The Center of Diagnosis, Treatment and Research of Hypertension, Xinjiang, China.
Clin Exp Hypertens. 2010 Jan;32(1):54-60. doi: 10.3109/10641960902993087.
Resistant hypertension is always fount to be accompanied with obstructive sleep apnea syndrome (OSAS). Previous studies assumed inflammation participated in OSAS and hypertension. The fact that tumor necrosis factor a (TNF-alpha) was related to OSAS, while neuropeptide Y (NPY) was related to hypertension, was widely reported separately. To investigate the involvement of TNF-alpha and NPY simultaneously in hypertension accompanied with OSAS, 417 subjects who underwent the polymonograph and blood pressure measurement were consecutively selected. Plasma TNF-alpha and NPY levels were determined in normotensive with OSAS (n = 113), hypertensive without OSAS (n = 73), hypertensive with OSAS (n = 134), and those of controls (n = 97), respectively. A significant increase of plasma TNF-alpha and NPY were both observed in hypertensive subjects with or without OSAS, the highest level of TNF-alpha and NPY were in hypertension with the OSAS group. TNK-alpha, NPY, and neck circumference contributed to OSAS and hypertension as risk factors in the logistic regression model. Neck circumference was impacted by apnea/hyponea index, mean diastolic blood pressure, and TNF-alpha level, which was indicated via the multiple linear model. The present study indicated a positive interplay between plasma TNF-alpha, NPY, hypertension, and OSAS in the Han population of Xinjiang. Although there is evidence that inflammation plays a role in the pathophysiology of hypertension and OSAS, clear evidence is still lacking, and raises the dilemma of the hen and the egg. Further studies are needed to clarify the role of inflammation in the pathogenesis of hypertension with OSAS, in which neck size should be considered as a linked independent factor.
耐药性高血压总是伴随着阻塞性睡眠呼吸暂停综合征（OSAS）。先前的研究假设炎症参与了 OSAS 和高血压。肿瘤坏死因子 a（TNF-α）与 OSAS 有关，而神经肽 Y（NPY）与高血压有关，这一事实已分别得到广泛报道。为了研究 TNF-α和 NPY 同时参与伴有 OSAS 的高血压，我们连续选择了 417 名接受多导睡眠图和血压测量的受试者。分别测定了伴有 OSAS 的正常血压者（n=113）、无 OSAS 的高血压者（n=73）、伴有 OSAS 的高血压者（n=134）和对照组（n=97）的血浆 TNF-α和 NPY 水平。在伴有或不伴有 OSAS 的高血压患者中，均观察到血浆 TNF-α和 NPY 水平显著升高，TNF-α和 NPY 水平最高的是伴有 OSAS 的高血压组。TNF-α、NPY 和颈围是 OSAS 和高血压的危险因素，在逻辑回归模型中得到了验证。颈围受呼吸暂停/低通气指数、平均舒张压和 TNF-α水平的影响，这一点通过多元线性模型得到了验证。本研究表明，在新疆汉族人群中，血浆 TNF-α、NPY、高血压和 OSAS 之间存在正相互作用。虽然有证据表明炎症在高血压和 OSAS 的病理生理学中起作用，但仍缺乏明确的证据，这就提出了一个先有鸡还是先有蛋的难题。需要进一步的研究来阐明炎症在伴有 OSAS 的高血压发病机制中的作用，其中颈围应被视为一个相关的独立因素。
