福建沿海地区人群心血管活性肽apelin水平与血压的相关性研究
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摘要
目的:探讨福建沿海地区人群心血管活性肽apelin水平与血压的关系。方法:采用横断面调查方法纳入福建沿海地区30~79岁人群1 031人,男性416例,平均年龄(55.1±10.9)岁,均行问卷调查、体格检查、血生化及血浆apelin水平检测。1 031人根据美国最新高血压治疗指南(JNC7)的高血压定义分组:高血压组(n=496),收缩压≥140 mm Hg(1 mm Hg=0.133 k Pa)或舒张压≥90 mm Hg或已开始服降压药者;正常高值血压组(n=314):未服用降压药物收缩压120~139 mm Hg和(或)舒张压80~89 mm Hg;正常血压组(n=221):未服用降压药物收缩压<120 mm Hg且舒张压<80 mm Hg。1031人根据apelin四分位水平分为四组,Q1组(n=258):<164.8ng/ml,Q2组(n=258):164.8~<220.0 ng/ml,Q3组(n=258):220.0~283.1 ng/ml,Q4组(n=257):>283.1 ng/ml。采用单因素方差分析趋势检验、协方差分析和多元线性回归分析评价血浆apelin与血压的相关性。结果:1 031人中男性血浆apelin水平[(220.57±78.87)pg/ml]比女性[(232.06±81.17)pg/ml]降低,正常高值血压组与正常血压组比较、高血压组与正常血压组和正常高值血压组比较,apelin水平均降低(P<0.05)。Q2、Q3组与Q1组比较,收缩压、舒张压与平均动脉压均降低,Q4组与其他三组比较,收缩压、舒张压(不包括Q2组和Q3组)与平均动脉压均降低,差异均有统计学意义(P均<0.05)。调整了性别和年龄,收缩压、舒张压及平均动脉压在apelin四分位组间的差异仍有统计学意义(P<0.05)。多元线性回归分析提示收缩压、舒张压及平均动脉压与apelin水平存在负相关,在调整了其它心血管危险因素后,这种相关关系仍然存在。结论:apelin水平随着血压水平的升高而降低,提示心血管活性肽apelin水平与血压调控相关。
Objectives: To explore the relationship between vascular active peptide, apelin level and blood pressure in a coastal population of Fujian province. Methods: A total of 1031 subjects with the mean age of(55.1 ± 10.9) years in a coastal area of Fujian province were included in this cross-sectional study, and 416 subjects with male gender. The questionnaire survey, physical examination and plasma level of apelin measurement were conducted. Based on JNC-7 definition of hypertension, the subjects were divided into 3 groups: 1 Hypertension group, the patients with systolic blood pressure(SBP) ≥ 140 mm Hg and/or diastolic blood pressure(DBP) ≥ 90 mm Hg, n=496. 2 Pre-hypertension group, SBP at(120-139) mm Hg and/or DBP at(80-89) mm Hg without medication, n=314. 3 Normal BP group, SBP < 120 mm Hg and DBP < 80 mm Hg without medication, n=221. Based on 4 quartiles of apelin levels, the subjects were further divided into 4 groups: Q1 group, apelin < 164.8 ng/ml, n=258. Q2 group, apelin at(164.8-< 220.0) ng/ml, n=258. Q3 group, apelin at(220.0-283.1) ng/ml, n=258. Q4 group, apelin > 283.1 ng/ml, n=257. One way analysis of variance, covariance analysis and multivariate linear regression analysis were used to study the relationship between apelin level and BP. Results: The apelin level in male gender(220.57 ± 78.87) pg/ml was lower than female gender(232.06 ± 81.17) pg/ml. Compared with Normal group, Pre-hypertension group had decreased apelin level, compared with Normal and Pre-hypertension groups, Hypertension group had decreased apelin level, P<0.05. Compared with Q1 group, Q2, Q3 groups presented decreased SBP, DBP and mean arterial blood pressure(MABP), and compared with other 3 groups, Q4 group had decreased SBP, DBP(not including Q2, Q3 groups) and MABP, P<0.05. With adjusted age and gender, SBP, DBP and MABP were significantly different among 4 quartiles of apelin groups, P<0.05. Multivariate linear regression analysis indicated that SBP, DBP and MABP were negatively related to apelin level, such relationship remained the same after adjusting the other cardiovascular risk factors.Conclusion: Apelin level dropping accompanying with BP increasing implies that vascular active peptide, apelin involved in BP regulation.
