Huang I-Ching, Chang Chao-Chien, Hsu Bang-Gee, Lee Chung-Jen, Wang Ji-Hung
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Nephrology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Tzu Chi Med J. 2017 Jul-Sep;29(3):148-153. doi: 10.4103/tcmj.tcmj_56_17.
Hypertension is a risk factor for peripheral artery disease (PAD). Serum leptin plays an important role in promoting endothelial dysfunction. The aim of this study is to investigate whether the leptin level is associated with PAD in hypertensive patients.
Ninety-eight hypertensive patients were enrolled in this study. Ankle-brachial index (ABI) values were measured using an automated oscillometric device. Patients with an ABI value <0.9 were considered the low ABI group. C-reactive protein (CRP) was measured using standard enzymatic automated methods. Serum levels of human leptin were determined using a commercially available enzyme immunoassay.
Eighteen (18.4%) hypertensive patients were included in the low ABI group. Hypertensive patients in the low ABI group had higher serum creatinine ( < 0.001), CRP ( = 0.003), and leptin ( < 0.001) levels, higher prevalence of diabetes ( = 0.036), and current smoking ( = 0.034) than patients in the normal ABI group. Univariate linear regression analyses revealed that body weight ( = 0.014), waist circumference ( = 0.010), body mass index ( = 0.002), and logarithmically transformed CRP (log-CRP, = 0.001) were positively correlated with serum log-leptin levels in hypertensive patients. Multivariate stepwise linear regression analysis showed that log-leptin (β = 0.439, adjusted change = 0.224, < 0.001) was also an associated factor of PAD in hypertensive patients.
A higher log-leptin value is an independent predictor of PAD in hypertensive patients.
高血压是外周动脉疾病（PAD）的一个危险因素。血清瘦素在促进内皮功能障碍中起重要作用。本研究的目的是调查瘦素水平是否与高血压患者的PAD相关。
本研究纳入了98例高血压患者。使用自动示波装置测量踝臂指数（ABI）值。ABI值<0.9的患者被视为低ABI组。使用标准酶促自动化方法测量C反应蛋白（CRP）。使用市售酶免疫测定法测定人瘦素的血清水平。
低ABI组纳入18例（18.4%）高血压患者。低ABI组的高血压患者血清肌酐（<0.001）、CRP（=0.003）和瘦素（<0.001）水平更高，糖尿病（=0.036）和当前吸烟（=0.034）的患病率高于正常ABI组患者。单因素线性回归分析显示，体重（=0.014）、腰围（=0.010）、体重指数（=0.002）和对数转换后的CRP（log-CRP，=0.001）与高血压患者的血清log-瘦素水平呈正相关。多因素逐步线性回归分析表明，log-瘦素（β=0.439，调整后的变化=0.224，<0.001）也是高血压患者PAD的一个相关因素。
较高的log-瘦素值是高血压患者PAD的独立预测因子。
