环境因素及线粒体基因突变在原发性高血压发病机制中的协同作用

Role of environmental factors and mitochondrial mutations in the pathogenesis of Chinese essential hypertension

目的:探讨环境因素及线粒体基因突变在原发性高血压(EH)发病机制中的协同作用,为临床诊断和治疗EH提供新的思路。方法:在解放军总医院就诊的990例EH患者接受了详细的病史采集、生化检查及线粒体基因测序分析。结果:多元统计分析显示,EH患者收缩压与线粒体A8343G点突变(β=-22.99±9.00,P=0.01),T8603C点突变(β=26.39±10.39,P=0.01)及性别(β=3.52±1.27,P=0.01)相关;动脉舒张压则与的线粒体基因A8343G点突变(β=-16.31±5.44,P=0.01)、性别(β=-0.34±0.03,P<0.01)、心率(β=0.13±0.03,P=0.01)、家族史(β=1.80±0.78,P=0.02)、入选年龄(β=-0.34±0.03,P<0.01)、发病年龄(β=-0.08±0.03,P=0.01)及空腹血糖(β=-1.96±0.80,P=0.01)相关。结论:线粒体多基因突变与环境因素协同作用影响EH患者的血压。

Objective： To investigate the role of environmental factors and mitochondrial mutations in the pathogenesis of Chinese essential hypertensives（EH）, to find a new way to diagnose and treat hypertension. Method：The 990 EH patients （18-100 years, average age [66.51± 15.82] years） were recruited. They were outpatients or in - patients at the General Hospital of PLA , China . All patients accepted thorough examinations including medical records review, biochemical assays and mitochondrial genome sequencing. Result： Multivariate analyses showed systolic blood pressure was related to sex （β= 3.52±1.27, P= 0.01）, mitochondrial point mutationsA8343G （β=-22. 99±9. 00, P=0.01） and T8603C （β=26.39±10.39, P=0.01）. Diastolic blood pressure was associated with sex （β=0.34±0.03, P〈0.01）,heart rate （β= 0.13 ± 0. 03 , P=0.01）, family history （β=1.80±0.78, P=0.02）, age （β=-0.34±0.03, P〈0.01）, age-on-set （β= 0.08±0.03, P=0.01）, fasting blood glucose （β= -1.96±0.80, P=0.01）, mutation A8343G （β=-16.31±5.44, P=0.01）. Conclusion： Multigenic changes together with environmental factors may affect blood pressure in EH.