中国全科医学2026，Vol.29Issue(15)：2014-2021,8.DOI:10.12114/j.issn.1007-9572.2025.0332
神经丝轻链蛋白与夜间高血压患者左心室肥厚发生风险的相关性研究
Correlation Analysis between Neurofilament Light Chain and the Risk of Left Ventricular Hypertrophy in Patients with Nocturnal Hypertension
摘要
Abstract
Background Neurofilament light chain(NfL),a sensitive biomarker of neuroal injury and neuroinflammation,has attracted increasing attention.Previous studies have demonstrated its associations with hypertension and adverse cardiovascular events;however,the potential relationship between NfL and left ventricular hypertrophy(LVH)in patients with nocturnal hypertension remains remains unclear.Objective To examine the association between serum NfL levels and the risk of LVH in patients with nocturnal hypertension.Methods A total of 351 patients with nocturnal hypertension who underwent 24-hour ambulatory blood pressure monitoring(ABPM)with complete clinical data at Renmin Hospital of Wuhan University from December 2022 to December 2024 were enrolled.Patients were divided into four groups according to NfL quartiles:Q1(NfL≤62.82,n=88),Q2(62.82<N fL≤92.00,n=88),Q3(92.00<NfL≤136.40,n=87),and Q4(NfL>136.40,n=88).Baseline characteristics,24-hour ABPM data,laboratory results,and transthoracic echocardiographic parameters were collected.Left ventricular mass(LVM)and left ventricular mass index(LVMI)were calculated using the formula recommended by the American Society of Echocardiography.Spearman's rank correlation analysis was used to assess associations between NfL and echocardiographic parameters.Generalized linear models were applied to analyze the associations between NfL quartiles and LVMI.Logistic regression analysis was used to evaluate the relationship between NfL levels and the risk of LVH.Receiver operating characteristic(ROC)curves were generated to evaluate the predictive value of NfL and autonomic function-related indicators for the risk of LVH in patients with nocturnal hypertension,and subgroup analyses were conducted.Results Significant differences were observed among the four groups in age,interventricular septal thickness in diastole(IVSd),left ventricular posterior wall thickness at end-diastole(LVPWd),LVM,and LVMI(P<0.05).Spearman correlation analysis showed that NfL levels were positively correlated with left ventricular internal diameter at end-diastole(LVIDd)(rs=0.135,P=0.011),IVSd(rs=0.128,P=0.016),LVPWd(rs=0.146,P=0.006),LVM(rs=0.162,P=0.002),and LVMI(rs=0.277,P<0.001).After adjustment for confounding factors,the generalized linear model showed that,compared with Q1,NfL levels in Q3(β=0.110,95%CI=0.003-0.217,P=0.044)and Q4(β=0.288,95%CI=0.180-0.395,P<0.001)were significantly associated with LVMI.Logistic regression analysis showed that elevated NfL levels were an independent risk factor for LVH in patients with nocturnal hypertension(OR=1.012,95%CI=1.007-1.016,P<0.001).Compared with Q1,NfL levels in Q3(OR=3.328,95%CI=1.152-9.611,P=0.026)and Q4(OR=9.059,95%CI=3.278-25.036,P<0.001)were associated with a significantly increased risk of LVH.ROC curve analysis showed that the areas under the ROC curve of NfL,norepinephrine(NE),acetylcholine(ACh),and the NE/ACh ratio for predicting LVH risk were 0.744,0.618,0.577,and 0.603,respectively,with sensitivities of 75.0%,50.0%,48.5%,and 48.5% and specificities of 63.3%,69.3%,51.5%,and 75.3%.Subgroup analyses indicated that NfL levels were positively associated with LVH risk in subgroups defined by age,male sex,BMI,and estimated glomerular filtration rate(P<0.05).Conclusion In patients with nocturnal hypertension,serum NfL levels are independently associated with the risk of LVH and may have clinical value in identifying individuals at high risk of LVH.关键词
高血压/肥大,左心室/夜间高血压/左心室肥厚/神经丝轻链蛋白/相关性研究/Logistic模型Key words
Hypertension/Hypertrophy,left ventricular/Nocturnal hypertension/Left ventricular hypertrophy/Neurofilament light chain/Correlation study/Logistic models分类
医药卫生引用本文复制引用
刘天缘,桑婉玥,彭继平,程思怡,黄伊伊,李欧文,江洪,周晓亚..神经丝轻链蛋白与夜间高血压患者左心室肥厚发生风险的相关性研究[J].中国全科医学,2026,29(15):2014-2021,8.基金项目
国家重点研发计划项目(2023YFC2705705),恒·心高血压/心肾保护医学研究基金资助项目(2022-CCA-HX-074) （2023YFC2705705）
