家族性混合型高脂血症家系血浆载脂蛋白B与脉压相关关系的研究

An association of apolipoprotein B with pulse pressure in Chinese pedigrees with familial combined hyperlipidemia

目的 探讨家族型混合性高脂血症 (FCHL)家系中血压表型 (收缩压、舒张压、平均动脉压及脉压 )的影响因子及家族性脂质异常性高血压 (FDH)家系的分布特征。方法 从北京地区搜集 4 2个FCHL家系 (共 4 35人 ) ,其中确诊了 11个FDH家系。采用多元线性逐步回归方法 ,分析FCHL家系年龄介于 30～ 6 0岁之间的家系成员 (共 2 37人 )血压表型的影响因子。结果 FCHL亲属脂质异常性高血压的患病率为 2 9 9% ,配偶的患病率为 8 9% ,危险度优势比为 3 37(95 %CI为1 4 4～ 8 14 ,P <0 0 1)。FCHL家系中体重指数、年龄、血糖与收缩压、舒张压及平均动脉压相关 (P<0 0 5 ) ;年龄、载脂蛋白B与脉压相关 (P <0 0 5 )。结论 体重指数、血糖升高可以增加FCHL家庭成员高血压的易患性 ,载脂蛋白B升高是脉压增加的一个独立的危险因素。

Objective To investigate the influencing factors of blood pressure phenotypes and the distribution of FDH in FCHL families. Methods Forty-two FCHL families with 435 members, 147 consanguine members and 90 members without consanguinity from Beijing area were studied. Eleven of the 42 FCHL families (26.2 %) were identified as families with FDH syndrome. Stepwise regression analysis was used to analyze the association between the target variables and blood pressure phenotypes, such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP), of the 237 FCHL members aged 30 to 60 years. Results The prevalence of dyslipidemic hypertension in the FCHL relatives was significantly higher than that in the spouses (29.9% versus 8.9%, P<0.01), with an odds ratio of 3.37 (95%CI 1.44 to 8.14). In the FCHL families body mass index (BMI), age and blood sugar were independent contributors to SBP, DBP, and MAP, respectively (all P<0.05). Age and apolipoprotein B (apoB) were important contributors to pulse pressure (both P<0.05). Conclusions BMI and glucose are significant contributors to different phenotypes of blood pressure. Moreover, apoB is a significant contributor to pulse pressure in FCHL families.