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

doi:10.3969/j.issn.1004-583X.2021.01.005

摘要/Abstract

摘要：

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。

关键词: 高血压, 糖尿病, 2型, C反应蛋白质, 磷脂酶A₂

Abstract:

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.

Key words: hypertension, diabetes melittus, type 2, C-reactive protein, phospholipase A₂

中图分类号:

R544.1

刘晓腾, 单伟超, 侯瑞田, 李金萍, 高宇, 金凤表, 刘畅. 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[J]. 临床荟萃, 2021, 36(1): 25-29.

Liu Xiaoteng, Shan Weichao, Hou Ruitian, Lin Jinping, Gao Yu, Jin Fengbiao, Liu Chang. Correlation between serum hypersensitive C-reactive protein, lipoprotein-related phospholipase A₂and senile essential hypertension complicated with type 2 diabetes[J]. Clinical Focus, 2021, 36(1): 25-29.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.01.005

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I1/25

图/表 5

参考文献 17

[1]	He QH, Dong M, Pan Q, et al. Correlation between changes in inflammatory cytokines and the combination with hypertension in patients with type 2 diabetes mellitus[J]. Minerva Endocrinol, 2019,44(3):252-258.
[2]	Xue X, Qiu Y, Cao SZ, et al. Detection and significance of TNF-α and hs-CRP in the pleural effusion of patients with diabetes and pulmonary tuberculosis[J]. Eur J Inflamm, 2019,17:1-5.
[3]	Qiao J, Zhou K C, Huang C, et al. Comparison of serum Lp-PLA₂ levels in ischemic stroke patients with H-type hypertension or non-H-type hypertension[J]. J Clin Lab Anal, 2020,34(2):23068.
[4]	中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志, 2011,39(7):579-616.
[5]	翁建平. 中国2型糖尿病防治指南(2013年版)[J]. 中华内分泌代谢杂志, 2014,30(10):893-942.
[6]	刘旭帮, 张朝华, 赵信科. 老年高血压合并冠心病患者同型半胱氨酸、胱抑素C与颈部血管超声指标的关系[J]. 中国老年学杂志, 2019,39(22):5397-5400.
[7]	Mehmet NA, Sedat A, Ali Ü, et al. Assessment of serum galectin-3, methylated arginine and Hs-CRP levels in type 2 diabetes and prediabetes[J]. Life Sci, 2019,231:116577. doi: 10.1016/j.lfs.2019.116577 URL
[8]	AlRubeaan K, Youssef AM, Ibrahim HM, et al. All-cause mortality and its risk factors among type 1 and type 2 diabetes mellitus in a country facing diabetes epidemic[J]. Diabetes Res Clin Pract, 2016,118:130-139. doi: 10.1016/j.diabres.2016.06.012 URL
[9]	Chen Z, Zhao GH, Zhang YK, et al. Research on the correlation of diabetes mellitus complicated with osteoporosis with lipid metabolism, adipokines and inflammatory factors and its regression analysis[J]. Eur Rev Med Pharmacol Sci, 2017,21(17):3900-3905. doi: 13353 pmid: 28975973
[10]	He QH, Dong M, Pan Q, et al. Correlation between changes in inflammatory cytokines and the combination with hypertension in patients with type 2 diabetes mellitus[J]. Minerva Endocrinol, 2019,44(3):252-258.
[11]	Bakirci EM, Degirmenci H, Hamur H, et al. New inflammatory markers for prediction of non-dipper blood pressure pattern in patients with essential hypertension: Serum YKL-40/Chitinase 3-like protein 1 levels and echocardiographic epicardial adipose tissue thickness[J]. Clin Exp Hypertens, 2015,37(6):505-510. doi: 10.3109/10641963.2015.1013122 URL
[12]	Hanan E, Azza MA, Inas MT, et al. Inflammatory markers and control of type 2 diabetes mellitus.Diabetes & metabolic syndrome[J]. Diabetes Metab Syndr, 2019,13(1):800-804. doi: 10.1016/j.dsx.2018.11.061 URL
[13]	Ali S, Khan MA Khan, MA, et al. CRP, an inflammatory biomarker in type 2 diabetes mellitus[J]. JPMI, 2015,29(1):18-23.
[14]	Li ZM, Liu JG, Shen YS, et al. Increased Lipoprotein-associated phospholipase A₂ activity portends an increased risk of resistant hypertension[J]. Lipids Health Dis, 2016,15(1):1-5. doi: 10.1186/s12944-015-0172-5 URL
[15]	Tsai WC, Lin CC, Huang YY. et al. Association of lipoprotein-associated phospholipase A₂ with central aortic pressure but not peripheral blood pressure in essential hypertension[J]. Atheroscler Suppl, 2007,8(1):107.
[16]	Saswati D, Gupta SK, Girish MP, et al. A comparison of lipoprotein associated phospholipase A₂ and high sensitive C-reactive protein levels between diabetic and non-diabetic patients with coronary artery disease[J]. Endocr Abstr, 2014,35.
[17]	周学玲, 张紫晨, 邱雪婷, 等. 初诊2型糖尿病患者脂蛋白相关磷脂酶A₂与胰岛素抵抗的相关性研究[J]. 南京医科大学学报(自然科学版), 2020,40(5):681-686.

