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不对称二甲基精氨酸减弱了褪黑素分泌与老年人夜间血压及血压波动的关联。

Asymmetric dimethylarginine attenuates the association of melatonin secretion with night-time blood pressure and dipping in elderly individuals.

作者信息

Obayashi Kenji, Saeki Keigo, Kurumatani Norio

机构信息

Department of Community Health and Epidemiology, Nara Medical University School of Medicine.

出版信息

Circ J. 2014;78(12):2908-14. doi: 10.1253/circj.cj-14-0613. Epub 2014 Oct 31.

Abstract

BACKGROUND

Melatonin decreases night-time blood pressure (BP) by increasing nitric oxide (NO) in endothelial cells. Whether serum asymmetric dimethylarginine (ADMA), a major endogenous competitive inhibitor of endothelial NO synthase, attenuates the association of melatonin with night-time BP and dipping in humans is unclear. METHODS AND RESULTS: In this cross-sectional study of 852 community-based elderly individuals, serum ADMA, overnight urinary 6-sulfatoxymelatonin excretion (UME), and ambulatory BP were measured. Mean ADMA was 0.46±0.06 μmol/L. In the low-ADMA group (n=451), crude OR for nocturnal hypertension (NH) and non-dipper significantly decreased with a quartile increase in UME (P=0.023 and 0.001, respectively), but these associations were not observed in the high-ADMA group (n=401). Higher UME was significantly and inversely associated with adjusted OR for NH and non-dipper in the low-ADMA group (Q1, 1.00 and 1.00; Q2, 0.92 and 0.74; Q3, 0.57 and 0.51; Q4, 0.48 and 0.40; P=0.004 and 0.002, respectively) but not in the high-ADMA group (P=0.75 and 0.12, respectively). These association trends were also observed on continuous variable analysis (low ADMA, P=0.031 and 0.003; high ADMA, P=0.52 and 0.13; respectively).

CONCLUSIONS

ADMA attenuates the association of endogenous melatonin with night-time BP and dipping in the general elderly population.

摘要

背景

褪黑素通过增加内皮细胞中的一氧化氮(NO)来降低夜间血压(BP)。血清不对称二甲基精氨酸(ADMA)作为内皮型一氧化氮合酶的主要内源性竞争性抑制剂,是否会削弱褪黑素与人类夜间血压及血压波动的关联尚不清楚。

方法与结果

在这项针对852名社区老年个体的横断面研究中,测量了血清ADMA、夜间尿6 - 硫酸氧褪黑素排泄量(UME)和动态血压。平均ADMA为0.46±0.06μmol/L。在低ADMA组(n = 451)中,随着UME四分位数增加,夜间高血压(NH)和非勺型血压的粗OR显著降低(分别为P = 0.023和0.001),但在高ADMA组(n = 401)中未观察到这些关联。在低ADMA组中,较高的UME与NH和非勺型血压的调整后OR显著负相关(第一四分位数,1.00和1.00;第二四分位数,0.92和0.74;第三四分位数,0.57和0.51;第四四分位数,0.48和0.40;分别为P = 0.004和0.002),而在高ADMA组中则无此关联(分别为P = 0.75和0.12)。在连续变量分析中也观察到了这些关联趋势(低ADMA,P = 0.031和0.003;高ADMA,P = 0.52和0.13;分别)。

结论

ADMA削弱了内源性褪黑素与一般老年人群夜间血压及血压波动的关联。

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