The Correlation Study Of Hypertensive Arteriosclerosis And Calcium Metabolism Disorders

Objective:To investigate the relationship between the degree of arteriosclerosis and calcium metabolism disorders by analysis of brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) changes and serum osteoprotegerin (OPG), calcitonin (CT), bone gla protein (BGP) expression in elderly patients with hypertension.Methods:(1)The study subjects comprised 61 diagnosed hypertension elderly patients(mean aged 69.45±5.70 years) and 28 age-and sex-matched normal blood pressure controls(mean aged 68.64±5.58 years). (2)The serum concentration of OPG was measured by ELISA.(3) The serum concentration of BGP and CT were measured by Radioimmunoassay (RIA).(4)The baPWV and ABI were measured by Colin atherosclerosis Instrument.The baPWV measurement using the following formula:the time interval between the upper arm peak waveform and ankle peak waveform was defined as the time apart(Δtba) between the upper arm to the ankle;based on statistical data, Colin Instrument can automatically calculate the distance between the baPWV measurement points according to the height of patients; the distance from the heart to the upper arm (lb)=0.2195×height (cm)-2.0734 and the distance from the heart to the ankle (la)=0.8129×height (cm)+12.328; according to the formula baPWV=(la-lb)/Δtba to calculate the value of baPWV.ABI was calculated by measuring the side of the ankle systolic blood pressure and bilateral upper arm brachial systolic blood pressure ratio of the maximum value.(5) Statistical analysis:all data were expressed for mean±standard deviation (x±s),and the statistical analysis use statistical software spss13.0.The control group using t test,and using linear correlation analysis of different indicators of intercropping,and multivariate analysis using multiple linear regression analysis(Independent variables'selection method use stepwise selection;the standard of P value of 0.05 was selecteded, and P value of 0.1 was removed), and P<0.05 was considered as statistically significant difference. Results:The baPWV, ABI and the serum level of OPG were significantly higher in elderly patients with hypertension group than the normal control group(P<0.01), the serum levels of CT and BGP were significantly lower than the control group(P<0.01 and P<0.05), whereas the calcium level between the two groups had no significantly difference. Linear correlation analysis showed that age, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), low density lipoprotein (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were positively correlated with baPWV, whereas Age, SBP, PP and LDL-C were negatively correlated with ABI. Using baPWV and ABI respectively as dependent variables, including Age, SBP, DBP, PP, LDL-C, calcium and hs-CRP as independent variables, and multiple linear regression analysis showed that:①baPWV was significantly associated with PP, Age and SBP;②ABI was significantly associated with Age and PP. Using the serum levels of BGP,CT and OPG respectively as dependent variables, including Age, SBP, DBP, PP, LDL-C, calcium and hs-CRP as independent variables, and multiple linear regression analysis showed that:①serum level of BGP was significantly associated with Age,PP and calcium;②serum level of CT was significantly associated with Age and SBP;③serum level of OPG was significantly associated with PP,Age and LDL-C. Linear correlation analysis showed that baPWV was significantly positively correlated with serum level of OPG (r=0.731, P<0.01), and significantly negatively correlated with serum levels of BGP and CT (r=-0.525 and -0.681, both P<0.01).Conclusion:(1)As independent non-invasive indicators of atherosclerosis, baPWV and ABI can detect the degree of arterial stiffness and forecast the reconstruction of hypertensive arteriosclerosis. (2)The serum levels of calcium metabolism regulators of OPG, CT and BGP in hypertensive patients with arteriosclerosis are significantly changed, suggesting that there is a certain correlation between abnormal calcium metabolism and the occurrence and development of hypertensive arteriosclerosis.(3)baPWV is significantly associated with the serum levels of OPG, CT and BGP, indicating that abnormal calcium metabolism and the dgree of arteriosclerosis may have some relevance.(4) Calcium metabolism regulators of OPG, CT and BGP involved in the occurrence and development of hypertensive arteriosclerosis may be related to regulate the the development of vascular calcification by directly or indirectly way.