高血压合并焦虑病人血清微RNA-451a、胰岛素样生长因子-1受体表达水平与焦虑程度的关系

Relationship between serum microRNA-451a and insulin-like growth factor-1 receptor expression levels and anxiety degree in patients with hypertension complicated with anxiety

目的探讨高血压合并焦虑病人血清微RNA-451a(miR-451a)、胰岛素样生长因子-1受体(IGF1R)表达水平与焦虑程度的关系。方法选取2020年2月至2022年1月在汉中市中心医院进行治疗的高血压病人160例,根据临床诊断和汉密尔顿焦虑量表(HAMA)评估将病人分为高血压组60例、高血压合并轻度焦虑情绪组48例、高血压合并中度焦虑情绪组32例和高血压合并重度焦虑情绪组20例,收集整理所有病例的临床基础资料。采用实时荧光定量PCR法检测血清miR-451a表达水平、ELISA法检测血清IGF1R表达水平;比较分析高血压病人和高血压合并焦虑情绪病人的临床病理特征;采用Pearson法分析HAMA评分与血清miR-451a、IGF1R表达水平的相关性;采用logistic回归分析高血压合并焦虑的影响因素。结果高血压组、轻度焦虑、中度焦虑和重度焦虑组病人血清miR-451a水平依次降低(0.88±0.30,0.59±0.14,0.48±0.11,0.38±0.09),IGF1R水平依次升高[(2.14±0.60)μg/L,(2.66±0.62)μg/L,(3.08±0.66)μg/L,(3.51±0.74)μg/L];血清miR-451a水平与HAMA评分呈负相关(r=−0.50,P<0.05),血清IGF1R水平与HAMA评分呈正相关(r=0.43,P<0.05);高血压合并焦虑组收缩压[(142.26±18.51)mmHg,(135.29±17.84)mmHg]、舒张压[(84.25±11.30)mmHg,(78.23±10.25)mmHg]、C-反应蛋白[(4.47±0.96)mg/L,(4.16±0.91)mg/L]、IL-6水平[(36.95±6.31)μg/L,(27.48±5.49)μg/L]显著高于高血压组,IL-10水平[(12.34±3.26)ng/L,(16.24±3.91)ng/L]显著低于高血压组(P<0.05);多因素logistic回归分析结果显示,收缩压[OR 95%CI=1.33(1.06,1.67)]、舒张压[OR 95%CI=1.20(1.00,1.45)]、IL-6[OR 95%CI=1.89(1.22,2.93)]、IL-10[OR 95%CI=0.38(0.17,2.93)]、miR-451a[OR 95%CI=0.01(0.00,0.47)]、IGF1R[OR 95%CI=7.62(1.21,48.03)]水平为高血压合并焦虑的影响因素(P<0.05)。结论高血压合并焦虑病人血清中miR-451a低表达,IGF1R高表达,且与病人焦虑程度密切相关。

Objective To investigate the relationship between serum microRNA-451a(miR-451a),insulin-like growth factor-1 recep⁃tor(IGF1R)and anxiety degree in patients with hypertension complicated with anxiety.Methods A total of 160 hypertension patients who underwent treatment in Hanzhong Central Hospital from February 2020 to January 2022 were selected,and the patients were divid⁃ed into 60 cases in the hypertension group,48 cases in the hypertension complicated with mild anxiety disorder group,32 cases in the hypertension complicated with moderate anxiety disorder group,and 20 cases in the hypertension complicated with severe anxiety disor⁃der group according to the clinical diagnosis and the assessment of the Hamilton Anxiety Scale(HAMA).The basic clinical data of all cases were collected and organized.The expression level of serum miR-451a was detected by real-time fluorescent quantitative PCR,and the expression level of serum IGF1R was detected by ELISA.To compare the clinicopathologic characteristics of hypertensive pa⁃tients and patients with hypertension complicated with anxiety.The Pearson method was used to analyze the correlation between HA⁃MA score and serum miR-451a and IGF1R expression levels.Logistic regression was used to analyze the influencing factors of hyper⁃tension with anxiety.Results Serum miR-451a levels were sequentially decreased(0.88±0.30,0.59±0.14,0.48±0.11,0.38±0.09)and IGF1R levels were sequentially increased[(2.14±0.60)μg/L,(2.66±0.62)μg/L,(3.08±0.66)μg/L,(3.51±0.74)μg/L]in patients from the hypertensive group,the mildly anxious,moderately anxious,and severely anxious groups.The serum miR-451a level was negatively correlated with the HAMA score(r=−0.50,P<0.05),and the serum IGF1R level was positively correlated with the HAMA score(r=0.43,P<0.05).In the hypertension combined with anxiety group,the systolic blood pressure[(142.26±18.51)mmHg,(135.29±17.84)mmHg],diastolic blood pressure[(84.25±11.30)mmHg,(78.23±10.25)mmHg],C-reactive protein[(4.47±0.96)mg/L,(4.16±0.91)mg/L],and IL-6 levels[(36.95±6.31)μg/L,(27.48±5.49)μg/L]were significantly higher than those in the hypertensive group,and IL-10 levels[(12.34±3.26)ng/L,(16.24±3.91)ng/L]were significantly lower than those in the hypertensive group(P<0.05).The multivariate logistic regression analysis showed that systolic blood pressure[OR 95%CI=1.33(1.06,1.67)],diastolic blood pressure[OR 95%CI=1.20(1.00,1.45)],IL-6[OR 95%CI=1.89(1.22,2.93)],IL-10[OR 95%CI=0.38(0.17,2.93)],miR-451a[OR 95%CI=0.01(0.00,0.47)],and IGF1R[OR 95%CI=7.62(1.21,48.03)]levels were the influencing factors of hypertension combined with anxiety(P<0.05).Conclu⁃sion The low expression of miR-451a and high expression of IGF1R in the serum of patients with hypertension combined with anxiety were closely related to the degree of anxiety.