Relation of plasma midregional proatrial natriuretic peptide to target organ damage in adults with systemic hypertension.
Relation of plasma midregional proatrial natriuretic peptide to target organ damage in adults with systemic hypertension.
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血浆中区心房钠尿肽前体与成人全身性高血压患者靶器官损伤的关系。
DOI：
10.1016/j.amjcard.2009.01.012
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Kullo,IftikharJ
中科院分区：
文献类型：
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作者：
Khaleghi,Mahyar;Al-Omari,MalikA;Kondragunta,Venkateswarlu;Morgenthaler,NilsG;Struck,Joachim;Bergmann,Andreas;Mosley,ThomasH;Kullo,IftikharJ
我们验证了这样一个假设，即在成人原发性高血压患者中，血浆中区域心钠素原（MR-proANP）水平与靶器官损伤相关。MR-proANP是一种新发现的稳定的N-末端心房钠尿肽前体片段。参与者包括1，919名来自社区的高血压成年人（1，037名非裔美国人，65 ± 9岁，72%女性; 882名非西班牙裔白人，61 ± 9岁，55%女性）。我们通过免疫发光测定法测量MR-proANP。靶器官损害的测量包括踝臂指数（ABI）、尿白蛋白肌酐比值（UACR）和左心室（LV）质量（仅适用于非裔美国人）。使用广义估计方程评估血浆MR-proANP是否与靶器官损伤测量值相关，与潜在混杂变量无关。在非裔美国人中，较高的MR-proANP与较低的ABI（p <0.0001）、较高的UACR（p <0.0001）和较大的LV质量（指数为身高的2.7次方，p <0.0001）显著相关。校正年龄、性别、体重指数、收缩压、估计肾小球滤过率、吸烟史、糖尿病、总胆固醇和高密度脂蛋白胆固醇、药物后（降血压、他汀类药物和阿司匹林）使用和既往心肌梗死或卒中，较高的MR-proANP水平仍然与较低的ABI显著相关（p = 0.01），较高的UACR（p = 0.0007）和较高的LV质量指数（p <0.0001）。在非西班牙裔白人中，较高的MR-proANP水平与较低的ABI（p = 0.002）和较大的UACR（p = 0.001）显著相关，但在调整了先前列出的协变量后，则不相关。总之，血浆MR-proANP可能是高血压患者靶器官损伤的标志物，尤其是在非洲裔美国人中。
We tested the hypothesis that, in adults with essential hypertension, plasma levels of midregional proatrial natriuretic peptide (MR-proANP) are associated with target organ damage. MR-proANP is a newly described stable fragment of N-terminal proatrial natriuretic peptide. Participants included 1,919 adults with hypertension identified from the community (1,037 African-Americans, 65 ± 9 years of age, 72% women; 882 non-Hispanic whites, 61 ± 9 years of age, 55% women). We measured MR-proANP by an immunoluminometric assay. Measurements of target organ damage included the ankle–brachial index (ABI), urinary albumin–creatinine ratio (UACR), and left ventricular (LV) mass (available only in African-Americans). Generalized estimating equations were used to assess whether plasma MR-proANP was associated with measurements of target organ damage, independent of potential confounding variables. In African-Americans, higher MR-proANP was significantly associated with lower ABI (p <0.0001), higher UACR (p <0.0001), and greater LV mass (indexed to height to the power of 2.7, p <0.0001). After adjustment for age, gender, body mass index, systolic blood pressure, estimated glomerular filtration rate, smoking history, diabetes mellitus, total and high-density lipoprotein cholesterols, medication (blood pressure lowering, statin, and aspirin) use, and previous myocardial infarction or stroke, higher MR-proANP levels remained significantly associated with lower ABI (p = 0.01), higher UACR (p = 0.0007), and greater LV mass index (p <0.0001). In non-Hispanic whites, higher MR-proANP levels were significantly associated with lower ABI (p = 0.002) and greater UACR (p = 0.001), but not after adjustment for the covariates listed earlier. In conclusion, plasma MR-proANP may be a marker of target organ damage in the setting of hypertension, especially in African-Americans.