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高血压患者血浆 ghrelin 水平与动脉僵硬度的相互关系。

Reciprocal relationship between plasma ghrelin level and arterial stiffness in hypertensive subjects.

机构信息

Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Clin Exp Pharmacol Physiol. 2013 Nov;40(11):735-9. doi: 10.1111/1440-1681.12165.

Abstract

Arterial stiffness, considered an independent predictor of cardiovascular morbidity and mortality, is closely associated with hypertension. Futhermore, the role of ghrelin in the development of hypertension has been widely recognized. The purpose of the present study was to explore the potential relationship between circulating ghrelin and arterial stiffness in hypertensive subjects. A total of 192 patients with primary hypertension and 107 normotensive (NT) control subjects were enrolled in the present cross-sectional study. Plasma ghrelin was determined by ELISA. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV) and the augmentation index (AIx). Both baPWV and AIx values were markedly higher in the hypertensive compared with NT group (P < 0.01). In contrast, plasma ghrelin concentrations were significantly lower in hypertensive patients compared with NT subjects (P < 0.01). Plasma ghrelin concentrations were negatively correlated with age (odds ratio (OR) -1.836; P < 0.001), smoking (OR -1.347; P = 0.042), baPWV (OR -1.762; P < 0.001) and AIx (OR -1.516; P = 0.005), but positively associated with fasting plasma glucose (OR 1.293; P = 0.047) and HbA1c (OR 1.413; P = 0.025). The inverse correlation between circulating ghrelin and the extent of arterial stiffness suggests that ghrelin is an independent determinant of arterial stiffness, even after adjustment for confounding cardiovascular risk factors, and it actively participates in the pathophysiology of arterial stiffness in hypertensive subjects.

摘要

动脉僵硬度被认为是心血管发病率和死亡率的独立预测因子,与高血压密切相关。此外,生长激素释放肽在高血压发展中的作用已得到广泛认可。本研究旨在探讨高血压患者循环生长激素释放肽与动脉僵硬度之间的潜在关系。本横断面研究共纳入 192 例原发性高血压患者和 107 例血压正常(NT)对照者。采用 ELISA 法测定血浆生长激素释放肽水平。肱踝脉搏波速度(baPWV)和增强指数(AIx)评估动脉僵硬度。与 NT 组相比,高血压组的 baPWV 和 AIx 值明显更高(P<0.01)。相反,高血压患者的血浆生长激素释放肽浓度明显低于 NT 组(P<0.01)。血浆生长激素释放肽浓度与年龄呈负相关(比值比(OR)-1.836;P<0.001)、与吸烟呈负相关(OR-1.347;P=0.042)、与 baPWV 呈负相关(OR-1.762;P<0.001)、与 AIx 呈负相关(OR-1.516;P=0.005),与空腹血糖呈正相关(OR 1.293;P=0.047)、与糖化血红蛋白(HbA1c)呈正相关(OR 1.413;P=0.025)。循环生长激素释放肽与动脉僵硬度之间的负相关表明,生长激素释放肽是动脉僵硬度的独立决定因素,即使在校正混杂心血管危险因素后也是如此,它积极参与高血压患者动脉僵硬度的病理生理过程。

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