不同海拔地区高血压患者同型半胱氨酸水平及代谢酶基因多态性与血压及氧化应激水平的关系研究  

Study on the Relationship between Homocysteine Levels,Polymorphisms of Homocysteine Metabolizing Enzyme Genes,Blood Pressure,and Oxidative Stress Levels in Hypertensive Patients at Different Altitudes

作　　者：张柠 樊世明[2] 任明[2] 沈有录[2] 马艳梅[2] 窦小红[2] 普措 鲁星琴 黄强 薛睿 王福彦 林莹 张吉辉 田辉珍 韩萍 韩玉娟 韩淑萍 刘青灵 卢天龙[2] 芦永良 鄂维建 ZHANG Ning;FAN Shiming;REN Ming;SHEN Youlu;MA Yanmei;DOU Xiaohong;PU Cuo;LU Xingqin;HUANG Qiang;XUE Rui;WANG Fuyan;LIN Ying;ZHANG Jihui;TIAN Huizhen;HAN Ping;HAN Yujuan;HAN Shuping;LIU Qingling;LU Tianlong;LU Yongliang;E Weijian(Graduate School of Qinghai University,Xining 810000,China;Department of Cardiology,Affiliated Hospital of Qinghai University,Xining 810000,China)

机构地区：[1]青海大学研究生院,青海省西宁市810000 [2]青海大学附属医院心血管内科,青海省西宁市810000

出　　处：《中国全科医学》2025年第15期1862-1870,共9页Chinese General Practice

基　　金：青海省卫生健康委员会2023年度“昆仑英才·高层次卫生健康人才”项目。

摘　　要：背景随着高海拔地区高同型半胱氨酸血症(HHcy)及高血压发病率的增加,同型半胱氨酸(Hcy)及其代谢酶基因多态性与血压、氧化应激水平之间的关系尚不明确,探讨其相关性或许可为高海拔地区H型高血压提供新的诊疗思路。目的分析海拔对Hcy代谢酶基因多态性的影响,比较不同基因型之间血压、Hcy及氧化应激水平的差异,探讨Hcy水平与血压、氧化应激之间的相关性。方法纳入2023年7月—2024年7月在青海大学附属医院诊治的玉树地区(海拔3800~4200 m)高血压患者60例(高海拔高血压组)、健康受试者30例(高海拔健康组);纳入西宁地区(海拔2260 m)高血压患者60例(低海拔高血压组)、健康受试者30例(低海拔健康组)为研究对象。收集研究对象的基线资料和实验室检查结果,检测Hcy代谢酶基因多态性。采用Pearson相关性分析探讨Hcy、血压、血清氧化型谷胱甘肽(GSSG)、一氧化氮(NO)、超氧化物歧化酶(SOD)水平的相关性。结果各组受试者年龄、性别、BMI、吸烟史、饮酒史、服药史、高血压家族史、民族比较,差异无统计学意义(P>0.05)。高海拔高血压组Hcy、收缩压(SBP)、舒张压(DBP)、GSSG高于高海拔健康组、低海拔高血压组,NO、SOD低于高海拔健康组、低海拔高血压组(P<0.05);高海拔健康组SBP、DBP、GSSG高于低海拔健康组,SOD低于低海拔健康组(P<0.05);低海拔高血压组Hcy、SBP、DBP、GSSG高于低海拔健康组,SOD低于低海拔健康组(P<0.05)。不同海拔地区高血压组受试者亚甲基四氢叶酸还原酶(MTHFR)C677T基因型频率比较,差异有统计学意义(P<0.05),MTHFR A1298C、蛋氨酸合酶还原酶(MTRR)A66G基因型频率比较,差异无统计学意义(P>0.05);不同海拔地区健康组受试者MTHFR C677T、MTHFR A1298C、MTRR A66G基因型频率比较,差异无统计学意义(P>0.05)。120例高血压患者MTHFR C677T位点中CC基因型56例(46.67%),CT基因型43例(35.83%),TT基因�Background With the increasing incidence of hyperhomocysteinemia(HHcy)and hypertension in high-altitude regions,the relationships among homocysteine(Hcy),polymorphisms of Hcy metabolizing enzyme genes,blood pressure,and oxidative stress levels remain unclear.Exploring these correlations may provide new diagnostic and therapeutic insights for H-type hypertension in high-altitude areas.Objective To analyze the impact of altitude on polymorphisms of Hcy metabolizing enzyme genes,compare differences in blood pressure,Hcy levels,and oxidative stress levels among different genotypes,and explore the correlations between Hcy levels and blood pressure as well as oxidative stress.Methods From July 2023 to July 2024,60 hypertensive patients(high-altitude hypertension group)and 30 healthy subjects(high-altitude healthy group)from the Yushu region(altitude:3800-4200 m)were recruited from the Affiliated Hospital of Qinghai University.Additionally,60 hypertensive patients(low-altitude hypertension group)and 30 healthy subjects(low-altitude healthy group)from the Xining region(altitude:2260 m)were included in the study.Baseline information and laboratory test results were collected from the subjects,and polymorphisms of Hcy metabolizing enzyme genes were detected.Pearson correlation tests were used to investigate the correlations among Hcy,blood pressure,serum oxidized glutathione(GSSG),nitric oxide(NO),and superoxide dismutase(SOD)levels.Results There were no significant differences in age,gender,BMI,smoking history,drinking history,medication history,family history of hypertension,or ethnicity among the groups(P>0.05).The high-altitude hypertension group had higher Hcy,systolic blood pressure(SBP),diastolic blood pressure(DBP),and GSSG levels,and lower NO and SOD levels compared to the high-altitude healthy group and the low-altitude hypertension group(P<0.05).The high-altitude healthy group had higher SBP,DBP,and GSSG levels,and lower SOD levels compared to the low-altitude healthy group(P<0.05).The low-altitude hypertension

关 键 词：高血压 高同型半胱氨酸血症 同型半胱氨酸 高海拔 MTHFR基因多态性 MTRR基因多态性 氧化应激 

分 类 号：R544.1[医药卫生—心血管疾病]