Eur Heart J:尿道下裂患者血管功能障碍和心血管风险增加

2022-03-18 MedSci原创 MedSci原创

尿道下裂与血管功能障碍有关,并在成年期易患高血压和心血管疾病。潜在机制涉及Rho激酶和Nox5/ROS依赖性信号传导。

性腺机能减退与心血管疾病有关。然而,发育过程中性腺机能减退对心血管的影响尚不清楚。使用尿道下裂作为性腺机能减退的替代物,近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员调查了尿道下裂是否与血管功能障碍相关,并且是否可作为心血管疾病的危险因素。

该研究的人体实验跨越了分子机制和流行病学调查。在患有尿道下裂的青少年和对照组中进行临床血管表型分析。从接受尿道下裂修复和对照的男孩的阴茎皮肤中分离出皮下小动脉,并通过肌电图评估功能研究。血管平滑肌细胞用于评估:Rho激酶、活性氧(ROS)、一氧化氮合酶/一氧化氮和DNA损伤。在血浆和尿液中评估了全身氧化应激水平。医院事件数据比较了有尿道下裂病史的男性与对照组。

在患有尿道下裂的青少年中,收缩压(P=0.005)、脉压(P=0.03)和颈动脉内膜中层厚度标准差评分(P=0.01)有所增加。尿道下裂男孩的动脉显示U46619诱导的血管收缩能力增加(P=0.009),乙酰胆碱诱导的内皮依赖性(P<0.0001)和硝普钠诱导的内皮非依赖性血管舒张(P<0.0001)能力降低。

患有尿道下裂的男性发生心律失常[比值比(OR)为2.8,95%置信区间(CI)为1.4-5.6,P = 0.003]、高血压(OR为4.2,95%CI为1.5-11.9,P = 0.04)和心力衰竭(OR为1.9,95%CI为1.7-114.3,P = 0.02)的风险增加。

由此可见,尿道下裂与血管功能障碍有关,并在成年期易患高血压和心血管疾病。潜在机制涉及Rho激酶和Nox5/ROS依赖性信号传导。该研究的新发现描述了性腺功能减退中血管损伤的分子机制,并将尿道下裂确定为男性心血管危险因素。

原始出处:

Angela K. Lucas-Herald,et al.Vascular dysfunction and increased cardiovascular risk in hypospadias.European Heart Journal.2022.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac112/6549830

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    2023-02-20 lifestar
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    2022-03-19 zhaojie88
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    2022-03-19 slcumt

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