血清皮质醇与高血压关联的病例对照研究

A case-control study on relationship between serum cortisol and hypertension

目的探讨血清皮质醇水平与高血压之间的关联,为高血压病因探索提供参考依据。方法本研究采用病例对照设计,2015年6月—2018年7月在本中心的高血压病例及本地未患高血压人群中收集对照组研究对象。采用面对面的问卷调查方式获得研究对象的基本情况,行为和生活方式以及疾病家族史和疾病史等方面的信息。采用放射免疫法测定研究对象血清皮质醇水平。采用多元logistic回归分析皮质醇与高血压患病之间的关联。结果在女性中,与对照组相比,病例组具有较高的血清皮质醇浓度,且差异存在统计学意义(P<0.05)。在调整相关协变量后,每增加1标准差(standard deviation,SD)的皮质醇,女性研究对象患高血压风险的OR(95%CI)为1.27(1.05, 1.53)。以T1组研究对象为参照,T3组研究对象患高血压风险的OR(95%CI)值为1.65(1.04, 2.60),趋势性检验显示随血清皮质醇水平的升高,其患高血压的风险逐渐增强(P trend=0.033)。在男性中未发现显著性关联。结论女性中较高水平血清皮质醇与高血压患病风险增加相关。

Objective This study aimed to explore the association of serum cortisol with hypertension,then to provide reference for the etiology of hypertension.Methods A case-control study was conducted in this study.From June 2015 to July 2018,the hypertension cases collected in the Yuzhou Center for Disease Control and Prevention.The control group were collected from the general population.A face-to-face interview questionnaire was used to collect information on basic characteristics,behavioral and lifestyle factors,family history of diseases,and medical history.Serum cortisol was measured by Radioimmunoassay.Multivariable logistic regression was used to explore the associations between serum cortisol and hypertension.Results Among women,individuals with hypertension had a significantly higher serum cortisol concentrations than those in control group(P<0.05).After adjustment for related covariates,each 1-SD increase in cortisol was associated with a higher risk of hypertension(OR:1.27,95%CI:1.05,1.53).Compared with the lowest levels of cortisol,participants in tertiles 3 had a 65%higher prevalence of hypertension,and the OR(95%CI)was 1.65(1.04,2.60).Trend testing showed that the prevalence of hypertension increased with the increase of serum cortisol levels(P=0.033).No significant association was found in men.Conclusion Higher serum cortisol levels were associated with a higher risk of hypertension in women.