血清可溶性Klotho与原发性高血压动脉硬化关系的研究

The relationship between serum soluble Klotho and arterial stiffness in patients with essential hypertension

目的:研究血清可溶性Klotho(sKlotho)水平与原发性高血压动脉硬化的相关性。方法:选取2017年1月—2018年12月在昆明医科大学附属延安医院就诊的196例初诊高血压患者(高血压组)和121例健康对照者(对照组),检测血清sKlotho、血脂、血糖、尿酸等常规生化指标,测定24 h尿钠排泄来计算估测摄盐量,同时检测臂踝脉搏波速度(baPWV)和颈动脉最大内膜中层厚度(IMT),研究血清sKlotho水平与高血压动脉弹性的关系。结果:高血压组血清sKlotho水平较对照组降低,而baPWV和Max IMT较对照组升高(均P<0.05)。高血压组估测摄盐量(10.51±4.19)g较对照组(8.97±3.48)g明显升高(P<0.01)。高血压组中,血清sKlotho水平与年龄、收缩压(SBP)、舒张压(DBP)、平均动脉压(MBP)、24 h尿钠呈负相关性,与估测肾小球滤过率(eGFR)呈正相关性(均P<0.01);高血压组baPWV和IMT与血清sKlotho水平呈负相关性(r=-0.59、-0.61,均P<0.01)。baPWV≥1400 cm/s和IMT≥1.0 mm的患者血清sKlotho显著降低(P<0.05)。多重logistic回归分析显示,年龄、吸烟、MBP、血脂异常、估测摄盐量是baPWV的危险因素,血清sKlotho是baPWV的保护因素(P=0.024,OR=0.86,95%CI:0.295~0.977)。结论:高血压患者血清sKlotho水平较非高血压患者降低,与动脉硬化指标baPWV、IMT呈负相关性,是baPWV的保护因素,可作为动脉僵硬度的生物标志物。

Objective:To explore the relationship between the serum soluble Klotho(sKlotho)and arterial stiffness in patients with essential hypertension.Method:A total of 196 patients who were newly diagnosed hypertension(hypertension group)and 121 healthy controls(control group)in Yan’an Hospital Affiliated of Kunming Medical University from January 2017 to December 2018 were included.Blood samples were collected to measure the levels of serum sKlotho,blood lipid,blood glucose,and uric acid.24-hour urine sodium excretion was measured to calculate the estimated salt intake.Brachial ankle pulse wave velocity(baPWV)and carotid artery maximum intima-media thickness(IMT)were detected.The relationship between serum sKlotho level and arterial elasticity in essential hypertension was investigated.Result:The serum sKlotho level in the hypertension group was lower than that in the control group,while baPWV and Max IMT were higher than those in the control group(all P<0.05).The estimated salt intake in the hypertension group was(10.51±4.19)g,which increased significantly compared with the control group(8.97±3.48)g(P<0.01).In the hypertension group,the serum sKlotho level negatively correlated with the age,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean blood pressure(MBP),24-hour urine sodium,and positively correlated with estimated glomerular filtration rate(eGFR)(all P<0.01),while the serum Klotho level negatively correlated with baPWV and IMT(r=-0.59,-0.61,both P<0.01).Serum sKlotho levels significantly decreased in patients with baPWV≥1400 cm/s and IMT≥1.0 mm(P<0.05).Multiple logistic regression analysis showed that age,smoking,MBP,dyslipidemia,and estimated salt intake were risk factors for baPWV,and serum sKlotho was a protective factor for baPWV(P=0.024,OR=0.86,95%CI:0.295-0.977).Conclusion:The serum level of sKlotho in patients with hypertension is lower than that without hypertension,which is negatively correlated with baPWV and IMT.SKlotho is a protective factor of baPWV,which could be used as a biomarker of arterial stiffness.