血浆醛固酮和肾素浓度对中国成年人血压变化和高血压风险的影响:一项基于人群的客家生物库研究。

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Fuxiang Fang, Jingwei Lin, Mingli Li, Zheng Wen, Diman Mai, Jingwen Liu, Lingyu Ye, Yezhou Wu, Xuefang Liang, Fuhua Hu, Yibi Lan, Junwu Ran, Renzhi Tan, Yongchen Li, Libing Lai, Jinlian Li, Yongxian Wu, Zheng Lu, Shengzhu Huang, Chao Wang, Zengnan Mo
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引用次数: 0

摘要

目的:肾素-血管紧张素-醛固酮系统(RAAS)与调节血压(BP)有关,但其对BP相关表型的影响在中国人群中尚未得到很好的表征。方法:基于来自中国客家生物库(HKB)的8914名参与者,采用回归模型、限制性三次样条(RCS)和亚组分析,分析血浆醛固酮浓度(PAC)、血浆肾素浓度(PRC)和醛固酮-肾素比(ARR)与多种bp相关表型的关系。结果:多变量回归模型显示,较高的log-PAC和log-ARR以及较低的log-PRC与较高的收缩压、舒张压、脉压和平均动脉压相关(均P < 0.001)。1个单位高的log-PAC或低的log-PRC与收缩期、舒张期、临床和收缩期-舒张期高血压的高风险相关,比值比(or)从1.67(95%可信区间[CI], 1.47-1.85)到6.29 (95% CI, 4.48-8.83);较高的log-ARR的OR范围从收缩期-舒张期高血压的1.66 (95% CI, 1.47-1.86)到临床高血压的2.42 (95% CI, 2.14-2.73)。在亚组和敏感性分析中,以及与醛固酮浓度正常或肾素依赖性醛固酮增多者相比,肾素非依赖型醛固酮增多者观察到一致的关联(均P < 0.05)。此外,RCS模型显示,log-PAC、log-PRC和log-ARR与高血压之间存在显著的非线性关系(均P非线性< 0.05)。结论:较高的PAC和ARR,较低的PRC与不利的血压变化和高血压风险升高有关,特别是在肾素抑制或自主醛固酮分泌的参与者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Plasma Aldosterone and Renin Concentrations with Blood Pressure Variation and Hypertension Risk in Chinese Adults: A Population-Based Hakka Biobank Study.

Objectives: The renin-angiotensin-aldosterone system (RAAS) has been implicated in regulating blood pressure (BP), yet its effects on BP-related phenotypes are not well characterized in the Chinese population.

Methods: Based on 8914 participants from the Hakka Biobank (HKB) cohort of China, regression models, restricted cubic spline (RCS), and subgroup analyses were used to analyze associations of plasma aldosterone concentration (PAC), plasma renin concentration (PRC), and the aldosterone-to-renin ratio (ARR) with multiple BP-related phenotypes.

Results: Multivariable regression models indicated that higher log-PAC and log-ARR, and lower log-PRC, were associated with higher systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure (all P < 0.001). A 1-unit higher log-PAC or lower log-PRC was linked to higher risks of systolic, diastolic, clinic, and systolic-diastolic hypertension, with the odds ratios (ORs) ranging from 1.67 (95% confidence interval [CI], 1.47-1.85) to 6.29 (95% CI, 4.48-8.83); and the OR of a higher log-ARR ranged from 1.66 (95% CI, 1.47-1.86) for systolic-diastolic hypertension to 2.42 (95% CI, 2.14-2.73) for clinic hypertension. Consistent associations were observed in subgroup and sensitivity analyses, as well as the participants with renin-independent aldosteronism compared to those with normal aldosterone concentration or renin-dependent aldosteronism (all P < 0.05). Moreover, RCS model revealed significant non-linear associations between log-PAC, log-PRC and log-ARR with hypertension (all P nonlinearity < 0.05).

Conclusions: Higher PAC and ARR, lower PRC were associated with adverse BP variation and elevated risk of hypertension, especially among participants in the context of renin suppression or autonomous aldosterone secretion.

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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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