| Objective: Hypertension is widely affecting the whole population and a main risk factor of cardiovascular disease. In China, more than 24% adult population has hypertension, which is the most common risk factor of Coronary Heart Disease and Cerebral Stroke. Though great progress has been found recent years in the field of hypertension, the Pathogeny of 95% hypertension remains unknown, called essential hypertension. It is known that hypertension can damage endothelial function, and endothelial dysfunction would worsen ones blood pressure in return. Research has been found that endothelial dysfunction plays a pivotal role in the early stage of hypertension and is also associated with atherosclerosis and the occurrence of atherosclerotic complications, which lead to Coronary Heart Disease, Cerebral Stroke and Chronic Heart Failure. Therefore early detection of endothelial function and prevention of endothelial dysfunction became very important not only in people who suffers from hypertension, but also people with cardiovascular disease.Endothelin-1(ET-1) is a polypeptide secreted by endothelial cells.ET-1 is one of three isoforms of human Endothelin and a potent vasoconstrictor. It can also promote vascular smooth muscle cells to proliferate. The determination of the ET-1 can be used to evaluate endothelial function.hs CRP(high-sensitive C-reactive protein) is a acute-phase protein synthesized by liver, and a sensitive inflammation marker. It is known as one of systemic markers for acute and chronic inflammation. Though hs CRP is quite sensitive but nonspecific, research shown that the determination of hs CRP could reflex the inflammation of vascular, in order to evaluate endothelial function. In patients with hypertension or atherosclerosis, the balance of inflammation and anti-inflammation broke, which leads to an increase of hs CRP. Research has shown that high hs CRP is related to endothelial dysfunction and a early indicator of atherosclerosis.Dipeptidyl peptidase-4(DPP4,also known as CD26) is a 766-amino-acid polypeptide secreted by endothelial cells, which could inactivate incretin to increase blood glucose. However it has many other biological properties involving inflammation and oxidative stress. Clinical trials shown that DPP4-inhibitor positively influence some risk factors for cardiovascular disease(CVD),to improve endothelial function, and to directly affect cardiac function. However the mechanism is not yet fully elucidated. Whether high DPP4 are correlated to endothelia dysfunction remains unknown. The purpose of this research is to investigate the level of DPP4 in patients with essential hypertension and its correlation with endothelia dysfunction and hope to provide a possible way to prevent and treat hypertension.Method: Collect 92 patients with Essential Hypertension(EH) in hospital and 30 healthy people from the Second Affiliated Hospital of Hebei Medical University, which were divided into 2 groups, EH and control. Divide the EH group into 3 sub-groups, EH grade1(n=26), EH grade2(n=35), EH grade(n=31), according to the 2010 Chinese guidelines for the management of hypertension. ET-1 and DPP4 were detected by enzyme-labeled immunosorbent assay(ELISA). All date were analyzed by SPSS 19.0 software. Measurement date expressed as mean ± standard deviation. We using T test to compare between two groups and the one-way analysis of variance test to compare the means of multiple groups. The interrelationships of DPP4, ET-1 and hs CRP were analyzed by Person correlation analysis.Results:1 The DPP4 level in EH group was significantly higher than the control group,(1.42±0.65,1.88±0.73, P <0.05).In EH sub-groups, the difference of DPP4 is significant between each group.(1.47±0.73u/L, 1.85±1.04u/L, 2.25±0.96, P<0.05)2 The ET-1 level in EH group was significantly higher than the control group(1.61±0.43pg/m L, 2.27±0.61pg/m L, P<0.05). There is no significant difference of ET-1 In EH sub-groups.3 The hs CRP level in EH group was significantly higher than the control group(2.91±2.02mg/L,4.38±3.41 mg/L, P <0.05). There is no significant difference of hs CRP In EH sub-groups.4 The DPP4 level was positive correlated with ET-1 level,(r=0.481, P<0.01) 5 The DPP4 level was positive correlated with hs CRP level.(r=0.420, P<0.01) The ET-1 level was positive correlated with hs CRP level.(r=0.279,P<0.01)6 There was no statistically significant differences among four groups in age, gender, smoking, Blood lipid level and other general clinical data(p >0.05).Conclusion:1 The DPP4 level in EH group was significantly higher than the control group. In EH sub-groups, with the increasing BP level, DPP4 level rises.2 The hs CRP and ET-1 level in EH group was significantly higher than the control group. However no difference noticed in the EH sub-groups.3 The DPP4 level was positive correlated with ET-1 and hs CRP level.4 The DPP4 level could positive correlated with endothelial dysfunction.It may become a new target for the prevention and treatment of hypertension. |
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