H型高血压患者HDL亚组分的改变及对内皮细胞抗炎功能的影响  

Changes of HDL subclasses and its effect on anti-inflammatory function of endothelial cells in H-type hypertension patients

作　　者：黄菁菁 黄灿霞[2,3] 张杰[1,2] 孙润陆[1,2] 包金兰[2,4] 阿依古力·阿不都克热木 李鸿炜 吴晓英 何智健 谢祥坤 陈文雅 黄心怡 王玥 张玉玲[1,2] HUANG Jingjing;HUANG Canxia;ZHANG Jie;SUN Runlu;BAO Jinlan;AYIGULI Abudukeremu;LI Hongwei;WU Xiaoying;HE Zhijian;XIE Xiangkun;CHEN Wenya;HUANG Xinyi;WANG Yue;ZHANG Yuling(Department of Cardiovascular Medicine,Sun Yat-sen University,Guangzhou,Guangdong 510120,China;Guangzhou Key Laboratory on the Molecular Mechanisms of Major Cardiovascular Disease,Sun Yat-sen University,Guangzhou,Guangdong 510120,China;Department of Intensive Care Unit,Sun Yat-sen University,Guangzhou,Guangdong 510120,China;Department of General Practice,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510120,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou,Guangdong 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院心血管内科 [2]中山大学孙逸仙纪念医院广州市重大心血管疾病分子调控与转化研究重点实验室 [3]中山大学孙逸仙纪念医院重症医学科 [4]中山大学孙逸仙纪念医院综合科 [5]广东药科大学附属第一医院心内科,广东省广州市510120

出　　处：《中国动脉硬化杂志》2022年第3期192-197,204,共7页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金面上项目(81970388);广东省自然科学基金面上项目(2019A1515011682);广东省国际科技合作领域粤港澳大湾区国际科技创新中心建设基金(2021A0505030021);广州市科技局重点实验室建设项目(202102010007);中山大学孙逸仙纪念医院逸仙临床研究培育项目(SYS-C-202004)。

摘　　要：目的观察H型高血压患者血同型半胱氨酸水平(Hcy)与高密度脂蛋白(HDL)亚组分的相关性,并研究HDL亚组分对内皮细胞抗炎功能的影响。方法选取健康人群133例、单纯高血压患者76例、H型高血压患者85例,测定空腹血糖(FBG)、血清肌酐(SCr)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)、HDL2、HDL3和Hcy等指标。分别留取各组血清各6例,应用快速蛋白液相色谱法(FPLC)提取大颗粒HDL(L-HDL),观察L-HDL对肿瘤坏死因子α(TNF-α)诱导的人脐静脉内皮细胞(HUVEC)炎症的改善作用。结果健康对照组、单纯高血压组和H型高血压组UA、FBG、TC、LDLC水平差异无统计学意义(P>0.05)。对比单纯高血压患者和健康对照组,H型高血压患者具有更低的HDLC、HDL2水平及更高的HDL3水平(P<0.001);血Hcy水平与血HDLC、HDL2呈显著负相关(P<0.01),但是与HDL3无显著相关性(P=0.083)。健康对照组、单纯高血压组L-HDL均可下调TNF-α诱导的血管内皮细胞表达血管细胞黏附分子1(VCAM-1),而H型高血压组L-HDL并不能明显减低VCAM-1表达。结论H型高血压患者可能通过高Hcy影响HDL的亚组分分布以及L-HDL对内皮细胞的抗炎功能。Aim To investigate the correlation between serum homocysteine(Hcy)level and high density lipoprotein(HDL)subclasses in patients with H-type hypertension,and to study the function of HDL subclasses on the anti-inflammatory capacity of endothelial cells.Methods 76 patients with isolated hypertension,85 patients with H-type hypertension and 133 healthy adults were included in our study.The concentration of fasting blood glucose(FBG),serum creatine(SCr),uric acid(UA),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDLC),high density lipoprotein cholesterol(HDLC),HDL2,HDL3 and Hcy were measured for each participants.Furthermore,HDL subclasses were isolated and purified from plasma of 6 participants for each group by fast protein liquid chromatography(FPLC).Large HDL(L-HDL)anti-inflammatory capacity was determined as its ability to suppress tumor necrosis factor alpha(TNF-α)-induced vascular cell adhesion molecule-1(VCAM-1)expression in human umbilical vein endothelium(HUVEC)in vitro.Results There were no significant differences of FBG,UA,TC,LDLC level between health control,isolated hypertension and H-type hypertension(P>0.05).Compared with health control and isolated hypertension,patients with H-type hypertension had significantly lower level of HDL2 and HDLC and higher level of HDL3(P<0.001).Correlation analysis indicated that plasma Hcy level was negatively related with HDLC(r=-0.532,P<0.01)and HDL2 level(r=-0.626,P<0.01).There was no significant relationship between plasma Hcy level and HDL3(r=0.10,P=0.083).The L-HDL from health controls and patients with isolated hypertension significantly decreased TNF-α-induced VCAM-1 expression in HUVEC(P<0.05).However,the L-HDL from patients with H-type hypertension indicated no effect on decreasing TNF-α-induced VCAM-1 expression in HUVEC(P>0.05).Conclusion Patients with H-type hypertension had abnormal HDL subclasses distribution and decreased function of L-HDL on anti-inflammatory capacity of HUVEC.

关 键 词：高同型半胱氨酸血症 高密度脂蛋白 H型高血压 抗炎 内皮细胞 

分 类 号：R5[医药卫生—内科学]