巨噬细胞移动抑制因子与原发性高血压患者左心室肥厚的关系

Macrophage migration inhibitory factor and left ventricular hypertrophy in patients with essential hypertension

目的分析巨噬细胞移动抑制因子(MIF)与原发性高血压患者发生左心室肥厚(LVH)的关系,探讨MIF在原发性高血压患者发生左心室肥厚过程中的作用。方法以2019年1月至2020年9月期间在新疆医科大学第一附属医院心内科接受诊断和治疗的802例原发性高血压患者作为研究对象记录性别、民族、年龄、吸烟史、饮酒史、收缩压、舒张压、体质量指数、心脏超声参数等指标,通过ELISA方法检测血清MIF水平。根据Devereux公式计算左心室质量(LVM)和左心室质量指数(LVMI),并根据LVMI水平(男性>125 g/m^(2)、女性>120 g/m^(2))将患者分为左心室肥厚组(136例)和非肥厚组(666例)。绘制散点图并采用Sperman相关分析MIF与LVM和LVMI的关联。采用多因素logistic回归分析高血压患者发生LVH的影响因素;绘制ROC曲线,评估MIF预测高血压患者发生LVH的效能。结果肥厚组的MIF水平高于非肥厚组,差异具有统计学意义[124.77(79.05,141.58)ng/ml比69.07(51.76,88.08)ng/ml,P<0.05]。此外,肥厚组的男性比例、冠心病病史比例、年龄、高血压病程、收缩压水平均高于非肥厚组(P<0.05)。Sperman相关性分析结果显示,MIF与LVM、LVMI呈正相关(r分别为0.270、0.320)。多因素logistic回归分析结果表明,MIF(OR=1.029,95%CI 1.023~1.036,P<0.001)、收缩压(OR=1.013,95%CI 1.003~1.024,P=0.013)、男性(OR=1.997,95%CI 1.169~3.472,P=0.012)、饮酒(OR=0.356,95%CI 0.173~0.704,P=0.004)是高血压患者发生LVH的影响因素。ROC曲线结果显示,MIF预测高血压患者发生LVH的曲线下面积(AUC)为0.777(95%CI 0.725~0.829,P<0.001)。结论MIF与原发性高血压患者左心室肥厚存在关联,提示MIF可能参与高血压影响心脏功能的过程。

Objective To investigate the relationship between macrophage migration inhibitory factor(MIF)and left ventricular hypertrophy(LVH)in patients with essential hypertension,and to investigate the role of MIF in the development of LVH in these patients.Methods A total of 802 patients with essential hypertension who were diagnosed and treated at the Department of Cardiology,First Affiliated Hospital of Xinjiang Medical University from January 2019 to September 2020 were included.The patients’gender,ethnicity,age,smoking history,alcohol consumption history,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)and echocardiographic parameters were recorded.The serum MIF level was measured using the ELISA method.Left ventricular mass(LVM)and left ventricular mass index(LVMI)were calculated using the Devereux formula.The patients were divided into the LVH group(n=136)and the non-LVH group(n=666)based on their LVMI levels(male>125 g/m^(2),female>120 g/m^(2)).Scatter plots were created,and Spearman correlation analysis was performed to assess the association between MIF and LVM and LVMI.Multivariate logistic regression was used to analyze the factors influencing LVH in hypertensive patients.The ROC curve was plotted to evaluate the predictive ability of MIF for LVH in hypertensive patients.Results The MIF level in the LVH group was significantly higher than thas in the non-LVH group[124.77(79.05,141.58)ng/ml vs.69.07(51.76,88.08)ng/ml,P<0.05].Additionally,the LVH group had the higher proportions of male,coronary heart disease history,older age,longer hypertension duration and higher systolic blood pressure compared to the non-LVH group(P<0.05).Spearman correlation analysis showed that MIF was positively correlated with both LVM(r=0.270)and LVMI(r=0.320).Multivariate logistic regression analysis indicated that MIF(OR=1.029,95%CI 1.023-1.036,P<0.001),systolic blood pressure(OR=1.013,95%CI 1.003-1.024,P=0.013),male gender(OR=1.997,95%CI 1.169-3.472,P=0.012)and alcohol consumption(OR=0.356,95%CI 0.173-0.704,P=0.004)were the factors influencing the development of LVH in hypertensive patients.The ROC curve analysis showed that the area under the curve(AUC)for MIF in predicting LVH in hypertensive patients was 0.777(95%CI 0.725-0.829,P<0.001).Conclusion MIF is associated with the left ventricular hypertrophy in patients with essential hypertension,suggesting that MIF may play a role in the process by which hypertension affects cardiac function.