肥胖高血压患者合并胰岛素抵抗对血脂及超敏C反应蛋白的影响

摘要

目的 研究肥胖高血压患者在不同胰岛素抵抗状况下血脂及超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的变化.方法 选择2015年6月至2016年12月西宁市第一人民医院一分院收治的高血压住院患者115例,其中符合肥胖标准者65例.取65例肥胖高血压患者胰岛素敏感性指数中位数为界,将肥胖高血压患者分为胰岛素抵抗组(38例)与非胰岛素抵抗组(27例),比较两组血脂、hs-CRP水平及肥胖相关指标的差异.结果 ①胰岛素抵抗组与非胰岛素抵抗组比较,腹围和腰臀比均升高[(96.14±5.84)cm vs(92.42±5.54)cm,P＜0.05;(0.94±0.06)vs(0.91±0.07),P＜0.01],hs-CRP水平明显升高[(2.27±0.86)mg/l vs(1.40±0.75)mg/l,P＜0.05].两组间胆固醇、甘油三酯、高密度脂蛋白及低密度脂蛋白比较差异无显著性(P＞0.05).②肥胖高血压患者hs-CRP与胰岛素敏感性指数呈显著负相关(r=－0.31,P＜0.01),与腹围、腰臀比、体重指数、胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白无明显相关性(P＞0.05).结论 肥胖高血压伴胰岛素抵抗者,反映血管内皮炎症状态的敏感指标hs-CRP显著升高,其心血管发病风险可能增大.%Objective To observe the changes of lipids and hypersensitive C-reactive protein (hs-CRP) in different state of insulin resistance in obese hypertensive patients. Method 115 hospitalized hypertensive patients from 6-2015 to 12-2016 were enrolled, and 65 of them were obesity. According to the middle point of ISI of the total(ISI=0.14), the obese hypertensive patients were divided into insulin resistance group(IR group, ISI＜0.14) and non-insulin resistance group(NIR group, ISI≥0.14). Then we compared hs-CRP, TG, HDL, CHOL, LDL between the IR group and NIR group by SPSS 16.0. Result In the obese hypertensive patients, hs-CRP, WC and WHR are higher in the IR group than the NIR group[WC:(96.14±5.84)cm vs (92.42±5.54)cm, P＜0.05; WHR: (0.94±0.06) vs (0.91±0.07), P＜0.01; CRP: (2.27±0.86)mg/L vs (1.40±0.75)mg/L, P＜0.05)]. Hs-CRP is only related to ISI in the obese hypertensive patients (R=-0.31, P＜0.01). Conclusion Hs-CRP is higher in the obese hypertensive patients with insulin resistance,which reflects the greater risk of cardiovascular disease.