Objectives: To explore the relationship between vascular active peptide, apelin level and blood pressure in a coastal population of Fujian province. Methods: A total of 1031 subjects with the mean age of(55.1 ± 10.9) years in a coastal area of Fujian province were included in this cross-sectional study, and 416 subjects with male gender. The questionnaire survey, physical examination and plasma level of apelin measurement were conducted. Based on JNC-7 definition of hypertension, the subjects were divided into 3 groups: 1 Hypertension group, the patients with systolic blood pressure(SBP) ≥ 140 mm Hg and/or diastolic blood pressure(DBP) ≥ 90 mm Hg, n=496. 2 Pre-hypertension group, SBP at(120-139) mm Hg and/or DBP at(80-89) mm Hg without medication, n=314. 3 Normal BP group, SBP < 120 mm Hg and DBP < 80 mm Hg without medication, n=221. Based on 4 quartiles of apelin levels, the subjects were further divided into 4 groups: Q1 group, apelin < 164.8 ng/ml, n=258. Q2 group, apelin at(164.8-< 220.0) ng/ml, n=258. Q3 group, apelin at(220.0-283.1) ng/ml, n=258. Q4 group, apelin > 283.1 ng/ml, n=257. One way analysis of variance, covariance analysis and multivariate linear regression analysis were used to study the relationship between apelin level and BP. Results: The apelin level in male gender(220.57 ± 78.87) pg/ml was lower than female gender(232.06 ± 81.17) pg/ml. Compared with Normal group, Pre-hypertension group had decreased apelin level, compared with Normal and Pre-hypertension groups, Hypertension group had decreased apelin level, P<0.05. Compared with Q1 group, Q2, Q3 groups presented decreased SBP, DBP and mean arterial blood pressure(MABP), and compared with other 3 groups, Q4 group had decreased SBP, DBP(not including Q2, Q3 groups) and MABP, P<0.05. With adjusted age and gender, SBP, DBP and MABP were significantly different among 4 quartiles of apelin groups, P<0.05. Multivariate linear regression analysis indicated that SBP, DBP and MABP were negatively related to apelin level, such relationship remained the same after adjusting the other cardiovascular risk factors.Conclusion: Apelin level dropping accompanying with BP increasing implies that vascular active peptide, apelin involved in BP regulation.
引文
[1]Lee DK,Cheng R,Nguyen T,et al.Characterization of apelin,the ligand for the APJ receptor.Neurochem,2000,74:34-41.
[2]Tatemoto K,Takayama K,Zou MX,et al.The novel peptide apelin lowers blood pressure via a nitric oxide-dependent mechanism.Regulatory Peptides,2001,99:87-92.
[3]Cheng X,Cheng XS,Pang CC.Venous dilator effect of apelin,an endogenous peptide ligand for the orphan APJ receptor,in conscious rats.Eur Pharmacol,2003,470:171-175.
[4]Lee DK,Saldivia VR,Nguyen T,et al.Modification of the terminal residue of apelin-13 antagonizes its hypotensive acti on.Endocrinology,2005,146:231-236.
[5]Barnes GD,Alam S,Carter G,et al.Sustained cardiovascular actions of APJ agonism during renin-angiotensin system activation and in patients with heart failure.Circ Heart Fail,2013,6:482-491.
[6]American Diabetes Association.Standards of medical care in diabetes-2011.Diabetes Care,2011,34(Suppl):S11-61.
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[8]Charles CJ.Putative role for apelin in pressure/volume homeostasis and cardiovascular disease.Cardiovsc Hematol Agents Med Chem,2007,5:1-10.
[9]Kleinz MJ,Davenport AP.Immunocytochemical localization of the endogenous vasoactive peptide apelin to human vascular and endocardial endothelial cells.Regul Pept,2004,118:119-125.
[10]Ishida J,Hashimoto T,Hashimoto Y,et al.Regulatory roles for APJ,a seven-transmembrane receptor related to angiotensin-type 1 receptor in blood pressure in vivo.J Biol Chem,2004,279:26274-26279.
[11]Zhong JC,Huang DY,Liu GF,et al.Effects of all-trans retinoic acid on orphan receptor APJ signaling in spontaneously hypertensive rats.Cardiovasc Res,2005,65:743-750.
[12]Zhong JC,Huang DY,Yang YM,et al.Upregulation of angiotension converting enzyme by all-trans retinoic acid in spontaneously hypertensive rats.Hypertension,2004,44:907-912.
[13]Sonmez A,Celebi G,Erdem G,et al.Plasma apelin and ADMA levels in patients with essential hypertension.Clin Exp Hypertens,2010,32:179-183.
[14]Strazynska A,Bryl W,Hoffmann K,et al.The estimation of concentration of apelin,insulin,fasting glucose and anthropometric factors in young hypertensive patients.J Hypertens,2010,28(e-Supplement A):e187.
[15]Li WW,Niu WQ,Zhang Y,et al.Family-based analysis of apelin and AGTRL1 gene polymorphisms with hypertension in Han Chinese.J Hypertens,2009,27:1194-1201.
