| Chapter 1 Analysis of Correlation between Siesta and risk of Metabolic and Target Organ Damage in untreated Hypertensive Subtype Objective:To investigate the correlation between siesta and the metabolic factors and target organ damage in untreated hypertensive subtypes of rural populations in North China Method:Participants completed questionnaires,physical examination,clinical examination and echocardiography.Single factor variance analysis,chi square test,multiple regression analysis and correlation analysis were used to compare the Correlation between siesta and risk of metabolic and target organ damage in hypertensive subtype.Result:A total of 4780 people recruited into our study and divided into normotension,isolated systolic hypertension(ISH),isolated diastolic hypertension(IDH)and systolic diastolic hypertension(SDH).For male,the level of BMI,triglycerin and total cholesterol in siesta group with SDH were significantly lower than non-siesta group,uric acid level in siesta group with normotension was lower than non-siesta;for female,BMI and triglyceride in siesta group with IDH were higher than those without siesta.Habitual siesta in each subgroup was not associated with renal dysfunction.Among elderly women,the correlation between habitual siesta and left ventricular hypertrophy was positive significantly.For women,the duration of siesta was positive correlated with BMI in normotension and with triglyceride in IDH.The left ventricular hypertrophy was negatively related significantly to the duration of siesta in young women with hypertension;for men with hypertension,duration of siesta was positively correlated with left ventricular hypertrophy significantly,while duartion of siesta was positively correlated with renal dysfunction Women in women with SDH.Conclusion:Habitual siesta is becoming more and more common lifestyle among the rural population with the age in northern China,the duration of siesta was similar regardless of gender,age and hypertensive subtypes.Siesta was related significantly with risk of metabolism in male with SDH and female with IDH.The correlation between siesta and target organ damage is not consistent in different hypertensive subtypes..Chapter 2 Study on relativity between the interaction of Sleep Quality with Siesta and metabolic index and target organ damage in patients with Hypertension Objective:To analyse association of sleep quality(score of PSQI on total and 7 sub component)with metabolic index and target organ damagein in patients with hypertension,and to compare the associated of siesta with metabolic index and target organ damage among different sleep quality group.Method:A total of 189 people completing the information collection,physical examination,blood biochemical examination,echocardiography and coronary angiography were included in the final analysis.According to the PSQI score,they were divided into male with sleep disorder(PSQI?7),male without sleep disorder(PSQI < 7),women with sleep disorder(PSQI?7)and female without sleep disorder(PSQI < 7).Analysis of covariance,chi square test,multiple linear and binary logistic regression analysis used to the association of PSQI,siesta,duration of siesta with age,gender,metabolic index,glomerular filtration rate,left ventricular mass index and coronary stenosis.Result:BMI,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol were not significantly correlated with sleep quality.For women,duration of sleep and sleep efficiency were significantly positively related with BMI,and latent period of falling asleep was negatively correlated with fasting blood glucose.The total score of PSQI had no correlation with the glomerular filtration rate regardless of gender and sleep quality.Intake of hypnotic was negatively correlated with left ventricular mass index in women.Total positive incidence of coronary stenosis and rate of severe stenosis in left anterior descending branch,left circumflex and right coronary artery were not significant difference between different sleep quality regardless of gender.For men,the ratio of severe stenosis in single coronary in subjects with sleep disorder was higher than those without sleep disorder.Body mass index,fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol were no association with siesta and duration of siesta between men with different sleep quality.Level of triglyceride in subjects with siesta was significantly higher than those without siesta in women with sleep disorder and the high density lipoprotein was on the contrary,and duration of siesta was significently positively associated with fasting blood glucose and triglyceride in women without sleep disorder.Siesta was not related with glomerular filtration rate in men with different sleep quality.Siesta was positively related with glomerular filtration rate in women without sleep disorder.Left ventricular mass index and sum of severe stenosis in coronary were negative correlation with siesta in men without sleep disorder.Conclusion:Poor sleep quality is common symptom in patients with hypertension,sleep quality of women was significantly worse than men in hypertensive subjects.Correlation was not significant between sleep quality and metabolic index regardless of gender.Total score of PSQI had no correlation with glomerular filtration rate and left ventricular mass index.Severe coronary artery stenosis might be affected by sleep quality in men.Habitual siesta might aggravate the metabolic disorder in women,and target organ damage might be improved by siesta in those without sleep disorders.Chapter 3 Study on correlation of Sleep Quality with DNA methylation in the promoter region of Thrombomodulin(TM)gene and gene expression in Hypertensive subjects Objective:To observe the association of DNA methylation in the promoter region of thrombomodulin gene and gene expressionin with sleep quality in patients with hypertension.Method:Sample from chapter 2 chosen into this study.According to PSQI score,screened eventually cases as follow:male with sleep disorder of 22,men without sleep disorder of 25,women with sleep disorder of 23 and women without sleep disorder of 24.Levels of DNA methylation in promoter reqion of TM gene were detected by bisulfite PCR sequencing,real-time fluorescent quantitative Q-PCR assay for the detection of serum level of m RNA of TM gene,Western blot was used to determine serum level of TM protein.The level of DNA methylation in Cp G island,expression of m RNA and TM protein between the groups were compared by using analysis of variance between the group;correlation of level of DNA methylation with PSQI and metabolic index by linear regression analysis;Bivariate correlation analysis,cluster analysis,principal component analysis and factor analysis were assessed in the analysis of relevance of DNA methylation among all Cp G sites.Result:In each group,any subcomponent of PSQI,metabolic index and NLR were not correlated with the average level of DNA methylation,level of DNA methylation in Cp G26 from male with good sleep quality,and Cp G8,Cp G13,Cp G19 and average level of DNA methylation from women with good sleep quality were higher than those from subjects with poor sleep qulity.DNA methylation was not detected in Cp G1,2,3,6,8,10,11,12,16,20 and 25 in men with poor sleep quality while not detected in Cp G 3 in men with good sleep quality.There were 11 Cp G sites without any DNA methylation in women with poor sleep quality and 7 loci without DNA methylation in women with good sleep quality.High correlation of DNA methylation in Cp Gs was found in subjects with good sleep quality.For men,Cp G19 site clustered into a category,Cp G3,22,25 and 26 site clustered,Cp G14 and Cp G15 clustered,while sample NO.1123(from good sleep quality)and sample 1142(from poor sleep quality)respectively for a category.For women,Cp G19 clustered into a category,Cp G6 and Cp G13 as a category,Cp G14 and Cp G15 for a category,sample No.2114(from good sleep quality)and 2143(from poor sleep quality)as a category,2117,2106,2109,2121,2104,2112 and 2101(all from the good sleep quality)for a category.In men with poor quality of sleep,main components one including Cp G7,23,24 and 9,main component two including Cp G14,15 and 5,main component three including Cp G17 and 18,main component four including Cp G13 and 4,main component five including Cp G26;while for men with good sleep quality,main components one including Cp G16,18,1,20,12,8,5,11,13,9,17,24,4,15,21,6,7,10,2,main component two contains Cp G19 and 22 and main component three contains only Cp G22.There were 6 and 7 main components in female with poor sleep quality and with sleep quality,the number of Cp G loci in each main component was 3 to 4.Relative level of expression of TM protein and m RNA was higher in subjects with poor sleep quality than those with good sleep quality.Conclusion:The level of DNA methylation in promoter region of TM gene were not associated with the metabolic index and NLR in patients with hypertension.The average level of the DNA methylation in each Cp G site,the distribution range of DNA methylation and the relevance features of DNA methylation among all Cp G sites between the groups with different sleep quality were significantly differential,and they could affect the regulation on the expression of TM gene. |
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