补体C1q肿瘤坏死因子相关蛋白1与老年原发性高血压患者微量白蛋白尿相关性研究

Association between complement C1q tumor necrosis factor-related protein and microalbuminuria in elderly essential hypertension patients

目的探讨补体C1q肿瘤坏死因子相关蛋白1(complement C1q tumor necrosis factor-related protein 1,CTRP1)与老年原发性高血压患者微量白蛋白尿的关系。方法选择2015年12月～2017年11月上海交通大学医学院附属瑞金医院门诊及住院的老年轻中度原发性高血压患者235例,根据是否合并微量白蛋白尿分为原发性高血压组112例,原发性高血压合并微量白蛋白尿组(微量白蛋白尿组) 123例。所有患者测量血压、空腹血糖、血脂、尿白蛋白肌酐比(urinary protein creatinine ratio,UACR)等,采用ELISA法测定CTRP1以及相关代谢脂肪因子水平。结果微量白蛋白尿组CTRP1、TNF-α、UACR水平明显高于原发性高血压组[(15. 63±2. 17)μg/L vs (9. 73±1. 99)μg/L,(74. 38±25. 60) ng/L vs (59. 72±17. 34) ng/L,(2. 45±0. 76) mg/mmol vs (2. 19±0. 88) mg/mmol,P <0. 01],脂联素水平明显低于原发性高血压组[(4. 26±0. 77) mg/L vs (7. 46±1. 67) mg/L,P <0. 01]。多元logistic回归分析显示,CTRP1、TNF-α、脂联素为原发性高血压合并微量白蛋白尿的影响因素(OR=0. 058,95%CI:0. 003～0. 174,P=0. 014; OR=1. 012,95%CI:1. 001～1. 025,P=0. 006; OR=0. 664,95%CI:0. 530～0. 833,P=0. 000)。结论CTRP1与老年原发性高血压及其肾脏亚临床损害的发生、发展有关。

Objective To study the relationship between complement C1q tumor necrosis factor-related protein 1(CTRP1)and microalbuminuria in elderly essential hypertension(EH)patients.Methods Two hundred and thirty-five elderly EH patients were divided into EH group(n=112)and EH+microalbuminuria group(n=123).Their blood pressure,fasting blood glucose and blood lipid level,urinary protein creatinine ratio(UACR)were measured,and their renal function was tested.Th serum levels of CTRP1 and related adipocytokines in two groups were measured by ELISA.Results The serum levels of CTRP1,TNF-αand UACR were significantly higher while those of adiponectin were significantly lower in EH+microalbuminuria group than in EH group(15.63±2.17μg/L vs 9.73±1.99μg/L,74.38±25.60 ng/L vs 59.72±17.34 ng/L,2.45±0.76 mg/mmol vs 2.19±0.88 mg/mmol,P<0.01;4.26±0.77 mg/L vs 7.46±1.67 mg/L,P<0.01).Multivariate logistic regression analysis showed that CTRP1,TNF-αand adiponectin were the risk factors for EH+microalbuminuria in EH patients(OR=0.058,95%CI:0.003-0.174,P=0.014;OR=1.012,95%CI:1.001-1.025,P=0.006;OR=0.664,95%CI:0.530-0.833,P=0.000).Conclusion CTRP1 is relted with the occurrence and development of hypertension and hypertension-induced subclinical renal damage.