Effect of Scavenger Receptor CD36 Gene Defect on Ambulatory Blood Pressure Rhythm and Metabolic Parameters in Patients with High-normal Blood Pressure

doi:10.12114/j.issn.1007-9572.2020.00.383

Abstract

Abstract: Background　With the change of arterial blood pressure rhythm and its absolute value，patients with high-normal blood pressure still have the risk of atherosclerotic cardiovascular diseases under the influence of associated metabolic factors.The CD36 gene defect of the scavenger receptor is related to the occurrence of various atherosclerotic cardiovascular diseases，so it is necessary to reveal the relationship between high-normal blood pressure and CD36 gene defect.Objective　To compare the 24-hour ambulatory blood pressure parameters and metabolic parameters between patients with high-normal blood pressure accompanied by CD36 gene defect and those with normal CD36 gene，in order to explore the effect of CD36 gene defect on blood pressure and metabolism in patients with high-normal blood pressure.Methods　A total of 200 patients who were diagnosed with high-normal blood pressure for the first time in the Department of Cardiology of Wuchang Hospital from October 2018 to April 2019 were selected as research subjects.24-hour ambulatory blood pressure monitoring was performed among all patients.Fasting venous blood was collected to detect related metabolic indicators and scavenger receptor CD36 gene defect.Thirty-one patients with high-normal blood pressure and CD36 gene defect were selected as the observation group，and 169 patients with high-normal blood pressure and normal CD36 gene were selected as the control group.Multivariate Logistic regression was used to analyze the influencing factors of CD36 gene defect.Results　A total of 31 cases of scavenger receptor CD36 gene defect were detected，and the detection rate was 15.5%.The body mass index（BMI），24-hour mean diastolic blood pressure（24 hDBP），nighttime mean systolic blood pressure （nSBP），24-hour mean arterial pressure （24 hMAP），incidence of non-dipper blood pressure，triacylglycerol （TG），and insulin resistance index （HOMA-IR）in the observation group were significantly higher than those in the control group （P<0.05）.Multivariate Logistic regression analysis showed that BMI 〔OR=5.649，95%CI（4.235，14.376）〕，24 hMAP 〔OR=5.836，95%CI（4.459，15.132）〕，non-dipper blood pressure〔OR=6.228，95%CI（5.876，16.812）〕，TG 〔OR=4.348，95%CI（2.247，10.168）〕，and HOMA-IR 〔OR=4.134，95%CI（1.630，5.245）〕 were independent influencing factors of scavenger receptor CD36 gene defect in patients with high-normal blood pressure（P<0.05）.Conclusion　The incidence of scavenger receptor CD36 gene defect in patients with high-normal blood pressure is 15.5%.The blood pressure and metabolism may have an effect on scavenger receptor CD36 gene defect in patients with high-normal blood pressure.

Key words: Scavenger receptor, CD36, Gene defect, High-normal blood pressure, Ambulatory blood pressure rhythm, Average arterial pressure, Metabolic index, Root cause analysis

摘要： 背景　处于正常高值血压阶段的患者，随着动脉血压的节律和绝对值的改变，以及受代谢因素的影响，仍然有发生动脉粥样硬化性心血管疾病的风险，而清道夫受体CD36基因缺陷与多种动脉粥样硬化性心血管疾病的发生有关，有必要揭示两者之间的内在联系。目的　对比清道夫受体CD36基因缺陷的正常高值血压患者与清道夫受体CD36基因正常者24 h动态血压指标及代谢指标是否存在差异，以探讨清道夫受体CD36基因缺陷对正常高值血压患者的血压和代谢是否产生影响。方法　选取2018年10月—2019年4月在武汉市武昌医院心内科门诊就诊的200例初诊正常高值血压患者为研究对象。均行24 h动态血压监测，抽取空腹静脉血检测相关代谢指标及清道夫受体CD36基因缺陷情况。以清道夫受体CD36基因缺陷的正常高值血压患者为观察组，以清道夫受体CD36基因正常的正常高值血压患者为对照组。正常高值血压患者CD36基因缺陷影响因素采用多因素Logistic回归分析。结果　200例初诊正常高值患者共检出31例清道夫受体CD36基因缺陷，检出率为15.5%。观察组体质指数（BMI）、24 h平均舒张压（24 hDBP）、夜间平均收缩压（nSBP）、24 h平均动脉压（24 hMAP）、非杓型血压发生率、三酰甘油（TG）、胰岛素抵抗指数（HOMA-IR）高于对照组（P<0.05）。多因素Logistic回归分析，结果显示：BMI〔OR=5.649，95%CI（4.235，14.376）〕、24 hMAP〔OR=5.836，95%CI（4.459，15.132）〕、非杓型血压〔OR=6.228，95%CI（5.876，16.812）〕、TG〔OR=4.348，95%CI（2.247，10.168）〕、HOMA-IR〔OR=4.134，95%CI（1.630，5.245）〕是正常高值血压患者清道夫受体CD36基因缺陷独立影响因素（P<0.05）。结论　正常高值血压患者清道夫受体CD36基因缺陷发生率达15.5%，血压和代谢可能对正常高值血压患者的清道夫受体CD36基因缺陷产生影响。

关键词: 清道夫受体, CD36, 基因缺陷, 正常高值血压, 动态血压节律, 平均动脉压, 代谢指标, 影响因素分析

ZHANG Aijun,GUO Hongwei,FENG Qiong, et al. Effect of Scavenger Receptor CD36 Gene Defect on Ambulatory Blood Pressure Rhythm and Metabolic Parameters in Patients with High-normal Blood Pressure[J]. Chinese General Practice, 2020, 23(23): 2890-2894. DOI: 10.12114/j.issn.1007-9572.2020.00.383.
张爱军,郭宏伟,冯琼等. 清道夫受体CD36基因缺陷对正常高值血压患者动态血压节律及代谢指标的影响研究[J]. 中国全科医学, 2020, 23(23): 2890-2894. DOI: 10.12114/j.issn.1007-9572.2020.00.383.

