Changes and significance of serum NPY, 5-HT, and BDNF levels in patients with essential hypertension and insomnia

doi:10.11817/j.issn.1673-9248.2023.06.009

Abstract

Abstract:

Objective

To investigate the changes and clinical significance of serum neuropeptide Y (NPY), 5-hydroxytryptamine (5-HT), and brain-derived neurotrophic factor (BDNF) in patients with essential hypertension and insomnia.

Methods

204 patients with simple primary hypertension (hypertension group) and 204 patients with primary hypertension and insomnia (hypertension and insomnia group) admitted in Hengshui People’s Hospital from January 2019 to October 2022 were included, and 204 healthy people (control group) at the same period were included, too. The serum NPY, 5-HT, and BDNF levels of them were measured and compared. The correlations between serum NPY, 5-HT, and BDNF levels and Pittsburgh sleep quality index (PSQI) score were analyzed by Pearson correlation analysis. Compared with patients with simple primary hypertension, the influencing factors of essential hypertension with insomnia were analyzed by multivariate conditional Logistic regression analysis method.

Results

The levels of serum NPY and 5-HT in the hypertension group and the hypertension with insomnia group were higher than those in the control group, but the level of serum BDNF was lower than that in the control group, with the differences statistically significant (P＜0.05). The levels of serum NPY and 5-HT in the hypertension with insomnia group were higher than those in with hypertension group, but the level of serum BDNF was lower than that in the hypertension group, with the differences statistically significant (P＜0.05). Pearson correlation analysis showed that serum NPY and 5-HT levels were positively correlated with PSQI score in patients with hypertension (r=0.624, 0.645, P＜0.05), and the serum BDNF level was negatively correlated with PSQI score (r=-0.638, P＜0.05). Serum NPY and 5-HT levels in patients with hypertension and insomnia were positively correlated with PSQI score (r=0.866, 0.879, P＜0.05), while the serum BDNF level was negatively correlated with PSQI score (r=-0.875, P＜0.05). Multivariate conditional Logistic regression analysis showed that grade 3 hypertension, course of hypertension, drink strong tea or coffee, smoking, obesity, life and work pressure, poor sleep habits, and serum NPY, 5-HT and BDNF levels were the influencing factors of insomnia in patients with essential hypertension (OR=2.795, 3.062, 2.255, 2.199, 2.413, 2.241, 2.375, 3.232, 3.758, 0.535, P＜0.05). After further correction of hypertension grade 3, hypertension course, drinking strong tea or coffee, smoking, obesity, life and work pressure, and poor sleep habits, multiple conditional Logistic regression analysis showed that the levels of serum NPY and 5-HT were risk factors for insomnia in patients with essential hypertension (OR=2.678, 2.849, P＜0.05), while the BDNF level was a protective factor (OR=0.561, P＜0.05).

Conclusion

The levels of serum NPY, 5-HT, and BDNF in patients with primary hypertension and insomnia are increased, while the level of BDNF is decreased, and these three are all related to the PSQI score of patients, and they are the influencing factors of primary hypertension and insomnia.

Key words: Essential hypertension, Insomnia, Neuropeptide Y, 5-hydroxytryptamine, Brain-derived neurotrophic factor

Jianghua Gong, Ningxiang Li, Jian Li, Feng Li, Li Tong, Hongli Xing, Xinxia. He. Changes and significance of serum NPY, 5-HT, and BDNF levels in patients with essential hypertension and insomnia[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(06): 582-590.

