| Objective(1)To analyze the distribution differences of different MTHFR and MTRR genotypes in blood pressure and normal Hcy group,normal blood pressure HHcy group,non H-type hypertension group and H-type hypertension group as well.(2)To analyze the effects of different genotypes of MTHFR and MTRR on Hcy levels.(3)To analyze daytime sleepiness,sleep quality status,plasma homocysteine levels and influencing factors among blood pressure and normal Hcy group,normal blood pressure HHcy group,non-H type hypertension group and H-type hypertension group.Method(1)An epidemiological case-control study method was used in this study.The subjects of the study included the inpatients in the Tibetan Hospital of Tibet Autonomous Region and Tibetan Fukang Hospital as well as community physical examiners who had been diagnosed with hypertension and non-hypertension from May 2018 to December 2019.A total of 1147 people were investigated,in which a total of 1104 subjects were measured blood pressure and 1120 were determined plasma Hcy value(14.93±6.22μmol/L).(2)The polymorphisms of MTHFR C677T site,MTHFR A1298C site and MTRR A66G site were detected by PCR-fluorescent probe,respectively.(3)General information,sleep quality,daytime sleepiness,BMI,blood lipids,fasting blood glucoseand and plasma homocysteine as well as the genotype distribution of MTHFR C677T,A1298C locus and MTRR A66G site were compared among the four groups.Results(1)The average age of 57.81±11.12(years old)in H-type hypertension group was higher than that of 47.75±11.71(years old)in blood pressure and normal Hcy group,50.46±11.52(years old)in normal blood pressure HHcy group and 55.97±11.60(years old)in non-H type hypertension group,what’s more,the difference was statistically significant(P<0.05).(2)The average Hcy value of Tibetan hypertensive patients living on the plateau was 15.22±6.75μmol/L,and about 44.4%of the patients which include 56.4%males and 43.6%females were associated with elevated plasma homocysteine levels.Comparison of systolic blood pressure,diastolic blood pressure and plasma Hcy level values among the four groups were significantly different,and the differences were all statistically significant(P<0.005).(3)BMI,TG,TC,HDL-C and Glu of H-type hypertension group were higher than those of blood pressure and Hcy normal group,normal blood pressure HHcy group and non-H type hypertension group.The LDL-C of non-H type hypertension group was higher than that of the blood pressure and normal Hcy group,normal blood pressure HHcy group and H-type hypertension group.There were significant differences in BMI,TG,TC,LDL-C and Glu compared among the four groups(P<0.05).There was no HDL-C was no statistical significance among the four groups(P>0.05).(4)MTHFR C677T genotype and MTRR A66G genotype were tested by Hardy-Weinberg balance check.C677T locus ~2=1.362,P=0.506;A66G locus ~2=0.222,P=0.895,which indicates that the genetic balance is achieved.Moreover,it has group representation in genetics and can represent the Tibetan population in Tibet.(5)In the H-type hypertension group,three genotype frequencies of CC,CT,and TT at the MTHFR gene 677 polymorphism site were 50.0%,38.5%,and 11.5%,respectively;1298 polymorphism site included three genotypes:AA,AC and CC,and the genotype frequencies were 53.5%,42.3%,and 4.2%,respectively;Three genotypes of AA,AG,and GG were found at 66 polymorphic site of MTRR gene,and the frequencies were 34.9%,48.0%,and 17.1%,respectively.The frequencies of TT genotype and T allele at MTHFR gene 677 polymorphism site in H-type hypertension group were higher than those of the other three groups,and the difference was statistically significant(P<0.05).(6)Plasma Hcy levels were compared among the three different genotypes of MTHFR C677T,MTHFR A1298C and MTRR A66G.The results revealed that the plasma Hcy level of MTHFR C677T TT was the highest at 18.00(12.20,26.30)μmol/L.The plasma Hcy levels of the three genotypes CC,CT,and TT at the MTHFR C677T polymorphic site were14.00(11.00,16.60)μmol/L,14.00(11.00,17.36)μmol/L and 18.00(12.20,26.30)μmol/L,respectively.In addition,the differences in plasma Hcy levels among the three genotypes were statistically significant(P<0.05).(7)There were significant occupation,long-term residence,education level,payment method of medical treatment,average monthly income,smoking,main physical exercise,exercise frequency,sleep latency,sleep persistence and sleep disorders between blood pressure and normal Hcy group,normal blood pressure HHcy group,non-H type hypertension group and H-type hypertension group,and the difference was statistically significant(P<0.05).Conclusions H-type hypertension patients are mostly concentrated in the 50-69 age group(years old),and males had higher detection rate than that of females.H-type hypertension is affected by factors such as age,occupation,long-term residence,education level,average monthly income,smoking,physical exercise and sleep quality and so on.Therefore,the formation of a good lifestyle,regular exercise and improvement of sleep quality have a positive impact on the prevention of H-type hypertension.In addition,more attention should be paid to plasma Hcy levels of native Tibetan patients with H-type hypertension at677 site with TT type.At the same time,precise and individualized treatment should be given according to genotypes.What’s more,timely control of TG,TC,LDL-C and Glu is an important measure for patients with H-type hypertension to prevent complications such as atherosclerosis. |
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