血浆中性粒细胞明胶酶相关脂质运载蛋白与原发性高血压及高血压左心室肥厚的相关性研究

Association of Elevated Neutrophil Gelatinase-Associated Lipocalin with Essential Hypertension and Hypertensive Left Ventricular Hypertrophy

目的中性粒细胞明胶酶相关脂质运载蛋白(NGAL)是一种促炎脂肪因子,已被证实与多种心血管疾病相关。而NGAL与高血压及高血压左心室肥厚的关系尚不明确,现探讨血浆NGAL与高血压及高血压左心室肥厚的相关性。方法纳入2017—2019年在成都市第三人民医院心血管内科住院诊治的高血压患者以及非高血压患者,研究对象共308例,高血压患者187例,非高血压患者(对照组)121例。采用逻辑回归模型分析血浆NGAL与高血压及高血压左心室肥厚的相关性。采用左心室质量指数评估患者是否存在高血压左心室肥厚。结果与对照组相比,高血压组患者的血浆NGAL水平明显升高[(14.97±2.94)ng/mL vs(12.33±2.88)ng/mL,P<0.001]。将NGAL作为连续变量分析,在单因素逻辑回归模型中,血浆NGAL与高血压风险增加相关(OR=1.35,95%CI 1.24~1.48,P<0.001)。多因素分析显示,血浆NGAL是高血压的独立危险因素(Model2:OR=1.35,95%CI 1.23~1.48,P<0.001;Model3:OR=1.36,95%CI 1.24~1.50,P<0.001)。与高血压无左心室肥厚组相比,高血压左心室肥厚组患者的血浆NGAL水平明显升高[(16.94±2.13)ng/mL vs(13.68±2.67)ng/mL,P<0.001]。单因素分析显示血浆NGAL升高与高血压患者左心室肥厚显著相关(OR=1.65,95%CI 1.42~1.91,P<0.001)。多因素分析仍然显示血浆NGAL是高血压左心室肥厚的独立危险因素(Model2:OR=1.67,95%CI 1.43~1.94,P<0.001;Model3:OR=1.69,95%CI 1.43~2.00,P<0.001)。受试者操作特征曲线分析显示,血浆NGAL对高血压左心室肥厚的预测具有很好的准确性,曲线下面积为0.83(95%CI 0.77~0.88,P<0.001)。结论血浆NGAL水平升高与高血压及高血压左心室肥厚具有相关性。

Objective Neutrophil gelatinase-associated lipocalin(NGAL)is a pro-inflammatory fat factor,which has been proved to be associated with various cardiovascular diseases.The association between NGAL and hypertension and hypertensive left ventricular hypertrophy(LVH)has not been evaluated.This study explored the association between NGAL and hypertension and the influence of NGAL on the LVH.Methods A total of 308 participants(including 187 hypertension patients and 121 non-hypertension patients as control group)were enrolled in Department of Cardiology,The Third People’s Hospital of Chengdu from 2017 to 2019.Logistic regression model was used to analyze the correlation between plasma NGAL and hypertension and hypertensive LVH.Left ventricular mass index was used to evaluate the presence of hypertensive LVH.Results Compared with the control group,the plasma NGAL level in hypertension group was significantly higher[(14.97±2.94)ng/mL vs(12.33±2.88)ng/mL,P<0.001].Using NGAL as a continuous variable,plasma NGAL was associated with an increased risk of hypertension in a univariate logistic regression model(OR=1.35,95%CI 1.24~1.48,P<0.001).Multivariate analysis showed that plasma NGAL was an independent risk factor for hypertension(Model2:OR=1.35,95%CI 1.23~1.48,P<0.001;Model3:OR=1.36,95%CI 1.24~1.50,P<0.001).Compared with the hypertensive group without LVH,the plasma NGAL level in the hypertensive LVH group was significantly higher[(16.94±2.13)ng/mL vs(13.68±2.67)ng/mL,P<0.001].Univariate analysis showed that the increase of plasma NGAL was significantly correlated with LVH in patients with hypertension(OR=1.65,95%CI 1.42~1.91,P<0.001).Multivariate analysis still showed that plasma NGAL was an independent risk factor for hypertensive LVH(Model2:OR=1.67,95%CI 1.43~1.94,P<0.001;Model3:OR=1.69,95%CI 1.43~2.00,P<0.001).The receiver operating characteristic curve analysis showed that plasma NGAL had a good accuracy in predicting the LVH in hypertensive subjects,and the area under the operating characteristic curve was 0.83(95%CI 0.77~0.88,P<0.001).Conclusion Elevated NGAL is associated with hypertension and hypertensive LVH.