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Figures/Tables 6

组别	对照组（204例）	高血压组（204例）	高血压伴失眠组（204例）	统计值	P值
性别（男/女，例）	91/113	95/109	97/107	χ²=0.368	0.832
年龄（岁， $x ¯$ ±s）	57.35±11.28	57.82±11.41	58.19±11.54	F=0.278	0.758
高血压病程（年， $x ¯$ ±s）	—	10.57±2.08	11.46±2.11	t=4.290	＜0.001
高血压等级[例（%）]				Z=8.814	0.017
1级	—	89（43.63）	56（27.45）^b
2级	—	108（52.94）	113（55.39）
3级	—	7（3.43）	35（17.16）^b
失眠病程（年， $x ¯$ ±s）	—	—	3.45±0.53	—	—
失眠类型[例（%）]				—	—
短期失眠	—	—	53（25.98）
慢性失眠	—	—	151（74.02）
PSQI评分（分， $x ¯$ ±s）	6.48±1.22	7.85±1.46^a	14.66±2.57^ab	F=1148.849	＜0.001
不良生活习惯[例（%）]
饮浓茶或咖啡	7（3.43）	14（6.86）	27（13.24）^ab	13.971	0.001
晚间进餐过多	5（2.45）	8（3.92）	11（5.39	2.342	0.310
白天睡眠时间过长	3（1.47）	5（2.45）	6（2.94）	1.023	0.599
吸烟	26（12.75）	39（19.12）	59（28.92）^ab	16.769	＜0.001
肥胖	42（20.59）	61（29.90）^a	82（40.20）^ab	18.609	＜0.001
入院前用药情况[例（%）]
血管紧张素转换酶抑制剂	—	129（63.24）	135（66.18）	0.386	0.534
β受体阻滞剂	—	105（51.47）	108（52.94）	0.088	0.768
钙通道阻滞剂	—	62（30.39）	65（31.86）	0.084	0.771
血管紧张素受体阻滞剂	—	9（4.41）	11（5.39）	0.210	0.647
利尿剂	—	43（21.08）	49（24.02）	10.505	0.477
生活工作压力[例（%）]	29（14.22）	45（22.06）^a	63（30.88）^ab	13.326	＜0.001
睡眠习惯不良[例（%）]	32（15.69）	49（24.02）^a	68（33.33）^ab	17.263	＜0.001
睡眠环境改变[例（%）]	4（1.96）	5（2.45）	8（3.92）	1.573	0.455
心理障碍[例（%）]	0（0）	0（0）	0（0）	—	—
周围环境改变[例（%）]	2（0.98）	4（1.96）	3（1.47）	0.677	0.713
疼痛[例（%）]	0（0）	1（0.49）	4（1.96）	5.243	0.073

组别	对照组（204例）	高血压组（204例）	高血压伴失眠组（204例）	统计值	P值
性别（男/女，例）	91/113	95/109	97/107	χ²=0.368	0.832
年龄（岁， $x ¯$ ±s）	57.35±11.28	57.82±11.41	58.19±11.54	F=0.278	0.758
高血压病程（年， $x ¯$ ±s）	—	10.57±2.08	11.46±2.11	t=4.290	＜0.001
高血压等级[例（%）]				Z=8.814	0.017
1级	—	89（43.63）	56（27.45）^b
2级	—	108（52.94）	113（55.39）
3级	—	7（3.43）	35（17.16）^b
失眠病程（年， $x ¯$ ±s）	—	—	3.45±0.53	—	—
失眠类型[例（%）]				—	—
短期失眠	—	—	53（25.98）
慢性失眠	—	—	151（74.02）
PSQI评分（分， $x ¯$ ±s）	6.48±1.22	7.85±1.46^a	14.66±2.57^ab	F=1148.849	＜0.001
不良生活习惯[例（%）]
饮浓茶或咖啡	7（3.43）	14（6.86）	27（13.24）^ab	13.971	0.001
晚间进餐过多	5（2.45）	8（3.92）	11（5.39	2.342	0.310
白天睡眠时间过长	3（1.47）	5（2.45）	6（2.94）	1.023	0.599
吸烟	26（12.75）	39（19.12）	59（28.92）^ab	16.769	＜0.001
肥胖	42（20.59）	61（29.90）^a	82（40.20）^ab	18.609	＜0.001
入院前用药情况[例（%）]
血管紧张素转换酶抑制剂	—	129（63.24）	135（66.18）	0.386	0.534
β受体阻滞剂	—	105（51.47）	108（52.94）	0.088	0.768
钙通道阻滞剂	—	62（30.39）	65（31.86）	0.084	0.771
血管紧张素受体阻滞剂	—	9（4.41）	11（5.39）	0.210	0.647
利尿剂	—	43（21.08）	49（24.02）	10.505	0.477
生活工作压力[例（%）]	29（14.22）	45（22.06）^a	63（30.88）^ab	13.326	＜0.001
睡眠习惯不良[例（%）]	32（15.69）	49（24.02）^a	68（33.33）^ab	17.263	＜0.001
睡眠环境改变[例（%）]	4（1.96）	5（2.45）	8（3.92）	1.573	0.455
心理障碍[例（%）]	0（0）	0（0）	0（0）	—	—
周围环境改变[例（%）]	2（0.98）	4（1.96）	3（1.47）	0.677	0.713
疼痛[例（%）]	0（0）	1（0.49）	4（1.96）	5.243	0.073

