Chu Xinglin, Liu Rui, Li Chunli, Gao Tao, Dong Yongqi, Jiang Yi, Ke Dazhi
Department of General Practice, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, China.
Front Cardiovasc Med. 2022 Oct 12;9:966890. doi: 10.3389/fcvm.2022.966890. eCollection 2022.
Sortilin, a protein that regulates glucose and lipid metabolism, has recently been linked to cardiovascular diseases (CVDs) such as coronary heart disease and carotid artery stenosis. In this study, we measured circulating sortilin concentrations in essential hypertensive (EH) patients, and evaluated the association between sortilin, hypertension, and subclinical carotid atherosclerosis in hypertensive individuals.
This cross-sectional study included 336 individuals, including 186 newly diagnosed EH patients and 150 age-and-sex-matched normotensive healthy subjects (NT). Plasma sortilin and adiponectin (ADI) levels were measured using ELISA kits. In the EH group, high-resolution B-mode ultrasound was used to detect the existence of subclinical carotid atherosclerosis (subAS), which was defined as having a carotid intima-media thickness (cIMT) ≥ 1.0 mm and/or plaque on the carotid artery without any clinical manifestations.
Our findings showed that plasma sortilin concentrations ranged from 3.34-11.34 ng/ml for all subjects. Sortilin levels were significantly higher in the EH group than in the NT group (8.10 ± 1.82 ng/ml vs. 6.37 ± 1.52 ng/ml, < 0.001) and were further upregulated in the EH with subclinical carotid atherosclerosis (EH + subAS) group compared to the EH without subclinical carotid atherosclerosis (EH-subAS) group (8.42 ± 1.75 ng/ml vs. 7.79 ± 1.84 ng/ml, < 0.05). In correlation analysis, sortilin was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), white blood cell (WBC), endothelin-1 (ET-1), high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and cIMT (all < 0.05) and negatively associated with NO and ADI ( < 0.001). Multiple linear regression analysis revealed that SBP, LDL-C, and ET-1 were independently associated with plasma sortilin levels. Increased sortilin levels were independently associated with the risk of EH (OR: 1.86, 95%CI: 1.56-2.20, < 0.001) and EH + subAS (OR: 1.33, 95%CI: 1.07-1.66, = 0.011), after adjustment for multiple risk factors. Restricted spline curve showed that elevated sortilin levels increase the odds of having EH.
Elevated sortilin levels are associated with an increased risk of essential hypertension and subclinical carotid atherosclerosis in hypertensive patients.
Sortilin是一种调节葡萄糖和脂质代谢的蛋白质，最近被认为与心血管疾病（如冠心病和颈动脉狭窄）有关。在本研究中，我们测量了原发性高血压（EH）患者循环中Sortilin的浓度，并评估了Sortilin、高血压与高血压患者亚临床颈动脉粥样硬化之间的关联。
这项横断面研究纳入了336名个体，包括186名新诊断的EH患者和150名年龄及性别匹配的血压正常健康受试者（NT）。使用酶联免疫吸附测定试剂盒测量血浆Sortilin和脂联素（ADI）水平。在EH组中，采用高分辨率B型超声检测亚临床颈动脉粥样硬化（subAS）的存在，其定义为颈动脉内膜中层厚度（cIMT）≥1.0 mm和/或颈动脉有斑块且无任何临床表现。
我们的研究结果显示，所有受试者的血浆Sortilin浓度范围为3.34 - 11.34 ng/ml。EH组的Sortilin水平显著高于NT组（8.10±1.82 ng/ml对6.37±1.52 ng/ml，<0.001），并且与无亚临床颈动脉粥样硬化的EH组（EH - subAS）相比，有亚临床颈动脉粥样硬化的EH组（EH + subAS）中Sortilin水平进一步上调（8.42±1.75 ng/ml对7.79±1.84 ng/ml，<0.05）。在相关性分析中，Sortilin与收缩压（SBP）、舒张压（DBP）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL - C）、白细胞（WBC）、内皮素 - 1（ET - 1）、高敏C反应蛋白（hsCRP）、白细胞介素 - 6（IL - 6）和cIMT均呈正相关（均<0.05），与一氧化氮（NO）和ADI呈负相关（<0.001）。多元线性回归分析显示，SBP、LDL - C和ET - 1与血浆Sortilin水平独立相关。在调整多个危险因素后，Sortilin水平升高与EH风险（比值比：1.86，95%置信区间：1.56 - 2.20，<0.001）和EH + subAS风险（比值比：1.33，95%置信区间：1.07 - 1.66，=0.011）独立相关。限制样条曲线显示，Sortilin水平升高增加了患EH的几率。
Sortilin水平升高与高血压患者原发性高血压和亚临床颈动脉粥样硬化风险增加有关。
