Bigazzi Roberto, Bianchi Stefano, Batini Valentina, Guzzo Daniela, Campese Vito M
Unità Operativa Nefrologia, Spedali Riuniti di Livorno, Livorno, Italy.
Am J Hypertens. 2006 Apr;19(4):426-31. doi: 10.1016/j.amjhyper.2005.10.002.
The prevalence of overweight and obesity in the United States has dramatically increased. Obesity clusters with a variety of hemodynamic and metabolic disturbances that increase the risk of cardiovascular disease. In this study we evaluated whether overweight subjects with hypertension also manifest hemodynamic and metabolic abnormalities compared with individuals of normal weight.
In a cohort of 129 patients with essential hypertension we measured the relationship between body mass index (BMI), blood pressure (BP), insulin sensitivity, lipid profile, and markers of organ damage including thickness of the carotid artery (IMT) and urine albumin excretion (UAE). A total of 41 normotensive, age-matched, healthy individuals served as control subjects.
Hypertensive individuals showed higher levels of serum triglycerides, insulin area-under-the-curve (AUC), UAE, and greater IMT than normotensive subjects. Overweight hypertensive subjects showed higher levels of serum triglycerides, LDL cholesterol, glucose AUC, insulin AUC, UAE, and IMT than hypertensive subjects with normal body weight (BMI <25). Night-time systolic BP was higher and night-time fall in BP was lower among overweight than among normal-weight hypertensive patients. Simple regression analysis showed that BMI was correlated with age, UAE, BP, insulin and glucose AUC, serum triglycerides, cholesterol, and IMT in hypertensive subjects. However multiple regression analyses showed that BMI significantly correlated only with UAE.
The study results show that increased body weight clusters with a variety of hemodynamic and metabolic abnormalities in hypertensive subjects. However multiple regression analyses showed a significant correlation only between BMI and UAE, a marker and predictor of cardiovascular and renal disease.
美国超重和肥胖的患病率急剧上升。肥胖与多种血液动力学和代谢紊乱相关，这些紊乱会增加心血管疾病的风险。在本研究中，我们评估了与正常体重个体相比，超重的高血压患者是否也表现出血液动力学和代谢异常。
在一组129例原发性高血压患者中，我们测量了体重指数（BMI）、血压（BP）、胰岛素敏感性、血脂谱以及包括颈动脉内膜中层厚度（IMT）和尿白蛋白排泄量（UAE）在内的器官损伤标志物之间的关系。共有41名年龄匹配的血压正常的健康个体作为对照。
高血压患者的血清甘油三酯、胰岛素曲线下面积（AUC）、UAE水平以及IMT均高于血压正常的受试者。超重的高血压患者的血清甘油三酯、低密度脂蛋白胆固醇、血糖AUC、胰岛素AUC、UAE水平以及IMT均高于体重正常（BMI<25）的高血压患者。超重的高血压患者夜间收缩压较高，夜间血压下降幅度低于体重正常的高血压患者。简单回归分析显示，高血压患者中BMI与年龄、UAE、BP、胰岛素和血糖AUC、血清甘油三酯、胆固醇以及IMT相关。然而，多元回归分析显示BMI仅与UAE显著相关。
研究结果表明，高血压患者体重增加与多种血液动力学和代谢异常相关。然而，多元回归分析显示BMI仅与UAE显著相关，UAE是心血管和肾脏疾病的标志物及预测指标。
