| Background Hypertension and stroke are common cardiovascular diseases,which have become a major public health problem threatening human health,but the exact causes of these diseases are not yet fully clear.Previous non-targeted metabolomics have shown that there are sugar,lipid,and amino acid metabolic disorders in patients with hypertension and stroke,and targeted metabolomics also indicate that patients exist plasma amino acid levels fluctuation.However,there was limited research of amino acid metabolism in 24 h urine with essential hypertension(EH)and ischemic stroke(IS).Objective To analyse the changes of amino acid metabolism profile in 24 h urine with EH and IS patients,and to explore the influence factors of EH and IS associated with amino acids and the relationship between blood pressure(BP)and amino acids,and comparing the amino acid metabolism profile difference between EH and IS.It would help further understand the disease pathogenesis and provide new points for the disease causes.Methods This study was conducted as a case-control study,and we selected Qingtongxia County and Pingluo County of Ningxia as investigation points.The EH and IS patients from the natural population were selected as the case groups,and recruited health control(HC)group based on the matching principle of age,gender and residence.Then,we employed uniform standards for questionnaires survey,physical examination,BP measurements and 24 h urine collection.The determination of amino acids in urine was carried out using Hitachi L-8900 automatic amino acid extraction analyzer.Finally,multivariate Logistic regression was used to explore the EH and IS influencing factors related to amino acids;Pearson correlation was used to explore the correlation between amino acid metabolites and BP,represented by heat maps;Multi-linear regression was used to further analyze the relationship between amino acids and BP.The linear trend testing was used to describe the BP variation in different amino acid quartiles.Results1 Analysis of amino acid metabolism profile in 24 h urine with EH patients and the relationship between amino acid and BPA total of 322 EH patients and 286 HC were selected for this study,of which 318 were men and 290 were women.Comparing for 14 amino acids in 24 h urine in the two groups,it was found that there was a statistical difference at 13 amino acid except to glycine(P < 0.05),and the levels in EH group were higher than HC.Logistic regression analysis showed that valine(OR: 3.702,95% CI: 1.014 ~ 13.516),isoleucine(OR: 0.001,95% CI: 0.000006 ~ 0.191)entered the model after adjusting age,gender,smoking history,current smoking habit,education,BMI classification.Then,we used Logistic regression to quantify the association between valine,isoleucine quartile levels and EH,and the results revealed that the risk of EH in the fourth quartile of valine was 4.146 than the first quartile,and the isoleucine level was not related to EH.Pearson analysis exhibited a weak correlation between amino acids and BP in EH patients.Further,we performed a multi-linear regression analysis,which showed that adjusted age,gender,smoking history,current smoking habit,education,BMI classification,phenylalanine was negatively correlated with systolic blood pressure(SBP)(?:-0.184,95% CI:-0.045 ~-0.003);phenylalanine and methionine were negatively correlated with diastolic blood pressure(DBP)(?:-0.234,95% CI:-0.070 ~-0.011;?:-0.206,95% CI:-0.069 ~-0.005,respectively);tryptophan was positively correlated with DBP(?: 0.278,95% CI: 0.015 ~ 0.076).Finally,we used the error bar to quantify the BP change at the different quartiles of phenylalanine,methionine and tryptophan,and it was found that BP showed a downward trend under the phenylalanine quartile.2 Analysis of amino acid metabolism profile in 24 h urine with IS patients and the relationship between amino acid and BP in EH,IS and HC populationA total of 161 IS patients and 286 HC were selected for this study,of which 243 were men and 204 were women.Comparing for 14 amino acids in 24 h urine in the two groups,it was found that the levels of cysteine,isoleucine and leucine were higher at IS group than HC(P < 0.05).Logistic regression analysis showed that cysteine(OR: 4.189,95% CI: 1.433 ~ 12.241),arginine(OR: 0.047,95% CI: 0.005 ~ 0.414)entered the model after adjusting age,gender,smoking history,current smoking habit,education,BMI classification.Then,we used Logistic regression to quantify the association between cysteine,arginine quartile levels and IS,and the results revealed that the risk of IS in the fourth quartile of cysteine was 1.875 than the first quartile,and the arginine level was not related to IS.Pearson analysis exhibited a weak correlation between amino acids and BP in EH,IS,and HC population.Further,we performed a multi-linear regression analysis,which showed that,adjusted age,gender,smoking history,current smoking habit,and education,alanine and cysteine were positively correlated with SBP(?: 0.329,95% CI: 0.020 ~ 0.132;?: 0.237,95% CI: 0.006 ~ 0.157,respectively),and phenylalanine was negatively correlated with SBP(?:-0.138,95% CI:-0.043 ~-0.001);alanine was positively correlated with DBP(?: 0.290,95% CI: 0.009 ~ 0.131),and serine was negatively correlated with DBP(?:-0.337,95% CI:-0.006 ~ 0.127).Finally,we used the error bar to quantify the BP change at the different quartiles of alanine,cysteine,phenylalanine,serine,and it was found that SBP and DBP of the first and second quartile in alanine,cysteine decreased significantly than the fourth(P < 0.05),and the linear trend test was statistically significant(P-trend < 0.05);the DBP of first quartile of phenylalanine was also lower than the second(P < 0.023).3 Comparison of amino acid metabolism profile in 24 h urine with EH and IS patientsA total of 120 pairs of EH and IS patients were selected for this study,of which 140 were men and 100 were women.Comparing for 14 amino acids in 24 h urine in the two groups,it was found that there was a significant statistical difference at isoleucine,and the levels in IS group were higher than EH.(P < 0.05).Logistic regression analysis showed that glycine(OR: 1.614,95% CI: 1.186 ~ 2.196),tyrosine(OR: 0.251,95% CI: 0.669 ~ 0.914),and isoleucine(OR: 1.114,95% CI: 1.005 ~ 1.234)entered the model after adjusting for age,gender,smoking history,current smoking habit,education,BMI classification,and drugs history.Then,we used Logistic regression to quantify the association between glycine,tyrosine,isoleucine quartile levels and IS,and the results revealed that the risk of IS in the fourth quartile of isoleucine was 3.461 than the first quartile,and the glycine and tyrosine levels were not related to IS.Conclusion1 Amino acid metabolism profile of EH and IS patients in 24 h urine was different from those of HC group,and the differences between EH and IS groups were also found.2 Compared with HC group,valine and isoleucine were the influencing factors of EH,while cysteine and arginine were the influencing factors of IS;and compared with EH group,glycine,tyrosine,and isoleucine were the influencing factors of IS.3 Methionine and tryptophan in 24 h urine of EH patients were correlated with BP,while alanine,cysteine,phenylalanine and serine in 24 h urine of EH,IS and HC population were correlated with BP... |
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