Xu Mei, Lu Yong-Ping, Hasan Ahmed Abdallah, Hocher Berthold
Department of Traditional Chinese Medicine, Medical School of the Jinan University, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Institute of Nutritional Science, University of Potsdam, Potsdam, Germany.
Kidney Blood Press Res. 2017;42(2):304-313. doi: 10.1159/000477572. Epub 2017 May 26.
BACKGROUND/AIMS: A recent study revealed that global overexpression of ET-1 causes a slight reduction in systemic blood pressure. Moreover, heterozygous ET-1 knockout mice are hypertensive. The role of ET-1 in human hypertension was so far not addressed by a strict meta-analysis of published human clinical studies.
We included studies published between January 1, 1990 and February 28, 2017. We included case control studies analyzing untreated essential hypertension or hypertensive patients where antihypertensive medication was discontinued for at least two weeks. Based on the principle of Cochrane systematic reviews, case control studies (CCSs) in PubMed (Medline) and Google Scholar designed to identify the role of endothelin-1 (ET-1) in the pathophysiological of hypertension were screened. Review Manager Version 5.0 (Rev-Man 5.0) was applied for statistical analysis. Mean difference and 95% confidence interval (CI) were shown in inverse variance (IV) fixed-effects model or IV random-effects models.
Eleven studies fulfilling our in- and exclusion criteria were eligible for this meta-analysis. These studies included 450 hypertensive patients and 328 controls. Our meta-analysis revealed that ET-1 plasma concentrations were higher in hypertensive patients as compared to the control patients [mean difference between groups 1.57 pg/mL, 95%CI [0.47∼2.68, P = 0.005]. These finding were driven by patients having systolic blood pressure higher than 160 mmHg and diastolic blood pressure higher than 100 mmHg.
This meta-analysis showed that hypertensive patients do have elevated plasma ET-1 concentrations. This finding is driven by those patients with high systolic/diastolic blood pressure. Given that the ET-1 gene did not appear in any of the whole genome association studies searching for hypertension associated gene loci, it is very likely that the elevated plasma ET-1 concentrations in hypertensive patients are secondary to hypertension and may reflect endothelial cell damage.
背景/目的：最近一项研究显示，内皮素-1（ET-1）的整体过表达会导致全身血压略有下降。此外，杂合子ET-1基因敲除小鼠患有高血压。迄今为止，已发表的人类临床研究尚未通过严格的荟萃分析探讨ET-1在人类高血压中的作用。
我们纳入了1990年1月1日至2017年2月28日期间发表的研究。我们纳入了分析未经治疗的原发性高血压或停用降压药物至少两周的高血压患者的病例对照研究。基于Cochrane系统评价的原则，对PubMed（Medline）和谷歌学术中旨在确定内皮素-1（ET-1）在高血压病理生理中的作用的病例对照研究（CCS）进行筛选。应用Review Manager 5.0版（Rev-Man 5.0）进行统计分析。均值差异和95%置信区间（CI）以逆方差（IV）固定效应模型或IV随机效应模型显示。
11项符合我们纳入和排除标准的研究符合该荟萃分析的要求。这些研究包括450例高血压患者和328例对照。我们的荟萃分析显示，与对照患者相比，高血压患者的ET-1血浆浓度更高[组间均值差异为1.57 pg/mL，95%CI[0.47～2.68]，P = 0.005]。这些结果是由收缩压高于160 mmHg和舒张压高于100 mmHg的患者驱动的。
该荟萃分析表明，高血压患者的血浆ET-1浓度确实升高。这一结果是由那些收缩压/舒张压高的患者驱动的。鉴于在任何寻找高血压相关基因位点的全基因组关联研究中均未出现ET-1基因，高血压患者血浆ET-1浓度升高很可能是高血压的继发结果，可能反映了内皮细胞损伤。
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