血清超敏C反应蛋白、脂蛋白相关性磷脂酶A2与老年原发性高血压合并2型糖尿病的相关性

目的探讨血清超敏C反应蛋白(hs-CRP)、脂蛋白相关性磷脂酶A2(Lp-PLA2)与老年原发性高血压(EH)合并2型糖尿病(T2DM)的相关性。方法选取EH且年龄≥60岁患者128例为研究对象,根据是否合并T2DM分为单纯EH组(n=60)和EH+DM组(n=68),选择同期单纯T2DM患者为单纯DM组(n=63)及健康体检者为对照组(n=61),分析EH合并T2DM患者在不同高血压亚组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、hs-CRP、Lp-PLA2的差异;分析hs-CRP、Lp-PLA2不同亚组中FPG、HbA1c、收缩压(SBP)、舒张压(DBP)的差异,分析hs-CRP、Lp-PLA2与HbA1c、SBP、DBP的相关性。结果EH+DM组、EH组、DM组低密度脂蛋白胆固醇(LDL-C)、hs-CRP、Lp-PLA2均高于对照组,而高密度脂蛋白胆固醇(HDL-C)低于对照组(均P<0.05),EH+DM患者随高血压级别的升高,FPG、HbA1c、hs-CRP、Lp-PLA2均升高(均P<0.05);随hs-CRP水平的升高,FPG、HbA1c、SBP均升高(均P<0.05);随Lp-PLA2水平升高,SBP、DBP均升高(均P<0.05);hs-CRP与HbA1c、SBP、DBP呈正相关;Lp-PLA2与HbA1c、SBP、DBP呈正相关;同时HbA1c与SBP、DBP呈正相关,在校正了年龄、性别、吸烟史、体质量指数(BMI)、三酰甘油(TG)后,hs-CRP、Lp-PLA2水平升高是EH合并T2DM的危险因素(均P<0.05)。结论hs-CRP、Lp-PLA2水平高低在一定程度上可预测EH合并T2DM的严重程度,且hs-CRP、Lp-PLA2是EH合并T2DM的危险因素,可以反应患者血压、血糖控制情况及高血压分级情况。

Correlation between serum hypersensitive C-reactive protein,lipoprotein-related phospholipase A2 and senile essential hypertension complicated with type 2 diabetes

Objective To investigate the correlation between serum hypersensitive C-reactive protein(HS-CRP),lipoprotein-associated phospholipase A2(LP-PLA2)and senile essential hypertension(EH)complicated with type 2 diabetes mellitus(T2DM).Methods A total of 128 EH patients aged≥60 years were selected as research subjects.According to whether T2DM was combined,the patients were divided into simple EH group(n=60)and EH+DM group(n=68).Patients with pure T2DM during the same period were selected as pure DM group(n=63)and healthy physical examinees as control group(n=61).The differences of FPG,HbA1c,hs-CRP,Lp-PLA2 in EH patients with T2DM in different hypertensive subgroups were analyzed.The differences of FPG,HbA1c,systolic blood pressure(SBP),diastolic blood pressure(DBP)in hs-CRP and Lp-PLA2 subgroups were analyzed.The correlation between hs-CRP,Lp-PLA2 and HbA1c,SBP and DBP was analyzed.Results In EH+DM group,EH group and DM group,LDL-C,hs-CRP and Lp-PLA2 were all higher than those in control group,while HDL-C was lower than that in control group(all P<0.05).In EH+DM patients,FPG,HbA1c,hs-CRP and Lp-PLA2 were all increased with the increase of hypertension level(all P<0.05).With the increase of hs-CRP level,FPG,HbA1c and SBP all increased(all P<0.05).With the increase of Lp-PLA2 level,both SBP and DBP increased(all P<0.05).Hs-CRP was positively correlated with HbA1c,SBP and DBP.Lp-PLA2 was positively correlated with HbA1c,SBP,and DBP.At the same time,HbA1c was positively correlated with SBP and DBP.After adjusting for age,gender,smoking history,body mass index(BMI)and triglyceride(TG),the elevated levels of hs-CRP and Lp-PLA2 were the risk factors for EH combined with T2DM(all P<0.05).Conclusion The levels of hs-CRP and Lp-PLA2 can predict the severity of EH combined with T2DM to a certain extent,and hs-CRP and Lp-PLA2 are risk factors of EH combined with T2DM,which can reflect the patients’blood pressure,blood glucose control and hypertension classification.