血清OPG/RANKL之值与高血压左心室厚度的相关性研究-现代医学

血清OPG/RANKL之值与高血压左心室厚度的相关性研究

作者：陈义高枫

单位：无锡市中医医院心血管科, 江苏无锡 214000

分类号：R544.1

出版年·卷·期（页码）：2023·51·第十二期（1714-1719）

摘要：

目的：分析血清骨保护素/破骨细胞分化因子(OPG/RANKL)之值与高血压左心室厚度的相关性。方法：将87例研究对象分为健康组(27例)和高血压组(60例)，其中高血压组通过测定左心室厚度又分为无左心室肥厚组(30例)与左心室肥厚组(30例)，所有研究者均测定血清OPG、RANKL水平，并计算OPG/RANKL之值。结果：与健康组相比，高血压组的血清OPG水平、血清OPG/RANKL之值均显著升高，血清RANKL水平显著降低，差异均具有统计学意义(P<0.05)；与高血压无左心室肥厚组相比，高血压左心室肥厚组的血清OPG水平、血清OPG/RANKL之值均显著升高，血清RANKL水平显著降低，差异均具有统计学意义(P<0.001)。相关性分析显示，室间隔厚度与血清OPG水平及OPG/RANKL之值呈正相关(r=0.685、0.636，P<0.001)，与血清RANKL水平呈负相关(r=-0.546,P<0.001)。进一步行多元线性回归分析显示，血压水平升高、血清OPG/RANKL之值增高是室间隔增厚的重要因素(B=0.076，P<0.001)。结论：高血压患者测定血清OPG/RANKL之值对其左室厚度评估可能具有一定临床意义。

Objective: To analyze the correlation between serum OPG/RANKL ratio and hypertension complicated with left ventricular hypertrophy. Methods: 87 research objects were divided into a healthy group(27 cases) and a hypertensive group(60 cases), in which the hypertensive group was subdivided into group without left ventricular hypertrophy(30 cases) and a group with left ventricular hypertrophy(30 cases). All research objects had to be detected the level of serum OPG、RANKL，then calculated the OPG/RANKL ratio. Results: Compared with the healthy group, serum OPG levels and serum OPG/RANKL ratio were significantly higher and serum RANKL levels were significantly lower in the hypertensive group, and the difference was statistically significant(P<0.05).Compared with the hypertensive group without left ventricular hypertrophy, the hypertensive left ventricular hypertrophy group showed a statistically significant increase in serum OPG levels, serum OPG/RANKL ratio, and a statistically significant decrease in serum RANKL levels(P<0.001). There was a positive linear correlation between interventricular septal thickness and the level of serum OPG、OPG/RANKL ratio(r=0.685, 0.636；P<0.001)， and negativery correlated with serum RANKL levels(r=-0.546，P<0.001). Multiple linear regression analysis showed that blood pressure elevated and serum OPG/RANKL ratio were an important factors to the increased thickness of interventricular septum(B=0.076，P<0.001). Conclusion: The serum OPG/RANKL ratio indicated that it might be used as a laboratory indicator for the evaluation of hypertensions' left ventricula.

