| Objective: To analyze the value of serum intermedin(IMD),Cystatin C(Cys C) and fibroblast growth factor23(FGF23) for left ventricular hypertrophy(LVH),atherosclerosis(AS) and renal damage assessment in essential hypertension(EH) patients.Methods: Serum IMD,Cys C and FGF23 levels of 60 patients with EH, 60 with healthy subjects were detected by enzyme-linked immunosorbent assay(ELISA). All the subjects did UCG for left ventricular mass index(LVMI)and carotid intima media thickness(c IMT),then used LVMI to assess the level of LVH,c IMT to assess the degress of AS.Detected related biochemical indicators at the same time.Separately based on the LVMI, c IMT and endogenous creatinine clearance rate(Ccr), all the subjects were divided into different groups.Discussed the statistical relationship between serum IMD, Cys C, FGF23 and LVMI, c IMT, Ccr respectively.Results: 1.In the patients with hypertension serum IMD, Cys C, FGF23 levels were significantly higher than healthy subjects. In the EH patients serum IMD, Cys C, FGF23 levels were increasing with increased blood pressure levels. 2.In order to analyze the relationship between serum IMD, Cys C, FGF23 with LVH, we divided all the subjects into EH group, HLVH group and control group based on the level of LVMI. Through statistical analysis, we found the following results:(1) LVMI and serum IMD, Cys C, FGF23 level were significantly higher in EH group than in control(P<0.05), higher in HLVH group than in EH and control groups(P<0.05).(2)LVMI level was positively correlated with serum IMD, Cys C and FGF23 levels(r=0.769,0.517,0.700; P<0.001). Line to LVMI level as the dependent variable,multiple stepwise regression analysis showed that: SBP, IMD, Cys C, Hcy, FGF23 entered regression equation. They were independent risk factors for LVMI. 3. In the process of investigating the connection between serum IMD, Cys C, FGF23 and c IMT, Based on the level of c IMT, all the subjects were divided into normal c IMT group, thickened c IMT group and mottling formation group.We found that:(1) The serum IMD, Cys C,FGF23 levels in the three groups were increased with elevated c IMT, the difference had statistical significance(P<0.001).(2)The c IMT level was positively correlated with serum IMD, Cys C and FGF23levels(r=0.770,0.616,0.822; P<0.001). Line to c IMT level as the dependent variable, unconditioned logistic regression analysis showed that: SBP, IMD,Cys C, FGF23, HDL were independent risk factors for c IMT(OR=1.104,1.120,1.107,1.069,3.592; P<0.05). 4.At the last part of our research, based on the Ccr, we divided the EH patients into normal renal function group(group A) and renal compensatory group(group B), the healthy subjects as control group. After the statistical analysis we got some findings as following:(1) Serum IMD, Cys C, FGF23 levels were significantly higher in Agroup than in control, higher in B group than in A and control groups, the differences had statistically significance(P<0.05).(2)The Ccr level was positively correlated with serum IMD, Cys C and FGF23levels((r=-0.566,-0.653,-0.569, P<0.001).(3) Line to Ccr level as the dependent variable, unconditioned logistic regression analysis showed that: IMD, Cys C,FGF23, Scr and m ALB were independent risk factors for Ccr(OR=1.156,1.150,1.078,1.040,1.143, P<0.05).Conclusion: Serum IMD, Cys C and FGF23 levels are closely associated with blood pressure, LVMI, c IMT and Ccr in EH patients. They were independent risk factors for LVMI, c IMT and Ccr. They may participate in the development of EH and affect the process of LVH, AS and renal injury.Combined detection of serum IMD, Cys C and FGF23 provide a new serological basis to evaluate the severity of cardiovascular and renal complications for EH patients. They have potential clinical value. |
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