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Title: [Association between serum levels of osteopontin and systolic pulmonary artery pressure among healthy adults post acute high altitude exposure]. Author: Yang YQ, Liu C, Yang J, Gao XB, Zhang JH, Shen Y, Huang L. Journal: Zhonghua Xin Xue Guan Bing Za Zhi; 2020 Jun 24; 48(6):489-494. PubMed ID: 32842259. Abstract: Objective: To explore the association between serum levels of osteopontin (OPN) and systolic pulmonary artery pressure (sPAP) in healthy men following acute high altitude exposure. Methods: According to the inclusion and exclusion criteria, this observational study included 94 male subjects (aged from 18 to 30 years, dwelling in lowland<500 m) who ascended to Litang (4 100 m) from Chongqing (400 m) by bus with a stair-like journey within 7 days in June 2013. Data including basic information, OPN, superoxide dismutase (SOD), and malondialdehyde (MDA) and echocardiographic derived sPAP were collected within 48 hours before ascent and within 2-7 hours after arrival. Accordingly, subjects were divided into 3 groups based on the tertiles of sPAP after acute high altitude exposure: low sPAP group (26.8-32.3 mmHg (1 mmHg=0.133 kPa)) (n=31), middle sPAP group (32.4-37.4 mmHg) (n=32) and high sPAP group (37.5-55.6 mmHg) (n=31). Associations of serum OPN and SOD levels with sPAP were analysed by univariate and multivariate linear regression analysis. Results: After acute high altitude exposure, the levels of sPAP were significantly increased (P<0.001). There were no differences in age, height, weight, body mass index, percent of Han nationality and smoking among 3 subgroups. However, following acute high altitude exposure, the levels of heart rate, systolic and diastolic blood pressure elevated (all P<0.05), whereas the levels of oxygen saturation were reduced in the total subjects and all subgroups (all P<0.05). Moreover, systolic blood pressure of subjects in the high sPAP group was higher than that in low and middle sPAP groups (both P<0.05), and diastolic blood pressure of subjects in high sPAP group was higher than that in low sPAP group (P<0.05). The serum levels of OPN were increased in total cohort(27.9 (22.5,34.0) μg/L vs. 25.6 (18.4, 33.1) μg/L, P<0.05), and high sPAP group (P<0.05), whereas no differences were found in serum SOD and MDA levels among groups. Furthermore, the serum level of OPN in high sPAP group was higher than that in low sPAP group at high altitude (P<0.05), and there was a trend for decline in SOD level with increasing sPAP (P>0.05). Results from univariable linear regression analysis showed that the serum levels of OPN (r=0.32, P=0.002) and SOD (r=-0.22,P=0.032) were linearly correlated with sPAP in total cohort after high altitude exposure. Multivariate regression analysis showed that the serum levels of OPN(β=0.310,P=0.002) and SOD (β=-0.199,P=0.043) were independently associated with the levels of sPAP at high altitude. Conclusion: After acute high altitude exposure, the serum level of OPN is positively associated with sPAP, suggesting that OPN may be a novel bio-marker for predicting the increase of pulmonary pressure in response to acute high altitude exposure. 目的: 探讨急性高原暴露的健康人群血清骨桥蛋白(OPN)水平与肺动脉收缩压(sPAP)的关系。 方法: 该研究为回顾性观察性研究。于2013年6月在重庆按照纳入与排除标准入选健康受试者94人,年龄18~30岁,均为男性,均久居平原(海拔<500 m)。所有受试者均从重庆(海拔400 m,平原)乘汽车以阶梯习服的方式经7 d到达理塘(海拔4 100 m,高原)。基线数据采集在受试者出发前48 h内完成,受试者乘汽车到达理塘后2~7 h内完成高原数据采集。采集的数据包括受试者的一般临床资料,血清OPN、超氧化物歧化酶(SOD)及丙二醛水平,采用超声心动图间接估测受试者sPAP。根据纳入人群急性高原暴露后测得的sPAP值将人群分为3组,即低值组[sPAP值26.8~32.3 mmHg(1 mmHg=0.133 kPa)](n=31)、中值组(sPAP值32.4~37.4 mmHg)(n=32)和高值组(sPAP值37.5~55.6 mmHg)(n=31)。采用单因素和多因素线性回归模型分析急性高原暴露后人群OPN和SOD水平与sPAP的相关性。 结果: 急性高原暴露后,纳入总体人群的sPAP显著升高(P<0.001)。sPAP低值组、中值组及高值组人群的年龄、身高、体重、体重指数、汉族占比、有吸烟史者占比差异均无统计学意义(P均>0.05)。急性高原暴露后,总体人群的心率、舒张压和收缩压均较平原时显著增加(P均<0.05),血氧饱和度(SpO2)显著降低(P <0.05);不同sPAP亚组人群的心率、收缩压、舒张压均较平原时显著增加(P均<0.05),SpO2均较平原时显著降低(P <0.05)。高值组人群平原收缩压高于低值组和中值组(P均<0.05),而高值组人群平原舒张压也高于低值组(P<0.05)。急性高原暴露后,纳入总人群的血清OPN水平显著增加[27.9(22.5,34.0)μg/L比25.6(18.4,33.1)μg/L, P<0.05],而SOD、丙二醛水平无明显变化(P均>0.05)。急性高原暴露后,高值组人群血清OPN水平明显升高(P<0.05),且明显高于低值组(P<0.05)。急性高原暴露后,人群血清SOD水平呈现出随着sPAP升高而下降的趋势,但差异无统计学意义(P>0.05)。单因素线性回归分析结果显示,急性高原暴露后纳入总人群的血清OPN水平与sPAP呈正相关(r=0.32,P=0.002),而血清SOD水平与sPAP呈负相关(r=-0.22,P=0.032)。多因素线性回归分析结果显示,高原血清OPN(β=0.310,P=0.002)及高原血清SOD(β=-0.199,P=0.043)与高原sPAP独立相关。 结论: 急性高原暴露后人群血清OPN水平与sPAP呈独立正相关,OPN有望成为急性高原暴露人群肺动脉压力升高的生物标志物。.[Abstract] [Full Text] [Related] [New Search]