Istanbul Medical Faculty, Bone Marrow Transplantation Unit, Department of Pediatric Haematology and Oncology, Istanbul University, Istanbul, Turkey.
J Thromb Thrombolysis. 2009 Nov;28(4):418-24. doi: 10.1007/s11239-008-0292-0. Epub 2008 Nov 11.
The aim of the present study is to determine and correlate adiponectin, homocysteine, nitric oxide, and ADP-induced platelet aggregation levels in untreated patients with essential hypertension and healthy individuals. A total of 36 individuals, 23 untreated patients with essential hypertension and 13 healthy individuals, were included in the scope of this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum adiponectin and TNF-alpha levels. The levels of serum homocysteine were measured by using competitive chemiluminescent enzyme immunoassay. Serum concentrations of hsCRP were measured by the Nephelometer. Plasma nitrite, nitrate, and total nitric oxide (NOx) levels were determined by colorimetric method. Homocysteine and hsCRP levels in patients with essential hypertension were found to be significantly higher than those in the control group (P = 0.02, P = 0.001, respectively). The average platelet aggregation levels in patient group were higher than control group, but there were no statistically significant differences between them (P > 0.05). In addition, in patients with essential hypertension adiponectin and nitrite levels are significantly lower than control group (P < 0.001, P = 0.045, respectively). We have also found significant correlations between nitrite-platelet aggregation amplitude, nitrite-platelet aggregation slope, nitrite-adiponectin, homocysteine-platelet aggregation amplitude, and sistolic blood pressure-platelet aggregation amplitude levels (r = -0.844; P < 0.001, r = -0.680; P = 0.011, r = 0.454; P = 0.05, r = 0.414; P = 0.05, r = 0.442; P = 0.035, respectively). Increased homocysteine and decreased adiponectin serum levels in patients with essential hypertension correlate well with changes in ADP-induced conventional platelet aggregation. This association may potentially contribute to future thrombus formation and higher risks for cardiovascular events in hypertensive patients.
本研究旨在确定并比较未经治疗的原发性高血压患者和健康个体的脂联素、同型半胱氨酸、一氧化氮和 ADP 诱导的血小板聚集水平。本研究共纳入 36 名个体，其中 23 名为未经治疗的原发性高血压患者，13 名为健康个体。采用酶联免疫吸附法（ELISA）测定血清脂联素和 TNF-α 水平。采用竞争化学发光酶免疫分析法测定血清同型半胱氨酸水平。采用散射浊度法测定血清 hsCRP 浓度。采用比色法测定血浆硝酸盐、亚硝酸盐和总一氧化氮（NOx）水平。结果发现，高血压患者的同型半胱氨酸和 hsCRP 水平明显高于对照组（P=0.02，P=0.001）。患者组的平均血小板聚集水平高于对照组，但两者之间无统计学差异（P>0.05）。此外，高血压患者的脂联素和亚硝酸盐水平明显低于对照组（P<0.001，P=0.045）。我们还发现，亚硝酸盐-血小板聚集幅度、亚硝酸盐-血小板聚集斜率、亚硝酸盐-脂联素、同型半胱氨酸-血小板聚集幅度和收缩压-血小板聚集幅度之间存在显著相关性（r=-0.844；P<0.001，r=-0.680；P=0.011，r=0.454；P=0.05，r=0.414；P=0.05，r=0.442；P=0.035）。原发性高血压患者血清同型半胱氨酸升高和脂联素降低与 ADP 诱导的常规血小板聚集变化密切相关。这种相关性可能会增加高血压患者血栓形成和心血管事件的风险。
