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目的:探讨睡眠呼吸暂停相关性高血压血清醛固酮及补体C1q-肿瘤坏死因子相关蛋白1(CTRP1)的水平及其相关因素。方法:在高血压科住院患者中选取正常及低肾素的睡眠呼吸暂停相关性高血压患者26例(病例组),取同期住院的且性别、年龄及肾素活性(PRA)匹配的原发性高血压患者30例作为对照组,放射免疫法测定所有患者的血清醛固酮水平,酶联免疫吸附法检测CTRP1浓度。结果:病例组BMI(P<0.01)、醛固酮水平(P<0.05)、超敏C反应蛋白水平(P<0.01)均明显高于对照组。Pearson相关分析显示,醛固酮与BMI呈正相关(r=0.283,P=0.035),与CTRP1不相关(r=0.109,P=0.425);CTRP1与血钾呈负相关(r=-0.284,P=0.035)。多元逐步线性回归分析显示,PRA(β=0.351,P=0.008)及BMI(β=0.270,P=0.039)进入以醛固酮为应变量的方程,贡献为PRA>BMI,在控制PRA的影响后发现,BMI是醛固酮水平独立的影响因素;血钾进入以CTRP1为应变量的方程(β=-0.289,P=0.029)。结论:睡眠呼吸暂停相关性高血压患者中,BMI对醛固酮水平的影响可能独立于肾素-血管紧张素-醛固酮系统,且患者血清中CTRP1与血钾呈负相关。
Objective: To investigate the levels of serum aldosterone and complement C1q-tumor necrosis factor-related protein 1 (CTRP1) in sleep apnea-related hypertension and its related factors. Methods: Twenty-six patients (control group) with normal and low-renin sleep apnea-hypopnea were enrolled in the inpatient department of hypertensive patients. The matched matched primary, sex, age and PRA matched patients Serum aldosterone levels were measured by radioimmunoassay in 30 patients with hypertension and CTRP1 concentration by enzyme-linked immunosorbent assay. Results: The BMI (P <0.01), aldosterone level (P <0.05), and hypersensitive C-reactive protein (P <0.01) in the case group were significantly higher than those in the control group. Pearson correlation analysis showed that aldosterone was positively correlated with BMI (r = 0.283, P = 0.035) and not related to CTRP1 (r = 0.109, P = 0.425); CTRP1 was negatively correlated with serum potassium ). Multivariate stepwise linear regression analysis showed that PRA (β = 0.351, P = 0.008) and BMI (β = 0.270, P = 0.039) entered the equation with aldosterone as a dependent variable, with a contribution of PRA> BMI, which was found after controlling for the effects of PRA , BMI was the independent factor of aldosterone level; serum potassium entered the equation with CTRP1 as the dependent variable (β = -0.289, P = 0.029). CONCLUSIONS: The effect of BMI on aldosterone levels may be independent of the renin-angiotensin-aldosterone system in patients with sleep apnea-related hypertension and the serum CTRP1 is negatively correlated with serum potassium levels.