References

［1］高磊，鲍羿，洪斌.B类清道夫受体CD36的研究进展［J］．医学分子生物学杂志，2006，3（1）：61-64．DOI：10.3870/j.issn.1672-8009.2006.01.016.
［2］CHEN K H M，HENDERSON V W，STOLWYK R J，et al．Prehypertension in midlife is associated with worse cognition a decade later in middle-aged and older women［J］．Age Ageing，2015，44（3）：439-445．DOI：10.1093/ageing/afv026.
［3］中国高血压防治指南修订委员会.中国高血压防治指南2010［J］．中国医学前沿杂志（电子版），2011，3（5）：42-93．DOI：10.3969/j.issn.1674-7372.2011.05.011.
［4］HERTZOG M A.Considerations in determining sample size for pilot studies［J］．Res Nurs Health，2008，31（2）：180-191．DOI：10.1002/nur.20247.
［5］YUASA-KAWASE M，MASUDA D，YAMASHITA T，et al．Patients with CD36 deficiency are associated with enhanced atherosclerotic cardiovascular diseases［J］．J Atheroscler Thromb，2012，19（3）：263-275．DOI：10.5551/jat.10603.
［6］梁爽，康静，徐亚坤，等．不同肥胖指数与胰岛素抵抗的相关性比较［J］．中国实验诊断学，2017，21（3）：423-425．DOI：10.3969/j.issn.1007-4287.2017.03.015.
［7］RAC M E，SAFRANOW K，PONCYLJUSZ W.Molecular basis of human CD36 gene mutations［J］．Mol Med，2007，13（5/6）：288-296．DOI：10.2119/2006-00088.rac.
［8］GIMBRONE M A Jr，GARCíA-CARDE?A G.Vascular endothelium，hemodynamics，and the pathobiology of atherosclerosis［J］．Cardiovasc Pathol，2013，22（1）：9-15．DOI：10.1016/j.carpath.2012.06.006.
［9］JIANG Y G，WANG M，HUANG K，et al．Oxidized low-density lipoprotein induces secretion of interleukin-1β by macrophages via reactive oxygen species-dependent NLRP3 inflammasome activation［J］．Biochem Biophys Res Commun，2012，425（2）：121-126．DOI：10.1016/j.bbrc.2012.07.011.
［10］RAHAMAN S O，ZHOU G，SILVERSTEIN R L.Vav protein guanine nucleotide exchange factor regulates CD36 protein-mediated macrophage foam cell formation via calcium and dynamin-dependent processes［J］．J Biol Chem，2011，286（41）：36011-36019．DOI：10.1074/jbc.M111.265082.
［11］YAMAMOTO N，IKEDA H，TANDON N N，et al．A platelet membrane glycoprotein （GP） deficiency in healthy blood donors：naka-platelets lack detectable GPIV （CD36）［J］．Blood，1990，76（9）：1698-1703.
［12］李大成，蓝欲晓，鲍自谦.深圳地区无偿献血者群体CD36抗原缺失型的表型分析［J］．中国输血杂志，2011，4（25）：17-20.
［13］FANG H，CHEN J，LIN S，et al．CD36-mediated hematoma absorption following intracerebral hemorrhage：negative regulation by TLR4 signaling［J］．J Immunol，2014，192（12）：5984-5992．DOI：10.4049/jimmunol.1400054.
［14］刘莉.脑梗死患者CD36抗原缺失的基因检测及临床意义［J］．中国实用神经疾病杂志，2016，19（10）：19-21．DOI：10.3969/j.issn.1673-5110.2016.10.009.
［15］XU X Z，YE X，XIA W J，et al．Studies on CD36 deficiency in South China：two cases demonstrating the clinical impact of anti-CD36 antibodies［J］．Thromb Haemost，2013，110（6）：1199-1206．DOI：10.1160/TH13-05-0435.
［16］喜杨，孙宁玲，祝之明，等．血压正常高值人群的动脉弹性特点及影响因素分析［J］．中华医学杂志，2013，93（4）：265-269．DOI：10.3760/cma.j.issn.0376-2491.2013.04.007.
［17］BADRNYA S，SCHROTTMAIER W C，KRAL J B，et al．Platelets mediate oxidized low-density lipoprotein-induced monocyte extravasation and foam cell formation［J］．Arterioscler Thromb Vasc Biol，2014，34（3）：571-580．DOI：10.1161/ATVBAHA.113.302919.
［18］CHEN K，LI W，MAJOR J，et al．Vav guanine nucleotide exchange factors link hyperlipidemia and a prothrombotic state［J］．Blood，2011，117（21）：5744-5750．DOI：10.1182/blood-2009-01-201970.

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