Koegelenberg Anna S E, Smith Wayne, Schutte Rudolph, Schutte Aletta E
Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.
Postgraduate Medical Institute, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK.
Eur J Clin Invest. 2016 Sep;46(9):795-803. doi: 10.1111/eci.12663. Epub 2016 Aug 9.
Black populations exhibit lower concentrations of the cardioprotective peptide, insulin-like growth factor-1 (IGF-1), and are more prone to develop hypertensive heart disease than whites. We therefore determined whether lower IGF-1 in black individuals relates to a marker of cardiac overload and systolic dysfunction, namely N-terminal prohormone B-type natriuretic peptide (NT-proBNP).
We included 160 black and 195 white nondiabetic South African men and women (aged 44·4 ± 9·81 years) and measured ambulatory blood pressure, NT-proBNP, IGF-1 and insulin-like growth factor-binding protein-3 (IGFBP-3).
Although the black group presented elevated ambulatory blood pressure accompanied by lower IGF-1 compared to the white group (all P < 0·001), we found similar NT-proBNP concentrations (P = 0·72). Furthermore, in blacks we found a link between NT-proBNP and systolic blood pressure (SBP) (R(2) = 0·37; β = 0·28; P < 0·001), but not with IGF-1. In the white group, NT-proBNP was inversely associated with IGF-1 (R(2) = 0·39; β = -0·22; P < 0·001) after adjusting for covariates and potential confounders. As IGF-1 is attenuated in diabetes, we added the initially excluded patients with diabetes (n = 38), and the aforementioned associations remained robust.
Contrary to the white group, we found no association between NT-proBNP and IGF-1 in black adults. Our findings suggest that SBP and other factors may play a greater contributory role in cardiac pathology in blacks.
黑人人群中具有心脏保护作用的肽——胰岛素样生长因子-1(IGF-1)的浓度较低,且比白人更容易患高血压性心脏病。因此,我们确定黑人个体中较低的IGF-1是否与心脏负荷和收缩功能障碍的标志物,即N末端前体激素B型利钠肽(NT-proBNP)有关。
我们纳入了160名黑人及195名白人非糖尿病南非男性和女性(年龄44.4±9.81岁),并测量了动态血压、NT-proBNP、IGF-1和胰岛素样生长因子结合蛋白-3(IGFBP-3)。
尽管与白人组相比,黑人组的动态血压升高且IGF-1较低(所有P<0.001),但我们发现两组的NT-proBNP浓度相似(P = 0.72)。此外,在黑人中,我们发现NT-proBNP与收缩压(SBP)之间存在关联(R² = 0.37;β = 0.28;P<0.001),但与IGF-1无关。在白人组中,调整协变量和潜在混杂因素后,NT-proBNP与IGF-1呈负相关(R² = 0.39;β = -0.22;P<0.001)。由于糖尿病会使IGF-1降低,我们纳入了最初排除的糖尿病患者(n = 38),上述关联仍然显著。
与白人组相反,我们发现黑人成年人中NT-proBNP与IGF-1之间无关联。我们的研究结果表明,收缩压和其他因素可能在黑人心脏病变中起更大的作用。