDF下载 | | | CAJViewer7.0阅读器支持所有CNKI文件格式，AdobeReader仅支持PDF格式 | | | | Relationship Between Arterial Elasticity and Fasting Serum Free Fatty Acid in Incident Hypertensives and Nonhypertensives | | | WANG Shun1;MA Ai-qun1;SONG Shao-wu2;QUAN Qing-hai2;ZHENG Xiao-hui3;ZHAO Xin-feng3.1.Cardiac Channelopathy Lab;Key Laboratory of Environment and Genes Related to Diseases;Ministry of Education;Department of Cardiology;The First Affiliated Hospital;School of Medicine of Xi'an Jiaotong University;Xi'an 710061;2.Department of Internal medicine;Employee General Hospital of JDC Molybdenum Mining Corporation;Huaxian 714102;3.Pharmacy College of Xi'an Jiaotong University;Xi'an 710061;China | | | Objective To investigate the baseline and 2-year changes of arterial elasticity and serum free fatty acid(FFA) composition in incident hypertensives and nomotensive subjects.Methods Fasting serum FFA were determined in 128 nonhypertensive from a community inhibitants aged between 35 and 60 years.In 2-year follow-up,19 cases of incident hypertensives were found.Arterial elasticity was assessed with arterial elasticity indexes(C1-large artery and C2-small artery) measured by CVProfilor DO-2020.Results Compared with normotensive subjects(n=97),incident hypertensives(n=19) had higher baseline level of saturated fatty acid(217±68 μmol/L vs 186±46 μmol/L,P=0.04),and lower level of polyunsaturated/saturated fatty acids ratio(P/S,1.60±0.37 vs 1.90±0.46,P=0.009).The levels of systolic BP and diastolic BP increased(P<0.01 for both) while the changes of large and small arterial elasticity index(ΔC1 and ΔC2) tended to decrease(P>0.05 for both) in incident hypertensives.Multivariate analysis showed ΔC1 remained positively associated with baseline P/S ratio(standard regression coefficient 0.201,P=0.041) after adjusting for traditional risk factors and level of baseline systolic BP in all subjects.The odds ratio of P/S for incident hypertension was 0.412(95% confidence interval(CI):0.17-0.99,P=0.048).Conclusion Reduced levels of fasting serum P/S is associated with age-related large arterial stiffness and development of hypertension in young and middle-aged subjects.
【Keyword】：Arterial elasticity;Hypertension;Free fatty acid composition |
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