组别		例数		女[例(%)]		年龄(岁)	吸烟[例(%)]		BMI(kg/m²)		FPG(mmol/L)
对照组		61		30(49.2)		66.38±4.77	33(54.1)		24.57±3.01		5.29±0.60
DM组		63		31(49.2)		65.63±3.04	36(57.1)		24.60±2.86		8.75±1.93
EH组		60		31(51.7)		67.40±4.41	30(50.0)		26.13±3.67		5.35±0.57
EH+DM组		68		32(47.1)		65.53±4.75	37(54.4)		26.85±4.10^*#		8.56±1.34
χ²/F值				0.271		2.499	0.642		6.964		147.298
P值				0.956		0.060	0.887		<0.01		<0.01
组别	例数		HbA₁c(%)		SBP(mmHg)			DBP(mmHg)		TG(mmol/L)		LDL-C(mmol/L)
对照组	61		5.26±0.84		126.62±10.34			76.90±7.57		1.87±0.94		2.14±0.43
DM组	63		8.66±1.87		127.15±9.87			80.37±8.78		2.11±1.33		2.55±0.77^*
EH组	60		5.30±0.74		155.60±16.48			93.75±9.39		1.89±0.87		2.52±0.92^*
EH+DM组	68		9.02±1.63		162.15±17.35			93.97±12.07		2.69±2.16^*▲		2.97±0.57^*#▲
F值			141.831		112.540			53.538		4.512		15.465
P值			<0.01		<0.01			<0.01		0.004		<0.01
组别	例数		HDL-C(mmol/L)		AST(U/L)			Scr(μmol/L)		hs-CRP(mg/dl)		Lp-PLA₂(μg/L)
对照组	61		1.47±0.40		25.79±8.66			60.14±11.18		1.24±0.19		158.50±15.68
DM组	63		1.06±0.31^*		29.32±26.08			55.91±15.25		2.89±2.44^*		196.63±24.06^*
EH组	60		1.10±0.24^*		25.05±9.39			68.51±16.76		3.26±0.65^*		191.69±49.69^*
EH+DM组	68		1.02±0.27^*		29.12±14.85			68.50±19.72		4.07±1.65^*#▲		208.62±19.12^*▲
F值			28.221		1.144			9.624		38.341		32.533
P值			<0.01		0.332			<0.01		<0.01		<0.01

