摘要
目的探讨老年非酒精性脂肪性肝病(NAFLD)与原发性高血压的关系及可能机制。方法选择2008-04-2009-10在我院门诊健康体检的非脂肪肝老年人60例,其中原发性高血压患者19例(A组),非原发性高血压患者41例(B组),老年科住院患者根据肝脏二维B型超声检查结果诊断为NAFLD患者94例,其中伴原发性高血压患者62例(C组),单纯非酒精性脂肪肝32例(D组)。测定血脂、肝功、肾功、血糖、胰岛素浓度、高敏C反应蛋白。结果与B组比较,C组的体质量指数[(31.6±5.0)比(25.4±3.2)kg/m2]、腰臀比值(0.93±0.06比0.81±0.07)、空腹血糖[(6.3±1.6)比(5.2±0.5)mmol/L]、胰岛素浓度[(17.8±9.5)比(7.5±4.0)U/L]、三酰甘油[(1.6±0.6)比(0.8±0.3)mmol/L]、高敏C反应蛋白[(14.2±2.9)比(3.3±1.6)mg/L]、胰岛素抵抗指数[(4.06±1.35)比(2.01±1.16)]、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和γ谷氨酰转肽酶升高水平(均P<0.05)。总胆固醇、低密度脂蛋白胆固醇两组水平相似;老年NAFLD患者原发性高血压的发生率高于非脂肪肝组(P<0.05)。经多变量Logistic分析发现,老年NAFLD和原发性高血压呈相关性(OR1.471,95%CI1.195～1.821,P<0.05)。结论老年NAFLD为原发性高血压的危险因素,机制可能与内脏性肥胖、胰岛素抵抗有关。
Objective To investigate the relationship between nonalcoholic fatty liver disease （NAFLD） and primary hypertension. Methods From April, 2008 to October, 2009,60 patients underwent physical check at outpatient service[19 patients with primary hypertension （group A）, 41 patients with non-primary hypertension （group B）] and 94 patients with NAFLD [62 patients with primary hypertension （group C）, non-alcoholic fatty liver disease 32 cases （group D）] underwent liver uhrasonographic examination were enrolled in department of geriatric. The pro- files of blood lipid, insulin levels, liver function, renal function, plasma glucose and high sensitive C-reactive protein were determined. These cases were compared in the field of check items. Results Compared with group B, the BMI [（31.6±5.0） vs （25.4±3.2）kg/mZ-], waist-hip ratio（0.93±0.06 vs 0. 814±0.07）, fasting glucose [（6.3±1.6） vs （5.24-0.5）mmol/L], insulin levels [（17.8＋9.5） vs [7.54-4.0）U/L], triglyceride [（1.6±0.6） vs （ 0.8±0.3 ） mmol/L], high sensitive C-reactive protein [ （ 14.2±2.9 ） vs （ 3.3±1.6 ） mg/L], insulin resistance index [ { 4.06±1.35 ） vs { 2.01±1.16 ） ], alanine aminotransferase, aspartate aminotransferaseand 7-GGT, glutamyl of group C were raised to higher levels （P〈0.05）; total cholesterol and low density lipoprotein levels were similar in both groups; Incidence of primary hypertension in elderly patients with NAFLD was higher than the non-fatty liver group, statistically significant differences （P〈0.05）. Through multivariate analysis, elderly patients with NAFLD was correlated with primary hypertension in certain degree （OR 1. 471, 95% CI 1. 195 -- 1. 821, P〈 0.05）. Conclusion Nonalcoholic fatty liver disease was a risk factor of primary hypertension. The pathogenesis may be related to visceral obesity, insulin resistance.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2011年第10期929-932,共4页
Chinese Journal of Hypertension
关键词
老年
非酒精性脂肪性肝病
原发性高血压
Elderly
Nonalcoholic fatty liver disease
Primary hypertension