参考文献：

[1] 马力媛,王增武,胡盛寿,等.中国心血管健康与疾病报告2021概要[J].中国循环杂志,2022,37(6):553-578.
[2] 林琳,宋芷薇,刘艳鑫,等.高血压患者发生复杂心律失常的危险因素分析[J].现代医学,2021,49(5):554-556.
[3] NAYLOR K E,ROGER S A,FRASER R B,et al.Serum osteoprotegerin as a determinant of bone metabolism in a longitudinal study of human pregnancy and lactation[J].J Clin Endocr Metab,2003,88(11):5361-5365.
[4] STĘPIEŃE,WYPASEK E,STOPYRA K,et al.Increased levels of bone remodeling biomarkers (osteoprotegerin and osteopontin) in hypertensive individuals[J].Clin Biochem, 2011,44(10-11):826-831.
[5] RØYSLAND R, BONACA M P, OMLAND T, et al.Osteoprotegerin and cardiovascular mortality in patients with non-ST elevation acute coronary syndromes[J].Heart,2012,98(10):786-791.
[6] FRIÕES F, LASZCZYNSKA O,ALMEIDA P B, et al. Prognostic value of osteoprotegerin in acute heart failure[J].Can J Cardiol,2015,31(10):1266-1271.
[7] KIM J, SONG T J,YANG S H,et al.Plasma osteoprotegerin levels increase with the severity of cerebral artery atherosclerosis[J].Clin Biochem,2013,46(12):1036-1040.
[8] 刘力生,王继光,王文,等.中国高血压防治指南2018年修订版[J].心脑血管病防治杂志,2019, 19(1):1-44.
[9] 张运,尹立雪,邓又斌,等.中国成人超声心动图检查测量指南[J].中华超声影像学杂志,2016,25(8):645-665.
[10] 孙宁玲,谢良地,王继光,等.亚洲高血压合并左心室肥厚诊治专家共识[J].中华高血压杂志,2016,24(7):619-627.
[11] BOYCE B F, XING L.Biology of RANK, RANKL, and osteoprotegerin[J].Arthritis Res Ther, 2007, 9(Suppl 1):S1.
[12] HUANG Q X,LI J B,HUANG F X,et al.Elevated osteoprotegerin concentration predicts increased risk of cardiovascular mortality in patients with chronic kidney disease:a systematic review and Meta-analysis[J].Kidney Blood Press R,2020,45(4):565-575.
[13] COLLIN-OSDOBY P.Regulation of vascular calcification by osteoclast regulatory factors RANKL and osteoprotegerin[J].Circ Res, 2004,95(11):1046-1057.
[14] ROCHETTE L,MELOUX A,RIGAL E,et al.The role of osteoprotegerin in vascular calcification and bone metabolism:the basis for developing new therapeutics[J].Calcified Tissue Int, 2019,105(3):239-251.
[15] VAN DEN BOS F,EMMELOT-VONK M H,VERHAAR H J,et al.Links between atherosclerosis and osteoporosis in middle aged and elderly men[J].J Nutr Health Aging, 2018,22(6):639-644.
[16] CATALANO A,LODDO S,BELLONE F,et al.Pulsed electromagnetic fields modulate bone metabolism via RANKL/OPG and Wnt/β-catenin pathways in women with postmenopausal osteoporosis:a pilot study[J].Bone, 2018,116:42-46.
[17] BERNARDI S,BOSSI F,TOFFOLI B,et al. Roles and clinical applications of OPG and TRAIL as biomarkers in cardiovascular disease[J].Biomed Res Int,2016,2016:1752854.
[18] 梁占东,刘彦芳,朱晓龙,等.利用CCTA分析舒张期扩张指数与升主动脉弹性及心肌缺血的关系[J].东南大学学报(医学版), 2023,42(2):289-294.
[19] BLÁZQUEZ-MEDELA A M,GARCÍA-ORTIZ L,GÓMEZ-MARCOS M A,et al,Osteoprotegerin is associated with cardiovascular risk in hypertension and/or diabetes[J].Eur J Clin Invest,2012,42(5):548-556.
[20] 苏蓉,刘云兰,唐树荣,等.原发性高血压患者血清骨保护素水平的变化及其临床意义[J].中国临床新医学,2017,10(11):1052-1055.
[21] MCGONIGLE J S,GIACHELLI C M,SCATENA M.Osteoprotegerin and RANKL differentially regulate angiogenesis and endothelial cell function[J].Angiogenesis, 2009,12(1):35-46.
[22] PANIZO S,CARDUS A,ENCINAS M,et al.RANKL increases vascular smooth muscle cell calcification through a RANK-BMP4-dependent pathway[J].Circ Res,2009,104(9):1041-1048.
[23] UELAND T,AUKRUST P,DAMAS J K,et al.The tumor necrosis factor superfamily in heart failure[J].Future Cardiol,2006,2(1):101-111.
[24] HELSKE S,KOVANEN P T,LINDSTEDT K A,et al.Increased circulating concentrations and augmented myocardial[LL]extraction of osteoprotegerin in heart failure due to left ventricular pressure overload[J].Eur J Heart Fail, 2007, 9(4):357-363.
[25] OMLAND T,DRAZNER M H,UELAND T,et al.Plasma osteoprotegerin levels in the general population:relation to indices of left ventricular structure and function[J].Hypertension, 2007,49(6):1392-1398.
[26] ZAMPETTI S,LUCANTONI F,PACIFICO L,et al.Association of OPG-RANKL ratio with left ventricular hypertrophy and geometric remodeling in male overweight/obese youths[J].J Endocrinol Invest,2019,42(4):427-434.
[27] VIK A,MATHIESEN E B,JOHNSEN S H,et al.Serum osteoprotegerin, sRANKL and carotid plaque formation and growth in a general population-the Tromsø study[J].J Thromb Haemost,2010,8(5):898-905.
[28] HARARI O A,LIAO J K.NF-κB and innate immunity in ischemic stroke[J].Ann Ny Acad Sci,2010,1207:32-40.
[29] MORONY S,TINTUT Y,ZHANG Z,et al.Osteoprotegerin inhibits vascular calcification without affecting atherosclerosis in ldlr (-/-) mice[J].Circulation,2008,117(3):411-420.
[30] VANCAMPENHOUT A,GOLLEDGE J.Osteoprotegerin,vascular calcification and atherosclerosis[J].Atherosclerosis, 2009,204(2):321-329.
[31] CZERWIŃSKA K,PORĘBA M,PROKOPOWICZ A,et al.Association between serum selenium concentration and OPG/RANKL/RANK axis in patients with arterial hypertension[J].Cardiovasc Toxicol,2022,22(7):620-630.
[32] KADEN J J,DEMPFLE C E,KILIÇ R,et al.Influence of receptor activator of nuclear factor kappa B on human aortic valve myofibroblasts[J].Exp Mol Pathol,2005,78(1):36-40.
[33] UELAND T,YNDESTAD A,ØIE E,et al.Dysregulated osteoprotegerin/RANK ligand/RANK axis in clinical and experimental heart failure[J].Circulation,2005,111(19):2461-2468.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录