组别		例数		女[例(%)]		年龄(岁)	吸烟[例(%)]		BMI(kg/m²)		FPG(mmol/L)
对照组		61		30(49.2)		66.38±4.77	33(54.1)		24.57±3.01		5.29±0.60
DM组		63		31(49.2)		65.63±3.04	36(57.1)		24.60±2.86		8.75±1.93
EH组		60		31(51.7)		67.40±4.41	30(50.0)		26.13±3.67		5.35±0.57
EH+DM组		68		32(47.1)		65.53±4.75	37(54.4)		26.85±4.10^*#		8.56±1.34
χ²/F值				0.271		2.499	0.642		6.964		147.298
P值				0.956		0.060	0.887		<0.01		<0.01
组别	例数		HbA₁c(%)		SBP(mmHg)			DBP(mmHg)		TG(mmol/L)		LDL-C(mmol/L)
对照组	61		5.26±0.84		126.62±10.34			76.90±7.57		1.87±0.94		2.14±0.43
DM组	63		8.66±1.87		127.15±9.87			80.37±8.78		2.11±1.33		2.55±0.77^*
EH组	60		5.30±0.74		155.60±16.48			93.75±9.39		1.89±0.87		2.52±0.92^*
EH+DM组	68		9.02±1.63		162.15±17.35			93.97±12.07		2.69±2.16^*▲		2.97±0.57^*#▲
F值			141.831		112.540			53.538		4.512		15.465
P值			<0.01		<0.01			<0.01		0.004		<0.01
组别	例数		HDL-C(mmol/L)		AST(U/L)			Scr(μmol/L)		hs-CRP(mg/dl)		Lp-PLA₂(μg/L)
对照组	61		1.47±0.40		25.79±8.66			60.14±11.18		1.24±0.19		158.50±15.68
DM组	63		1.06±0.31^*		29.32±26.08			55.91±15.25		2.89±2.44^*		196.63±24.06^*
EH组	60		1.10±0.24^*		25.05±9.39			68.51±16.76		3.26±0.65^*		191.69±49.69^*
EH+DM组	68		1.02±0.27^*		29.12±14.85			68.50±19.72		4.07±1.65^*#▲		208.62±19.12^*▲
F值			28.221		1.144			9.624		38.341		32.533
P值			<0.01		0.332			<0.01		<0.01		<0.01

高血压分级	例数	FPG(mmol/L)	HbA₁c(%)	hs-CRP(mg/dl)	Lp-PLA₂(μg/L)
高血压1级	26	7.16±1.25	7.85±1.12	3.04±0.93	194.82±14.26
高血压2级	21	8.62±0.39^*	8.94±0.59^*	4.11±1.10^*	208.84±10.68^*
高血压3级	21	9.66±1.21^*#	10.55±1.67^*#	5.31±1.96^*#	225.47±17.89^*#
F值		22.299	29.327	15.947	25.768
P值		<0.01	<0.01	<0.01	<0.01

高血压分级	例数	FPG(mmol/L)	HbA₁c(%)	hs-CRP(mg/dl)	Lp-PLA₂(μg/L)
高血压1级	26	7.16±1.25	7.85±1.12	3.04±0.93	194.82±14.26
高血压2级	21	8.62±0.39^*	8.94±0.59^*	4.11±1.10^*	208.84±10.68^*
高血压3级	21	9.66±1.21^*#	10.55±1.67^*#	5.31±1.96^*#	225.47±17.89^*#
F值		22.299	29.327	15.947	25.768
P值		<0.01	<0.01	<0.01	<0.01

项目	例数	FPG(mmol/L)	HbA₁c(%)	SBP(mmHg)	DBP(mmHg)
hs-CRP
低分位组	84	6.08±1.83	6.13±1.98	129.05±11.29	78.17±8.00
中分位组	88	7.05±1.95^*	7.07±2.08^*	146.76±18.48^*	89.95±10.69^*
高分位组	80	8.07±2.02^*#	8.25±2.22^*#	154.63±23.96^*#	91.09±13.40^*
F值		21.634	21.018	41.265	36.221
P值		<0.01	<0.01	<0.01	<0.01
Lp-PLA₂
低分位组	84	5.88±1.48	5.70±1.34	135.86±17.64	82.36±10.71
中分位组	84	7.34±2.25^*	7.49±2.14^*	140.57±18.57	85.15±11.70
高分位组	84	7.94±1.91^*	8.22±2.37^*	153.63±23.36^*#	91.64±12.66^*#
F值		25.793	35.510	17.777	13.882
P值		<0.01	<0.01	<0.01	<0.01

