Connection Of Vitamin D To Essential Hypertension And Hypertensive Kidney Lesion

Objective Observe the level of 25-hydroxyvitamin D,vitamin d receptor(VDR)and VDR gene polymorphism in essential hypertension and hypertensive kidney lesion patients.Investigate the association between inflammation,oxidative stress and 25(OH) D.Observe the influence of Alfacalcidol on 25(OH) D and VDR mRNA.Methods 20 patients with essential hypertension,35 with hypertensive kidney lesion(20 with microalbuminuria,15 with clinical albuminuria)and 20 normal adults were enrolled in the study.VDR mRNA was measured by RT-PCR.Polymorphism defined by the Fok I restriction enzyme using polymerase chain reaction-restriction fragment length polymorphism(RFLP).Serum levels of 25(OH)D,intact parathyroid hormone(iPTH),C-reactive protein(CRP),Interleukin-6(IL-6) and Interleukin-10(IL-10) were measured by enzyme linked immunosorbent assay(ELISA).The malondialdehyde(MDA) was measured by colorimetric technique.Results The levels of iPTH,CRP,IL-6 and MDA were increased both in essential hypertension group and hypertensive kidney lesion group(P<0.05,P<0.01or P<0.001),while 25(OH)D was decreased in these two groups(P<0.01).The expression of VDR mRNA was lower in hypertensive kidney lesion group(P < 0.05 ).There were no differences of IL-10 level or VDR genotype distribution among all the groups(P>0.05).The level of 25(OH)D was positively correlated with VDR mRNA(r=0.261 P< 0.01),but negatively correlated with age,iPTH,MDA and IL-6(r=-0.586> r=-0.377 P<0.001,r =-0.188.r=-0.215 P<0.05).After treated with Alfacalcidol,25(OH)D was increased,and iPTH was decreased significantly both in essential hypertension group and hypertensive kidney lesion group, while IL-6 was decreased only in essential hypertension group.Conclusions The inflammation and oxidative stress are enhanced in patients with essential hypertension as well as hypertensive kidney lesion.Serum 25(OH)D levels are inversely associated with risk of incident hypertension and hypertensive kidney lesion.The level of 25(OH)D is positively correlated with VDR mRNA,but negatively correlated with age,iPTH,MDA and IL-6.Vitamin d analogues can increase the expression of VDR and 25(OH)D,and decrease serum iPTH and IL-6 levels. VDR genotypes had no differences between essential hypertension patients and normal adults。...