Department of Preventive Medicine, Unit of Public Health and Environmental Care, University of Valencia, Valencia, Spain.
Hypertens Res. 2011 Jun;34(6):758-66. doi: 10.1038/hr.2011.37. Epub 2011 Apr 7.
There is evidence that uncontrolled arterial hypertension (AHT) in patients with metabolic syndrome (MS) increases cardiovascular risks. The renin-angiotensin-aldosterone system (RAAS) and its polymorphisms apparently confer a genetic risk for uncontrolled AHT. This study aims to investigate the influence of RAAS polymorphisms on AHT control in patients diagnosed with MS. This is a two-stage population-based nested case-control pilot study (n=1514). We differentiated between MS-diagnosed patients and non-MS patients (ATP-III criteria) and selected those individuals diagnosed with AHT from each group (n=161 and n=156, respectively). Those who successfully controlled their AHT (controls) and those who did not were compared. In the MS population, the C/G and G/G genotypes of single-nucleotide polymorphism rs1040288 (NR3C2) and A/G and G/G of rs11099680 (NR3C2) were associated with uncontrolled AHT (odds ratio (OR)=2.94 (1.34-6.47) and OR=2.54 (1.09-5.93), respectively). According to Akaike's information criteria, the best adjusted model included gender and age as confounding variables (adjusted OR (ORa)=2.91 (1.31-6.46) and ORa=2.67 (1.13-6.31), respectively). Regarding rs1040288, an ORa of 4.03 (1.44-11.26) was obtained for the saturated model (adjusted for gender, age, waist-to-hip ratio, body mass index, biochemical profile, renal damage, smoking habit and anti-AHT treatment). Yet, when the same analysis was performed on the non-MS population, no association was found between rs11099680 and the failure to control AHT. The results reveal a possible association between the rs11099680 RAAS polymorphism and uncontrolled AHT in MS-diagnosed patients. rs1040288 appears to be associated with uncontrolled blood pressure regardless of MS profile.
有证据表明，代谢综合征（MS）患者的未控制动脉高血压（AHT）会增加心血管风险。肾素-血管紧张素-醛固酮系统（RAAS）及其多态性显然为未控制的 AHT 提供了遗传风险。本研究旨在探讨 RAAS 多态性对 MS 患者 AHT 控制的影响。这是一项基于人群的两阶段嵌套病例对照试点研究（n=1514）。我们区分了 MS 确诊患者和非 MS 患者（ATP-III 标准），并从每组中选择了诊断为 AHT 的个体（n=161 和 n=156）。比较了那些成功控制 AHT 的患者（对照组）和那些未控制的患者。在 MS 人群中，单核苷酸多态性 rs1040288（NR3C2）的 C/G 和 G/G 基因型和 rs11099680（NR3C2）的 A/G 和 G/G 基因型与未控制的 AHT 相关（比值比（OR）=2.94（1.34-6.47）和 OR=2.54（1.09-5.93））。根据赤池信息量准则，最佳调整模型包括性别和年龄作为混杂变量（调整后的比值比（ORa）=2.91（1.31-6.46）和 ORa=2.67（1.13-6.31））。关于 rs1040288，饱和模型（调整性别、年龄、腰臀比、体重指数、生化特征、肾损伤、吸烟习惯和抗 AHT 治疗）得到 ORa 为 4.03（1.44-11.26）。然而，当在非 MS 人群中进行相同的分析时，rs11099680 与未能控制 AHT 之间没有关联。结果表明，rs11099680 RAAS 多态性与 MS 确诊患者的未控制 AHT 之间可能存在关联。rs1040288 似乎与未控制的血压有关，而与 MS 无关。
