Ding Xiaoying, Xu Ying, Wang Yufan, Li Xiaohua, Lu Chunhua, Su Jing, Ma Yuhang, Chen Yuting, Yin Yanhua, Zhang Lijun, Wu Yong, Jin Yaqiong, Zheng Lijun, Xu Songmei, Zhu Xiuli, Ma Jilin, Yu Lihua, Jiang Junyi, Zhao Naisi, Yan Qingwu, Greenberg Andrew S, Huang Qianfang, Ren Qian, Sun Haiyan, Gu Mingyu, Zhao Li, Huang Yunhong, Wu Yijie, Qian Chunxian, Peng Yongde
Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Rd, Shanghai 200080, China.
Obesity and Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
Int J Endocrinol. 2017;2017:5262560. doi: 10.1155/2017/5262560. Epub 2017 Mar 26.
The mechanisms facilitating hypertension in diabetes still remain to be elucidated. Nonalcoholic fatty liver disease (NAFLD), which is a higher risk factor for insulin resistance, shares many predisposing factors with diabetes. However, little work has been performed on the pathogenesis of hypertension in type 2 diabetes (T2DM) with NAFLD. The aim of this study is to investigate the prevalence of hypertension in different glycemic statuses and to analyze relationships between NAFLD, metabolic risks, and hypertension within a large community-based population after informed written consent. A total of 9473 subjects aged over 45 years, including 1648 patients with T2DM, were enrolled in this cross-sectional study. Clinical and biochemical parameters of all participants were determined. The results suggested that the patients with prediabetes or T2DM were with higher risks to have hypertension. T2DM with NAFLD had significantly higher levels of blood pressure, triglyceride, uric acid, and HOMA-IR than those without NAFLD. Data analyses suggested that hypertriglyceridemia [OR = 1.773 (1.396, 2.251)], NAFLD [OR = 2.344 (1.736, 3.165)], hyperuricemia [OR = 1.474 (1.079, 2.012)], and insulin resistance [OR = 1.948 (1.540, 2.465)] were associated with the higher prevalence of hypertension independent of other metabolic risk factors in type 2 diabetes. Further studies are needed to focus on these associations.
糖尿病中促使高血压发生的机制仍有待阐明。非酒精性脂肪性肝病（NAFLD）是胰岛素抵抗的一个更高风险因素，与糖尿病有许多共同的易感因素。然而，关于2型糖尿病（T2DM）合并NAFLD患者高血压发病机制的研究较少。本研究的目的是在获得知情书面同意后，调查不同血糖状态下高血压的患病率，并分析一个大型社区人群中NAFLD、代谢风险和高血压之间的关系。本横断面研究共纳入了9473名45岁以上的受试者，其中包括1648例T2DM患者。测定了所有参与者的临床和生化参数。结果表明，糖尿病前期或T2DM患者患高血压的风险更高。合并NAFLD的T2DM患者的血压、甘油三酯、尿酸和HOMA-IR水平显著高于未合并NAFLD的患者。数据分析表明，高甘油三酯血症[比值比（OR）=1.773（1.396，2.251）]、NAFLD[OR=2.344（1.736，3.165）]、高尿酸血症[OR=1.474（1.079，2.012）]和胰岛素抵抗[OR=1.948（1.540，2.465）]与2型糖尿病中独立于其他代谢风险因素的高血压较高患病率相关。需要进一步的研究关注这些关联。