[16]Niu W,Wu S,Zhang Y,et al.Validation of genetic association in apelin-AGTRL1 system with hypertension in a larger Han Chinese population.J Hypertens,2010,28:1854-1861.
[17]贾荣波,刘永选,王兆红.高血压患者强化管理与常规管理的比较研究.中国循环杂志,2013,28:360-363.
[18]Sung KC,Suh JY,Kim BS,et al.High sensitivity C-reactive protein as an independent risk factor for essential hypertension.Am J Hypertens,2003,16:429-433.
[19]Andrievskaia EM,Ivleva AIa,Minina ES,et al.Predictive value C-reactive protein assessment level in women with arterial hypertension.Kardiologiia,2011,51:32-38.
[20]刘蓉,杨跃进,乔树宾,等.高敏C反应蛋白对急性ST段抬高型心肌梗死患者近期预后的预测价值.中国循环杂志,2011,26:19-22.
[2]Tatemoto K,Takayama K,Zou MX,et al.The novel peptide apelin lowers blood pressure via a nitric oxide-dependent mechanism.Regulatory Peptides,2001,99:87-92.
[3]Cheng X,Cheng XS,Pang CC.Venous dilator effect of apelin,an endogenous peptide ligand for the orphan APJ receptor,in conscious rats.Eur Pharmacol,2003,470:171-175.
[4]Lee DK,Saldivia VR,Nguyen T,et al.Modification of the terminal residue of apelin-13 antagonizes its hypotensive acti on.Endocrinology,2005,146:231-236.
[5]Barnes GD,Alam S,Carter G,et al.Sustained cardiovascular actions of APJ agonism during renin-angiotensin system activation and in patients with heart failure.Circ Heart Fail,2013,6:482-491.
[6]American Diabetes Association.Standards of medical care in diabetes-2011.Diabetes Care,2011,34(Suppl):S11-61.
[7]Chobanian AV,Bakris GL,Black HR,et al.The Seventh Report of the Joint National Committee on Prevention,Detection,Evaluation,and Treatment of High Blood Pressure:the JNC 7 report.JAMA,2003,289:2560-2572.
[8]Charles CJ.Putative role for apelin in pressure/volume homeostasis and cardiovascular disease.Cardiovsc Hematol Agents Med Chem,2007,5:1-10.
[9]Kleinz MJ,Davenport AP.Immunocytochemical localization of the endogenous vasoactive peptide apelin to human vascular and endocardial endothelial cells.Regul Pept,2004,118:119-125.
[10]Ishida J,Hashimoto T,Hashimoto Y,et al.Regulatory roles for APJ,a seven-transmembrane receptor related to angiotensin-type 1 receptor in blood pressure in vivo.J Biol Chem,2004,279:26274-26279.
[11]Zhong JC,Huang DY,Liu GF,et al.Effects of all-trans retinoic acid on orphan receptor APJ signaling in spontaneously hypertensive rats.Cardiovasc Res,2005,65:743-750.
[12]Zhong JC,Huang DY,Yang YM,et al.Upregulation of angiotension converting enzyme by all-trans retinoic acid in spontaneously hypertensive rats.Hypertension,2004,44:907-912.
[13]Sonmez A,Celebi G,Erdem G,et al.Plasma apelin and ADMA levels in patients with essential hypertension.Clin Exp Hypertens,2010,32:179-183.
[14]Strazynska A,Bryl W,Hoffmann K,et al.The estimation of concentration of apelin,insulin,fasting glucose and anthropometric factors in young hypertensive patients.J Hypertens,2010,28(e-Supplement A):e187.
[15]Li WW,Niu WQ,Zhang Y,et al.Family-based analysis of apelin and AGTRL1 gene polymorphisms with hypertension in Han Chinese.J Hypertens,2009,27:1194-1201.
[16]Niu W,Wu S,Zhang Y,et al.Validation of genetic association in apelin-AGTRL1 system with hypertension in a larger Han Chinese population.J Hypertens,2010,28:1854-1861.
[17]贾荣波,刘永选,王兆红.高血压患者强化管理与常规管理的比较研究.中国循环杂志,2013,28:360-363.
[18]Sung KC,Suh JY,Kim BS,et al.High sensitivity C-reactive protein as an independent risk factor for essential hypertension.Am J Hypertens,2003,16:429-433.
[19]Andrievskaia EM,Ivleva AIa,Minina ES,et al.Predictive value C-reactive protein assessment level in women with arterial hypertension.Kardiologiia,2011,51:32-38.
[20]刘蓉,杨跃进,乔树宾,等.高敏C反应蛋白对急性ST段抬高型心肌梗死患者近期预后的预测价值.中国循环杂志,2011,26:19-22.