中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
24期
11189-11192
,共4页
张喻平%邓武权%张军霞%陈兵
張喻平%鄧武權%張軍霞%陳兵
장유평%산무권%장군하%진병
高血压%肥胖症%尿酸%胰岛素抵抗
高血壓%肥胖癥%尿痠%胰島素牴抗
고혈압%비반증%뇨산%이도소저항
Hypertension%Obesity%Uric acid%Insulin resistance
目的：探讨初诊未治疗原发性高血压患者血尿酸水平和肥胖、胰岛素抵抗的相关性。方法选取2012年11月至2013年7月第三军医大学西南医院体检中心高血压患者260例，根据体质指数（BMI）分为肥胖高血压组（OHT）（132例）和非肥胖高血压组（HT）（128例），64例健康体检者作为对照组（NC），观察3组尿酸水平，比较高尿酸血症（HUA）患病率。探讨人体测量参数、血压、代谢指标、胰岛素抵抗指数（HOMA-IR）与尿酸的相关性。结果 OHT组HUA患病率明显高于HT组（43.94%vs.13.27%， P＜0.05）。OHT组和HT组尿酸、HOMA-IR明显高于NC组，OHT组尿酸、HOMA-IR明显高于HT组（P＜0.05）。Pearson相关分析提示尿酸与体重、BMI、腰围、腰臀比、收缩压、舒张压、甘油三酯、LDL-C、FINS、HOMA-IR正相关，与HDL-C负相关（P＜0.05）。多元回归显示，性别、BMI、舒张压、甘油三酯、HDL-C是尿酸的独立影响因素。结论高血压患者体内出现明显高尿酸血症并伴胰岛素抵抗，随体质指数增加，血尿酸水平增高，胰岛素抵抗进一步加重。推测血尿酸可能通过促进胰岛素抵抗参与肥胖高血压的发生发展。
目的：探討初診未治療原髮性高血壓患者血尿痠水平和肥胖、胰島素牴抗的相關性。方法選取2012年11月至2013年7月第三軍醫大學西南醫院體檢中心高血壓患者260例，根據體質指數（BMI）分為肥胖高血壓組（OHT）（132例）和非肥胖高血壓組（HT）（128例），64例健康體檢者作為對照組（NC），觀察3組尿痠水平，比較高尿痠血癥（HUA）患病率。探討人體測量參數、血壓、代謝指標、胰島素牴抗指數（HOMA-IR）與尿痠的相關性。結果 OHT組HUA患病率明顯高于HT組（43.94%vs.13.27%， P＜0.05）。OHT組和HT組尿痠、HOMA-IR明顯高于NC組，OHT組尿痠、HOMA-IR明顯高于HT組（P＜0.05）。Pearson相關分析提示尿痠與體重、BMI、腰圍、腰臀比、收縮壓、舒張壓、甘油三酯、LDL-C、FINS、HOMA-IR正相關，與HDL-C負相關（P＜0.05）。多元迴歸顯示，性彆、BMI、舒張壓、甘油三酯、HDL-C是尿痠的獨立影響因素。結論高血壓患者體內齣現明顯高尿痠血癥併伴胰島素牴抗，隨體質指數增加，血尿痠水平增高，胰島素牴抗進一步加重。推測血尿痠可能通過促進胰島素牴抗參與肥胖高血壓的髮生髮展。
목적：탐토초진미치료원발성고혈압환자혈뇨산수평화비반、이도소저항적상관성。방법선취2012년11월지2013년7월제삼군의대학서남의원체검중심고혈압환자260례，근거체질지수（BMI）분위비반고혈압조（OHT）（132례）화비비반고혈압조（HT）（128례），64례건강체검자작위대조조（NC），관찰3조뇨산수평，비교고뇨산혈증（HUA）환병솔。탐토인체측량삼수、혈압、대사지표、이도소저항지수（HOMA-IR）여뇨산적상관성。결과 OHT조HUA환병솔명현고우HT조（43.94%vs.13.27%， P＜0.05）。OHT조화HT조뇨산、HOMA-IR명현고우NC조，OHT조뇨산、HOMA-IR명현고우HT조（P＜0.05）。Pearson상관분석제시뇨산여체중、BMI、요위、요둔비、수축압、서장압、감유삼지、LDL-C、FINS、HOMA-IR정상관，여HDL-C부상관（P＜0.05）。다원회귀현시，성별、BMI、서장압、감유삼지、HDL-C시뇨산적독립영향인소。결론고혈압환자체내출현명현고뇨산혈증병반이도소저항，수체질지수증가，혈뇨산수평증고，이도소저항진일보가중。추측혈뇨산가능통과촉진이도소저항삼여비반고혈압적발생발전。
Objective To investigate the correlation between serum uric acid and insulin resistance, obesity in untreated essential hypertension. Methods From November 2012 to July 2013, 260 hypertension patients were enrolled in Southwest Hospital medical examination center of Third Military Medical University. These patients were divided into obese hypertensive group(OHT) (132 cases) and non-obese hypertensive group (HT)(128 cases) according to body mass index (BMI), in addition 64 healthy individuals as control group(NC). Observe serum uric acid levels of 3 groups, compare the hyperuricemia (HUA) prevalence. The correlation between anthropometric parameters, blood pressure, metabolic markers, insulin resistance index (HOMA-IR) and serum UA was analyzed. Results HUA prevalence of OHT was significantly higher than HT (43.94%vs. 13.27%, P<0.05). Compare to NC group, serum UA and HOMA-IR were significantly higher in OHT and HT group (P<0.05). Serum UA and HOMA-IR of OHT was significantly higher than the HT(P<0.05). Pearson correlation show that Serum UA and body weight, BMI, waist circumference, waist-hip ratio, SBP, DBP, TG, LDL-C, FINS, HOMA-IR was positively correlated, and negatively correlated with HDL-C(P<0.05). Multiple regression analysis showed that sex, BMI, DBP, TG, HDL-C were the independent influence factors of serum UA. Conclusion There was significant hyperuricemia associated with insulin resistance in hypertension patients. With the increase in body mass index, serum uric acid increased, insulin resistance further. Speculated that uric acid may though promote insulin resistance participate the occurrence and development of obesity hypertension.
