Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
Key Laboratory of Molecular Biology in Jiangxi Province, Nanchang of Jiangxi, China.
Am J Hypertens. 2017 Nov 6;30(12):1203-1210. doi: 10.1093/ajh/hpx116.
Homocysteine-lowering intervention with folate was recently shown to be able to increase day-night difference of blood pressure (BP) in humans indicating a potential relationship between homocysteine and circadian BP variation. We thus sought to investigate the association between plasma total homocysteine level (tHcy) and circadian BP variation in hypertensive adults.
We enrolled 244 eligible dipping and 249 nondipping BP status adults from 560 adults who were randomly sampled from 5,233 Chinese hypertensive adults who received ambulatory BP monitoring (ABPM). We further enrolled 390 adults with CC/CT genotypes of the methylenetetrahydrofolate reductase (MTHFR) and 79 TT genotype who received ABPM at the same time from 1858 hypertensive adults with MTHFR polymorphisms detection.
Plasma tHcy in nondippers was significantly higher than dippers (P < 0.001). Simple linear analysis revealed that tHcy significantly correlated with nocturnal systolic BP fall (r = -0.145, P = 0.001) and diastolic BP fall (r = -0.141, P = 0.002). Multivariate logistic regression analysis further identified tHcy as an independent factor correlated with the presence of nondipping BP status in hypertensive adults (odds ratio: 1.873, 95% confidence interval: 1.171-2.996, P = 0.009). The percentage of dipping BP status was 19.49% or 8.86% and the percentage of nondipping BP status was 80.51% or 91.14% in CC/CT or TT genotypes, respectively. The above different between CC/CT and TT genotypes was significant (P = 0.024).
These results indicated that high homocysteine levels associate with disturbed circadian BP variation in Chinese hypertensive adults.
最近的研究表明，降低同型半胱氨酸水平的叶酸干预能够增加人类血压的昼夜差异，表明同型半胱氨酸与昼夜血压变化之间存在潜在关系。因此，我们试图研究高血压成年人血浆总同型半胱氨酸水平（tHcy）与昼夜血压变化之间的关系。
我们从接受动态血压监测（ABPM）的 560 名高血压成年人中随机抽取了 5233 名成年人，共纳入了 244 名符合夜间血压下降（dipping）标准的成年人和 249 名不符合夜间血压下降标准的成年人。此外，我们还从 1858 名携带亚甲基四氢叶酸还原酶（MTHFR）CC/CT 基因型的高血压成年人中，选取了 390 名接受 ABPM 的成年人和 79 名 TT 基因型的成年人。
非夜间血压下降者的血浆 tHcy 水平明显高于夜间血压下降者（P < 0.001）。简单线性分析显示，tHcy 与夜间收缩压下降（r = -0.145，P = 0.001）和舒张压下降（r = -0.141，P = 0.002）显著相关。多变量 logistic 回归分析进一步确定 tHcy 是与高血压成年人非夜间血压下降状态相关的独立因素（比值比：1.873，95%置信区间：1.171-2.996，P = 0.009）。CC/CT 或 TT 基因型的夜间血压下降状态的比例分别为 19.49%或 8.86%，非夜间血压下降状态的比例分别为 80.51%或 91.14%。CC/CT 与 TT 基因型之间存在显著差异（P = 0.024）。
这些结果表明，高同型半胱氨酸水平与中国高血压成年人昼夜血压变化紊乱有关。
