Zhang Jianan, Li Jing, Chen Shi, Gao Linglin, Yan Xiaoluan, Zhang Mingzhi, Yu Jia, Wang Fenchun, Peng Hao
Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
Center for Disease Prevention and Control of Taicang City, Suzhou, China.
Int J Hypertens. 2020 Feb 14;2020:5983574. doi: 10.1155/2020/5983574. eCollection 2020.
Platelet consumption followed by homocysteine-induced endothelial injury suggests a crosstalk between platelet activation and homocysteine on hypertension. Platelet count has been found to modify the effect of folic acid on vascular health. However, whether platelet count could modify the contribution of homocysteine to blood pressure (BP) remains unclear.
Leveraging a community-based cross-sectional survey in 30,369 Chinese hypertensive patients (mean age 62 years, 52% female), we examined the moderation of platelet count on the association between serum homocysteine and BP by constructing hierarchical multiple regression models, adjusting for conventional risk factors. If adding the interaction term of homocysteine and platelet count could explain more variance in BP and the interaction is significant, then we believe that moderation is occurring.
The association between serum homocysteine and diastolic BP was significantly stronger ( = 0.092 vs. 0.035, = 0.004) in participants with low platelet count (<210 × 10/L) than in those with high platelet count (≥210 × 10/L). Adding the interaction term of homocysteine and platelet count additionally explained 0.05% of the variance in diastolic BP ( = 0.004) in participants with low platelet count (<210 × 10/L) than in those with high platelet count (≥210 × 10/L). Adding the interaction term of homocysteine and platelet count additionally explained 0.05% of the variance in diastolic BP ( = 0.092 vs. 0.035, = 0.004) in participants with low platelet count (<210 × 10/L) than in those with high platelet count (≥210 × 10/L). Adding the interaction term of homocysteine and platelet count additionally explained 0.05% of the variance in diastolic BP (.
The association between homocysteine and BP was significantly stronger in participants with low . high platelet count and was partially moderated by platelet count. These results indicate that platelet count may be useful in the identification of individuals who are most beneficial to reducing-homocysteine treatments but this usefullness still needs further investigation.
血小板消耗继之以同型半胱氨酸诱导的内皮损伤提示血小板活化与同型半胱氨酸在高血压发生过程中存在相互作用。已发现血小板计数会改变叶酸对血管健康的影响。然而，血小板计数是否会改变同型半胱氨酸对血压（BP）的影响仍不清楚。
利用对30369名中国高血压患者（平均年龄62岁，52%为女性）进行的基于社区的横断面调查，我们通过构建分层多元回归模型并对传统危险因素进行校正，来研究血小板计数对血清同型半胱氨酸与血压之间关联的调节作用。如果加入同型半胱氨酸与血小板计数的交互项能解释血压中更多的变异且该交互作用具有显著性，那么我们认为存在调节作用。
血小板计数低（<210×10⁹/L）的参与者中，血清同型半胱氨酸与舒张压之间的关联显著强于血小板计数高（≥210×10⁹/L）的参与者（β = 0.092对0.035，P = 0.004）。加入同型半胱氨酸与血小板计数的交互项后，血小板计数低（<210×10⁹/L）的参与者中舒张压变异的额外解释比例为0.05%（β = 0.092对0.035，P = 0.004），高于血小板计数高（≥210×10⁹/L）的参与者。加入同型半胱氨酸与血小板计数的交互项后，血小板计数低（<210×10⁹/L）的参与者中舒张压变异的额外解释比例为0.05%（P = 0.004）。
血小板计数低的参与者中同型半胱氨酸与血压之间的关联显著更强，且部分受血小板计数调节。这些结果表明血小板计数可能有助于识别那些从降低同型半胱氨酸治疗中获益最大的个体，但这种作用仍需进一步研究。
