Blood Pressure Variability And Inflammation Factors In Hypertensive Patients With Obstructive Sleep Apnea Syndrome And Its Correlation With ZFP36Genes

Objective:(1) To discuss the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and blood pressure variation (BPV) in patients with hypertension. To investigate heart, peripheral vascular and kidney damage in OSAHS patients with hypertension and its correlation with BPV.(2) To discuss the relationship between OSAHS and tumor necrosis factor-a (TNF-a), the correlation of interleukin-6(IL-6) in patients with hypertension.(3) To discuss the relationship between OSAHS and TNF-a, IL-6and ZFP36gene polymorphism in patients with hypertension. Methods: Part1:Adopting the case-control study, a total of583OSAHS patients with hypertension were divided into mild OSAHS group, the moderate OSAHS group, the severe OSAHS group according AHI. In control group,136cases of hypertension patients were selected. All patients was undergone PSG monitoring, ambulatory blood pressure monitoring, cardiac ultrasound, and biochemical examination. The collected data were analyzed. Part2and Part3:A case-control study was done by our study. A total of653OSAHS patients with hypertension were divided into mild OSAHS group (average age:47.16±10.18year), the moderate OSAHS group (average age:48.99±9.75year), the severe OSAHS group (average age:48.09±9.45year);243cases (average age:43.59±8.94year) were selected in essential hypertension group; and326control group cases (average age:58.37±8.23year) were selected from the physical examination of hospital of Xinxiang Uyghur autonomous region people’s. All of the cases undergone PSG monitoring. All of the cases were performed medical history, somatology determination, blood lipid, blood glucose, TNF-a and IL-6which were detected with Radio-Immun-Assay (RIA). The risk factors of OSAHS, TNF-a and IL-6were performed the correlation analysis, and the multiple lea regression analysis were performed the possible factors for AHI. Part4:The methods were same with Part2and3, the tagSNP ZFP36rs251846(-194A>G), rs3746083(1181C>T) and rsl7879933(2436-/T) were detected using TaqMan-PCR method. Finally, the polymorphisms were analyzed in ZFP36, TNF-a, IL-6and OSAHS with hypertension. Results:Part1:The difference of BPV in four groups was statistical significance (P<0.05). The variability of dSBP, the mean of nSBP, the variability of nSBP, the mean of nDBP, the variability of nSBP, the rate of nSBP descent impacted AHI IVST, LVPWT, LVMI and EDV increased with the increase of AHI (P<0.05), and were impacted by BPV. The intima-media thickness of bilateral carotid artery and the detection rate of atherosclerosis plaque increased with AHI (P<0.05). The intima-media thickness of bilateral common carotid artery were impacted by BPV. The abnormal percent of dSBP was the independent risk factor for OSAHS patients with hypertension. The differences of UA and TUPQ in four groups were statistical significance (P<0.05), but not in CCr. While UA, TUPQ and CCr were impacted by BPV. Part2and Part3:The level of TNF-a and IL-6were positively correlated with abdomen circumference, BMI, DBP, AHI, ODI4, Time with SaO2<90%and TRTSaO2<90%, and were negatively correlated with HDL-C, the lowest of SaO2and the average of SaO2in OSAHS patients with hypertension. Multiple linear regression analysis found that AHI, abdomen circumference, TNF-a and IL-6were linearly related. Part4:The genotype and allele frequency distribution of ZFP36rs251846and rs17879933(P<0.05), but not rs3746083were differences in five groups. Separated by age, the genotype and allele frequency distribution of ZFP36rs251846, rsl7879933and rs3746083were no differences in five groups in male, while the genotype and allele frequency distribution of ZFP36rs251846and rs3746083were differences in five groups, especially in female (P<0.05). Abdomen circumference, BMI, TG, TNF-a and IL-6were differences in the genotype of ZFP36rs251864(P<0.05); Abdomen circumference, BMI, and TNF-α were differences in the genotype of ZFP36rs17879933(P<0.05); while all of the data were no differences in the genotype of ZFP36rs3746083. Separated by age, abdomen circumference and TNF-α were differences in the genotype of ZFP36rs251864(P<0.05). UA and TNF-α were differences in the genotype of ZFP36rsl7879933in male (P <0.05). BMI, TNF-α and IL-6were differences in the genotype of ZFP36rs251846and rs3746083in female (P<0.05). While the date of PSG were no differences in the genotype of ZFP36rs251846, rs17879933and rs3746083, even separated by age. Logistic regression analysis showed that abdomen circumference and FPG were independent risk factors for OSAHS, but TNF-a, IL-6and ZFP36were not independent risk factors for OSAHS. Conclusions:Part1:The obviously change were observe between AHI and BPV in OSAHS patients with hypertension. The damage in heart, peripheral vascular and kidney increased with AHI, and impacted by BPV. Part2and Part3:Abdomen circumference, TNF-a and IL-6were line related with AHI in OSAHS patients with hypertension. Part4:The genotype and allele frequency distribution of ZFP36rs251846, rs17879933and rs3746083were differences in five groups, especially in female. ZFP36rs251846, rs3746083and rsl7879933participated the regulation of TNF-a and IL-6, but no independent of OSAHS.