Turner S T, Weidman W H, Michels V V, Reed T J, Ormson C L, Fuller T, Sing C F
Department of Internal Medicine, Mayo Clinic Foundation, Rochester, Minnesota 55905.
Hypertension. 1989 Apr;13(4):378-91. doi: 10.1161/01.hyp.13.4.378.
Case-control studies suggest that increased erythrocyte sodium-lithium countertransport may predict increased susceptibility to the development of essential hypertension. To characterize interindividual variation in sodium-lithium countertransport and its relation to blood pressure levels in the general population, we studied 1,475 Caucasians between 5 and 89 years of age (711 males and 764 females) ascertained through 266 households with children in the schools of Rochester, Minnesota. Individuals who were taking antihypertensive agents or combinations of estrogen and progesterone were not included in the sample. A third-order polynomial regression on age accounted for only a small fraction of variability in sodium-lithium countertransport (2.8% in males, p less than 0.001; 2.1% in females, p less than 0.01), whereas a fourth-order regression on age accounted for a large proportion of variability in systolic blood pressure (45.7% in males, p less than 0.001; 52.5% in females, p less than 0.001) and diastolic blood pressure (39.8% in males, p less than 0.001; 33.0% in females, p less than 0.001). Mean sodium-lithium countertransport was higher in males than females at all ages; but the rank order of male and female means for systolic and diastolic blood pressure was age dependent. Positively skewed distributions for age-, height-, and weight-adjusted sodium-lithium countertransport in male and female cohorts between 5-19.9, 20-49.9, and 50-89.9 years of age were explained significantly better by postulating a mixture of two partially overlapping sodium-lithium countertransport distributions rather than a single normal distribution (p less than 0.01). Among men in the 20-49.9-year-old cohort, adjusted sodium-lithium countertransport values in the upper distribution were associated with higher systolic and diastolic blood pressure (mean +/- SD) than values in the lower distribution (for systolic blood pressure: 115 +/- 11 vs. 111 +/- 11 mm Hg, p less than 0.07; for diastolic blood pressure: 71.2 +/- 8.0 vs. 68.4 +/- 8.6 mm Hg, p less than 0.08). Among females in the 50-89.9-year-old cohort, adjusted sodium-lithium countertransport values in the upper distribution were associated with significantly greater diastolic blood pressure than values in the lower distribution (77 +/- 10 vs. 70 +/- 9 mm Hg, p less than 0.03).(ABSTRACT TRUNCATED AT 400 WORDS)
病例对照研究表明，红细胞钠-锂逆向转运增加可能预示原发性高血压发病易感性增加。为了描述钠-锂逆向转运的个体间差异及其与普通人群血压水平的关系，我们研究了明尼苏达州罗切斯特市266户有在校儿童家庭中的1475名5至89岁的白种人（711名男性和764名女性）。服用抗高血压药物或雌激素与孕酮组合药物的个体未纳入样本。年龄的三阶多项式回归仅解释了钠-锂逆向转运变异性的一小部分（男性为2.8%，p<0.001；女性为2.1%，p<0.01），而年龄的四阶回归解释了收缩压变异性的很大一部分（男性为45.7%，p<0.001；女性为52.5%，p<0.001）和舒张压变异性的很大一部分（男性为39.8%，p<0.001；女性为33.0%，p<0.001）。各年龄段男性的平均钠-锂逆向转运均高于女性；但男性和女性收缩压与舒张压均值的排序与年龄有关。在5至19.9岁、20至49.9岁和50至89.9岁的男性和女性队列中，年龄、身高和体重校正后的钠-锂逆向转运呈正偏态分布，假设为两个部分重叠的钠-锂逆向转运分布的混合而非单一正态分布能更好地解释这一现象（p<0.01）。在20至49.9岁年龄组的男性中，较高分布中的校正钠-锂逆向转运值比较低分布中的值与更高的收缩压和舒张压相关（收缩压：115±11 vs. 111±11 mmHg，p<0.07；舒张压：71.2±8.0 vs. 68.4±8.6 mmHg，p<0.08）。在50至89.9岁年龄组的女性中，较高分布中的校正钠-锂逆向转运值比较低分布中的值与显著更高的舒张压相关（77±10 vs. 70±9 mmHg，p<0.03）。（摘要截短至400字）