组别	例数	NPY（ng/L）	5-HT（ng/L）	BDNF（μg/L）
对照组	204	88.69±13.58	207.46±10.52	44.17±6.58
高血压组	204	187.42±18.54^a	269.33±13.15^a	27.65±4.22^a
高血压伴失眠组	204
短期失眠	53	221.63±20.45^ab	305.41±12.96^ab	20.58±3.31^ab
慢性失眠	151	219.32±20.84^ab	306.72±13.28^ab	20.64±3.35^ab
F值		1989.977	2226.634	824.270
P值		＜0.001	＜0.001	＜0.001

组别	例数	NPY		5-HT		BDNF
组别	例数	r值	P值	r值	P值	r值	P值
对照组	204	0.152	＜0.05	0.164	＜0.05	0.149	＜0.05
高血压组	204	0.624	＜0.05	0.645	＜0.05	-0.638	＜0.05
高血压伴失眠组	204	0.866	＜0.05	0.879	＜0.05	-0.875	＜0.05

危险因素	β值	SE	Wald χ²	P值	OR值	95%CI
高血压2级 vs1级	0.541	0.306	3.126	0.098	1.718	0.949~2.705
高血压3级 vs1级	1.028	0.355	8.386	0.015	2.795	1.814~3.912
高血压病程	1.119	0.339	10.896	＜0.001	3.062	2.084~4.253
饮浓茶或咖啡	0.813	0.316	6.619	0.033	2.255	1.308~3.294
吸烟	0.788	0.311	6.412	0.038	2.199	1.255~3.147
肥胖	0.881	0.317	7.724	0.022	2.413	1.496~3.597
生活工作压力	0.807	0.325	6.166	0.042	2.241	1.283~3.276
睡眠习惯不良	0.865	0.328	6.955	0.030	2.375	1.362~3.348
血清NPY水平	1.173	0.335	12.260	＜0.001	3.232	2.301~4.539
血清5-HT水平	1.324	0.324	16.699	＜0.001	3.758	2.765~5.123
血清BDNF水平	-0.625	0.169	13.677	＜0.001	0.535	0.337~0.771

变量	β值	SE	Wald χ²	P值	OR值	95%CI
高血压3级	0.449	0.265	2.871	0.115	1.567	0.724~2.513
高血压病程	0.485	0.279	3.022	0.104	1.624	0.756~2.598
饮浓茶或咖啡	0.374	0.228	2.691	0.148	1.454	0.679~2.335
吸烟	0.326	0.214	2.321	0.192	1.385	0.627~2.254
肥胖	0.381	0.231	2.720	0.139	1.464	0.683~2.341
生活工作压力	0.332	0.218	2.319	0.194	1.394	0.635~2.272
睡眠习惯不良	0.357	0.224	2.540	0.153	1.429	0.671~2.318
血清NPY水平	0.985	0.346	8.104	0.015	2.678	1.758~3.967
血清5-HT水平	1.047	0.332	9.945	0.003	2.849	1.995~4.302
血清BDNF水平	-0.578	0.195	8.786	0.009	0.561	0.369~0.786

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