福建沿海地区人群心血管活性肽apelin水平与血压的相关性研究

Relationship Between Apelin Level and Blood Pressure in a Coastal Population of Fujian Province

目的：探讨福建沿海地区人群心血管活性肽apelin水平与血压的关系。 方法：采用横断面调查方法纳入福建沿海地区30~79岁人群1031人，男性416例，平均年龄（55.1±10.9）岁，均行问卷调查、体格检查、血生化及血浆apelin水平检测。1031人根据美国最新高血压治疗指南（JNC7）的高血压定义分组：高血压组（n=496）,收缩压≥140 mmHg（1 mmHg=0.133 kPa）或舒张压≥90 mmHg或已开始服降压药者；正常高值血压组（n=314）：未服用降压药物收缩压120~139 mmHg和（或）舒张压80~89 mmHg；正常血压组（n=221）：未服用降压药物收缩压〈120 mmHg且舒张压〈80 mmHg。1031人根据apelin四分位水平分为四组，Q1组（n=258）：〈164.8ng/ml，Q2组（n=258）：164.8±220.0 ng/ml，Q3组（n=258）：220.0~283.1 ng/ml，Q4组（n=257）：〉283.1 ng/ml。采用单因素方差分析趋势检验、协方差分析和多元线性回归分析评价血浆apelin与血压的相关性。 结果：1031人中男性血浆apelin水平[（220.57±78.87）pg/ml]比女性[（232.06±81.17）pg/ml]降低，正常高值血压组与正常血压组比较、高血压组与正常血压组和正常高值血压组比较，apelin水平均降低（P〈0.05）。Q2、Q3组与Q1组比较，收缩压、舒张压与平均动脉压均降低, Q4组与其他三组比较，收缩压、舒张压（不包括Q2组和Q3组）与平均动脉压均降低，差异均有统计学意义（P均＆lt;0.05）。调整了性别和年龄，收缩压、舒张压及平均动脉压在apelin四分位组间的差异仍有统计学意义（P〈0.05）。多元线性回归分析提示收缩压、舒张压及平均动脉压与apelin水平存在负相关，在调整了其它心血管危险因素后，这种相关关系仍然存在。 结论：apelin水平随着血压水平的升高而降低，提示心血管活性肽apelin水平与血压调控相关。

Objectives： To explore the relationship between vascular active peptide, apelin level and blood pressure in a coastal population of Fujian province. Methods： A total of 1031 subjects with the mean age of （55.1±10.9） years in a coastal area of Fujian province were included in this cross-sectional study, and 416 subjects with male gender. The questionnaire survey, physical examination and plasma level of apelin measurement were conducted. Based on JNC-7 deifnition of hypertension, the subjects were divided into 3 groups： ① Hypertension group, the patients with systolic blood pressure （SBP）≥140 mmHg and/or diastolic blood pressure （DBP）≥90 mmHg, n=496. ② Pre-hypertension group, SBP at （120-139） mmHg and/or DBP at （80-89） mmHg without medication, n=314.③Normal BP group, SBP〈120mmHg and DBP〈80mmHg without medication, n=221. Based on 4 quartiles of apelin levels, the subjects were further divided into 4 groups：Q1 group, apelin＆lt;164.8 ng/ml, n=258. Q2 group, apelin at （164.8-＆lt;220.0） ng/ml, n=258. Q3 group, apelin at （220.0-283.1） ng/ml, n=258. Q4 group, apelin＆gt;283.1 ng/ml, n=257. One way analysis of variance, covariance analysis and multivariate linear regression analysis were used to study the relationship between apelin level and BP. Results： The apelin level in male gender （220.57±78.87） pg/ml was lower than female gender （232.06±81.17） pg/ml. Compared with Normal group, Pre-hypertension group had decreased apelin level, compared with Normal and Pre-hypertension groups, Hypertension group had decreased apelin level, P〈0.05. Compared with Q1 group, Q2, Q3 groups presented decreased SBP, DBP and mean arterial blood pressure （MABP）, and compared with other 3 groups, Q4 group had decreased SBP, DBP （not including Q2, Q3 groups） and MABP, P〈0.05. With adjusted age and gender, SBP, DBP and MABP were signiifcantly different among 4 quartiles of apelin groups, P〈0.05. Multivariate linear regression analysis indicated that SBP, DBP and MABP were negatively related to apelin level, such relationship remained the same after adjusting the other cardiovascular risk factors. Conclusion： Apelin level dropping accompanying with BP increasing implies that vascular active peptide, apelin involved in BP regulation.