Obayashi Kenji, Saeki Keigo, Kurumatani Norio
Department of Community Health and Epidemiology, Nara Medical University School of Medicine.
Circ J. 2014;78(12):2908-14. doi: 10.1253/circj.cj-14-0613. Epub 2014 Oct 31.
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).
ADMA attenuates the association of endogenous melatonin with night-time BP and dipping in the general elderly population.
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。
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)。
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。