Department of Endocrinology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Nuclear Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.
J Renin Angiotensin Aldosterone Syst. 2021 Jan-Dec;22(1):1470320321999491. doi: 10.1177/1470320321999491.
Studies have shown that primary aldosteronism (PA) has a higher risk of cardiovascular events than essential hypertension (EH). Endothelial dysfunction is an independent predictor of cardiovascular events. Whether PA and EH differ in the endothelial dysfunction is uncertain. Our study was designed to investigate the levels of biomarkers of endothelial dysfunction (Asymmetric dimethylarginine, ADMA; E-selectin, and Plasminogen activator inhibitor-1, PAI-1) and assess the microvascular endothelial function in patients with PA and EH, respectively.
The biomarkers of endothelial dysfunction were measured by enzyme-linked immunosorbent assay (ELISA). Microvascular endothelial function was evaluated by Pulse amplitude tonometry (PAT).
Thirty-one subjects with EH and 36 subjects with PA including 22 with aldosterone-producing adenoma (APA) and 14 with idiopathic hyperaldosteronism (IHA) were enrolled in our study. The ADMA levels among the three groups were different (APA 47.83 (27.50, 87.74) ng/ml vs EH 25.08 (22.44, 39.79) ng/ml vs IHA 26.00 (22.23, 33.75) ng/ml; = 0.04), however, when the APA group was compared with EH and IHA group, there was no statistical significance (47.83 (27.50, 87.74) ng/ml vs 25.08 (22.44, 39.79) ng/ml for EH, = 0.11; 47.83 (27.50, 87.74) ng/ml vs IHA 26.00 (33.75) ng/ml, = 0.07). The results of ADMA levels are presented as Median (p25, p75). Whereas, levels of PAI-1 and E-selectin, microvascular endothelial function were not significantly different between PA and EH subjects.
Our study shows no significant differences between PA and EH in terms of biomarkers of endothelial dysfunction and microvascular endothelial function. The microvascular endothelial function of PA and EH patients is comparable.
研究表明,原发性醛固酮增多症(PA)比原发性高血压(EH)发生心血管事件的风险更高。血管内皮功能障碍是心血管事件的独立预测因子。PA 和 EH 是否存在血管内皮功能障碍尚不确定。我们的研究旨在分别研究 PA 和 EH 患者的血管内皮功能障碍生物标志物(不对称二甲基精氨酸,ADMA;E-选择素和纤溶酶原激活物抑制剂-1,PAI-1)水平,并评估微血管内皮功能。
采用酶联免疫吸附试验(ELISA)测定血管内皮功能障碍生物标志物。采用脉搏幅度体积描记法(PAT)评估微血管内皮功能。
本研究纳入了 31 名 EH 患者和 36 名 PA 患者,其中包括 22 名醛固酮分泌腺瘤(APA)患者和 14 名特发性醛固酮增多症(IHA)患者。三组 ADMA 水平不同(APA 47.83(27.50,87.74)ng/ml 比 EH 25.08(22.44,39.79)ng/ml 比 IHA 26.00(22.23,33.75)ng/ml; = 0.04),然而,当 APA 组与 EH 和 IHA 组比较时,无统计学意义(APA 47.83(27.50,87.74)ng/ml 比 EH 25.08(22.44,39.79)ng/ml, = 0.11;APA 47.83(27.50,87.74)ng/ml 比 IHA 26.00(33.75)ng/ml, = 0.07)。ADMA 水平结果以中位数(p25,p75)表示。而 PA 和 EH 患者的 PAI-1 和 E-选择素水平以及微血管内皮功能无显著差异。
本研究表明,PA 和 EH 在血管内皮功能障碍和微血管内皮功能方面无显著差异。PA 和 EH 患者的微血管内皮功能相当。