不同血压水平与转甲状腺素蛋白的关系研究

The Relationship between Transthyretin and the Level of Blood Pressure

目的探讨高血压患者转甲状腺素蛋白(transthyretin,TTR)的水平及其与血压的关系。方法在流行病学调查中将调查对象分为正常组、高血压前期组和高血压组。对所调查对象测量人体测量学指标,进行75g口服葡萄糖耐量试验,测定血脂、血糖、胰岛素和TTR等。结果①3组TTR水平分别为(321.5±4.5)、(335.1±3.6)与(354.6±4.2)mg/L,3组间差异有显著性(P<0.01);进一步校正年龄、性别、BMI、WHR、WC和HOMA-IR后,高血压组与正常组和高血压前期组相比差异仍有显著性(P均<0.01),正常组与高血压前期组之间无显著性差异(P>0.05)。②校正年龄、性别因素后,TTR与SBP和DBP相关系数分别为0.1617、0.1708,P均<0.01;进一步校正年龄、性别、BMI、WC、HOMA-IR后,TTR与SBP和DBP的相关系数为0.1515、0.1670,P均<0.01。③多元逐步回归分析显示,影响血压的主要因素是BMI、WC、TTR、HOMA-IR和年龄。结论高血压患者存在不同程度的TTR水平的升高,高血压前期患者亦存在相似的变化,血压与TTR的关系不依赖于体脂参数、胰岛素抵抗等相关因素,血压与TTR的关系有待进一步研究。

Objective To explore the level of transthyretin（TTR） in hypertensive patients and the relationship between TTR and blood pressure. Methods Seventy-five gram oral glucose tolerance tests were conducted, somatometry parameters, lipid-profile, blood glucose, insulin and TTR were assayed. They were divided into control group, pre-hypertensive group and hypertensive group. Results ①The concentration of TTR in three groups had significant difference[（321.5± 4.5）mg/L, （335.1±3.6） mg/L, （354.6±4.2） mg/L,P〈0.01]. Rejecting the age,gender,BMI, WHR,WC and HOMA-IR, there was significant difference between hypertensive group and either control group or pre-hypertensive group（all P〈0.01） ,but there was no significant difference between control group and pre-hypertensive group（all P〉0.05）. ②Rejecting the age, gender,the coefficient correlation between TTR,SBP and DBP were 0. 161 7.0. 170 8（P〈0.01）. Then Rejecting the age and gender,BMI,WC, HOMA-IR, the coefficient correlation between TTR, SBP and DBP were 0. 151 5.0. 167 0（all P〈0.01）. ③Muhielement stepwise regression analysis suggest that BMI,WC,TTR, HOMA-Ir and age were major factors to regulate the level of blood pressure. Conclusion There is increased TTR no matter blood presure level in hypertentive patients, so is the similar situation in pre-hypertensive patients. The relationship between blood pressure and TTR does not rely body fat parameter and IR,and it need to further study.