| Objective To investigate the serum levels of Toll-like receptors 4(TLR4)as well as the correlative cytokines and high molecular weight-adiponectin(HMW-ADP)in patients with essential hypertension and explore the impact on blood pressure(BP),the target organ damage and the BP decrement.Method One hundred and fifty cases of newly diagnosed essential hypertensive patients were selected and divided into 3 groups according to the BP levels.Fifty non-hypertensive subjects were recruited as normal control.TLR4 as well as the correlative cytokines and HMW-ADP were measured before treatment by enzyme-linked immuno sorbent assay(ELISA).The relationship between those biochemical factors and BP levels as well as target organ damage was explored.The information of BP levels after 6 monthes follow-up were collected and the impact on the BP decrement was studied.Statistical analysis was made by SPSS18.0 software.The serum levels of those cytokines and the relationship between them were analysed by using one-way ANOVA and linear correlation.The association of the cytokines with the BP levels and organ damage as well as the BP decrement was analysed by using multiple linear regression and logistic regression.Results(1)In the 1st,2nd and 3rd grade hypertensive groups,the expression levels of TLR4 were(14.51±4.37)ng/m L,(23.57±6.05)ng/m L and(36.41±7.68)ng/m L respectively and were significantly higher than in the normal control group(7.77±3.24)ng/m L;the levels of CRP were(4.50±1.23)mg/L,(6.19±1.00)mg/L and(8.69±1.53)mg/L respectively and were significantly higher than in the normal control group(3.71±1.59)mg/L;the levels of IL-6 were(6.94±1.30)ng/L,(8.66±1.35)ng/L and(11.88±1.11)ng/L respectively and were significantly higher than in the normal control group(3.77±0.85)ng/L;the levels of TNF-α were(47.00±5.46)ng/L,(55.19±9.75)ng/L and(69.08±8.83)ng/L respectively and were significantly higher than in the normal control group(37.39±3.65)ng/L(all P<0.01).(2)The expression levels of HMW-ADP were(7.48±1.33)mg/L,(5.48±1.21)mg/L and(3.44±1.04)mg/L respectively and were significantly lower than in the normal control group(11.36±3.20)mg/L(all P<0.01).(3)Pearson correlation analysis revealed TLR4 was negatively correlated with HMW-ADP(r=-0.782,P<0.05)and positively correlated with CRP and BMI(r=0.747、0.721,all P<0.05).(4)Multiple linear regression showed that mean BP was associated with TLR4(B=0.408,P<0.01)and HMW-ADP(B=-2.51,P<0.01).Logistic regression showed end organ damage was associated with TLR4(OR=1.335,P<0.05)and HMW-ADP(OR=0.717,P<0.05).The AUC of TLR4/HMW-ADP ratio in receiver operating characteristic curve(ROC)analysis for organ damage was greater than that of CRP or HMWA alone(P<0.05).(5)Multiple linear regression showed that TLR4 was the only influential factor for all medication groups to the the BP decrement after 6 months of medication(P≤0.01).Conclusion(1)The serum content of TLR4 and HMW-ADP in hypertensive patients are associated with mean BP levels and organ damage.TLR4-induced inflammation might promote the progression of hypertensive pathogenesis,while HMW-ADP should be a protective factor.(2)The serum TLR4 levels before treatment may have a great impact on the BP control after six months of follow-up. |
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