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

Correlation between serum hypersensitive C-reactive protein, lipoprotein-related phospholipase A₂and senile essential hypertension complicated with type 2 diabetes

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 17

相关文章 15

编辑推荐

Metrics

本文评价

项目	HbA₁c		SBP		DBP
项目	r值	P值	r值	P值	r值	P值
hs-CRP	0.360	<0.01	0.465	<0.01	0.406	<0.01
Lp-PLA₂	0.381	<0.01	0.304	<0.01	0.341	<0.01
HbA₁c	-	-	0.218	<0.01	0.203	0.01

自变量	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
自变量	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
LDL-C	1.608	0.609	6.970	0.008	4.992	1.513	16.468
HDL-C	-4.659	1.413	10.877	0.01	0.009	0.001	0.151
hs-CRP	3.796	0.825	21.199	<0.01	44.544	8.850	224.208
Lp-PLA₂	0.095	0.021	19.377	<0.01	1.099	1.054	1.147

[1]	吕莎莎, 宋金兰, 石健. m.3243A>G突变相关线粒体糖尿病1例并文献复习[J]. 临床荟萃, 2024, 39(2): 160-163.
[2]	张佳楠, 孙琳琳, 詹潇燕, 李冰. 血清维生素B₁₂与老年2型糖尿病轻度认知功能障碍的关系[J]. 临床荟萃, 2024, 39(1): 34-37.
[3]	位增, 曹灵, 佘敦敏, 刘彦, 王艳, 张真稳. 54例2型糖尿病患者合并新型冠状病毒感染的死亡原因分析[J]. 临床荟萃, 2023, 38(9): 806-812.
[4]	张娜文, 黄少敏, 田利民. 2型糖尿病与帕金森病相关性研究的进展[J]. 临床荟萃, 2023, 38(9): 845-850.
[5]	杨鑫, 许华娇. 基于Web of Science糖尿病患者心理干预研究的文献计量学分析[J]. 临床荟萃, 2023, 38(8): 731-736.
[6]	马光宇, 罗慧娟, 王冬菊, 肖小敏. 黄芩苷治疗糖尿病及其并发症的研究进展[J]. 临床荟萃, 2023, 38(8): 757-762.
[7]	张欣欣, 刘国庆, 王蓓蓓. 糖尿病酮症酸中毒引起极度血小板增多症1例并文献复习[J]. 临床荟萃, 2023, 38(8): 719-721.
[8]	金家辉, 杨阳, 秦铜, 何雨欣, 苏美华. 补充益生菌对2型糖尿病患者糖代谢改善的meta分析[J]. 临床荟萃, 2023, 38(7): 581-587.
[9]	李志勇, 李星. 多模态超声在高血压患者大脑中动脉狭窄筛查中的临床价值[J]. 临床荟萃, 2023, 38(7): 613-617.
[10]	贾丽娜, 吴美妮, 尹昌浩. 2型糖尿病认知功能障碍发病机制的研究进展[J]. 临床荟萃, 2023, 38(6): 554-558.
[11]	陈婷, 刘金彦. 中药靶向PI3K/Akt/mTOR通路调节自噬在糖尿病肾脏病中的研究进展[J]. 临床荟萃, 2023, 38(6): 564-568.
[12]	苏晨蓓, 王富军. 糖尿病下肢动脉疾病介入治疗疗效的研究进展[J]. 临床荟萃, 2023, 38(6): 569-572.
[13]	倪艺芸, 刘彬, 梁琪, 李晓凤. 白细胞介素6和C反应蛋白预测新型冠状病毒肺炎严重程度的meta分析[J]. 临床荟萃, 2023, 38(6): 493-499.
[14]	吴亚楠, 延天美, 梁鹏, 魏立民. 中老年糖尿病患者抑郁症状的高危识别[J]. 临床荟萃, 2023, 38(6): 516-520.
[15]	吕丽丽, 翟满满, 丁小艳, 陈永清. 线粒体转录因子A介导的线粒体功能障碍在糖尿病心肌病中的作用[J]. 临床荟萃, 2023, 38(5): 465-468.