高血压患者血清人软骨糖蛋白水平变化及其与内皮功能的相关性研究

Association between serum YKL-40 levels and endothelial function in hypertensive patients

目的探讨高血压患者血清人软骨糖蛋白（YKL40）水平的变化及YKL40与血管内皮功能各指标的相关性。方法收集60例初发的原发性高血压患者（高血压组）及30例健康受试者（对照组），应用ELISA方法测定血清YKL-40浓度，并测定内皮素1（ET-1）、一氧化氮（NO）、肱动脉血流介导的血管舒张功能（FMD）以评估血管内皮功能。比较两组间血清YKL—40浓度的差异及YKL-40与内皮功能各项指标之间的相关性；按照有无合并代谢综合征（MS）将高血压组分为2组，比较两组间血清YKL-40浓度的差异。结果高血压组血清YKL-40水平（51．7μg/L）明显高于对照组（33．2μg/L）（P〈0．01）。对照组、无Ms高血压组、Ms高血压组三组间血清YKL--40水平有显著差异（分别为33．2μg/L、94．2μg/L、152．3μg/L，P〈0．05）。在所有研究对象中YKL-40与收缩压、舒张压、体质指数（BMI）、甘油三酯（TG）、超敏C反应蛋白（hs—CRP）正相关（r=0．360、0．303、0．281、0．216、0．530，P〈0．05），与FMD、ET-1、NO之间无相关性。MS高血压组血清YKL40水平（152．3μg/L）高于无MS高血压组（94．2μg/L），差异具有显著统计学意义（P〈0．01）。结论与对照组相比，高血压组血清YKL40水平升高且与血压水平正相关，但未见与血管内皮功能有相关性。

Objective To explore the relationship between serum YKL-40 levels and endothelial function in patients with essential hypertension （EH）. Method Sixty EH patients [ 34 male, aged between 43 - 76 years, mean（ 59 ± 7 ） years ] and 30 healthy subjects [ 17 male, mean age （57 ± 5） years ] were enrolled in this study. Serum YKL-40 levels were measured by enzyme immunoassay （ELISA）. Endothelial function [ endothelin-1 （ ET-1 ）, nitric oxide （ NO）, flow-mediated dilatation （FMD） ] was also measured. EH patients were further divided to no metabolic syndrome and metabolic syndrome group. Results Serum uric acid, ET-1, hs-CRP were significantly higher while serum NO, FMD and NMD were significantly lower in EH group than in control group （ all P 〈 0. 05）. YKL-40 was significantly higher in EH group than in the control group [ 51.7 （ 35, 6 - 341.9）μg/L vs. 33.2 （ 23.3 - 167.3 ） μg/L, P 〈 0.05 ] and significantly higher in EH patients with metabolic syndrome than in EH patients without metabolic syndrome（ 152. 3μg/L vs. 94. 2 μg/L, P〈O. 05）. In this cohort, serum YKL-40 level was positively correlated with SBP, DBP, BMI, TG and hsCRP（r =0. 360,0. 303,0. 281,0. 216, 0. 530, all P 〈0. 05）but not correlated with FMD, ET-1 and NO （all P 〉 0. 05 ）. Conclusions Serum YKL-40 levels are increased compared to normal controls and positively correlated with blood pressure level but not with endothelial function parameters in hypertensive patients. Serum YKL-40 level might thus be used as a biomarker reflecting inflammation status other than endothelium function in hypertensive patients.