Study Of Correlation Between Serum Cystatin C And Atherosclerosis And Left Ventricular Hypertrophy In Patients With Essential Hypertension

Objective: We studied the change of serum cystatin C concentration inpatients with essential hypertension combining atherosclerosis and leftventricular hypertrophy，and We investigated the correlation betweenserum cystatin C levels and this two diseases in patients with essentialhypertension in order to provide a valuable biomarker for monitoringcomplications of the patients with essential hypertension.Methods: We collected250hospital patients with essential hypertension,and strictly ruled out diabetes、neoplastic disease、infection、secondaryhypertension and other diseases, as well as patients takingantihypertensive drugs of ACEI or ARB class in all patients, andeventually screened out206cases with creatinine clearance being greaterthan all equal to80ml/min according to the Cockcroft-Gault formula.All participants were measured the serum cystatin C and otherbiochemical indexes. All selected objects were carried out to measure thecarotid-intima media thickness、left ventricular end-diastolic diameter、wall thickness、left ventricular septal thickness measurements as well ascalculating left ventricular mass index by using color Doppler ultrasoundtechnology. According to left ventricular mass index and carotid-intima media thickness,all subjects were grouped by the following three ways:(1) group with thickening carotid IMT (n=84)，normal group with carotidIMT (n=122);(2) group with left ventricular hypertrophy (n=61), groupwithout left ventricular hypertrophy(n=145);(3)group with onlythickening carotid IMT (n=55), group with only left ventricularhypertrophy (n=32),group with thickening carotid IMT and leftventricular hypertrophy (n=29), hypertension group (n=90). We analyzedserum cystatin C levels in each group, and respectively analyzed theirrelationship between serum cystatin C and carotid intima media thicknessand left ventricular mass index, and studied further the clinicalrelationship between cystatin C and the formation of left ventricularhypertrophy and atherosclerosis. All data collected was analyzed bySPSS17.0statistical software.Results:1. The level of serum cystatin C in group with thickening C-IMTwere significantly higher than in that with normal C-IMT (P<0.01).2.Correlation analysis of carotid IMT: carotid IMT was positivelycorrelated with s-CC、BMI、Cr、LDL-C (P<0.05).3.That carotid IMT asthe dependent variable did multiple regression analysis with all indicatorsshowed that LDL-C、s-CC were independent risk factors for carotid IMT(β values were seperately0.488、0.406, P<0.01).4. Partial correlationanalysis between serum Cys C and carotid IMT: Because studies hadshown that Cys C was elevated with the increase of age, in order to avoid the influence of age, a partial correlation analysis adjusted for age showedthat there was still a statistically significant correlation between the serumCys C and carotid IMT (P<0.01).5. Serum cystatin C level in group withLVH was significantly higher than in that without LVH (P<0.01).6.group with LVH and group without LVH: After adjustment for age、BMI、TC、TG、HDL-C、LDL-C、Cr and other risk factors, a multivariateregression analysis showed respectively positive correlation betweens-CC and IVST (β=0.167, P<0.01)、LPWT (β=0.187, P<0.05) andLVMI (β=0.245, P<0.01).7. The206EH patients were divided into thefollowing four groups: hypertension group, group with thickening C-IMTand LVH, group with only thickening C-IMT, group with only LVH.Comparing the s-CC level of each group:The s-CC levels of group withthickening C-IMT and LVH、group with only thickening C-IMT, groupwith only LVH were significantly higher than the hypertension group, thedifference was statistically significant (P<0.01); the s-CC levels ofbetween group with only thickening C-IMT and group with only LVHhad no significant difference (P>0.05); the s-CC levels of between groupwith only thickening C-IMT and group with thickening C-IMT and LVHhad statistically significant (P＜0.05);the s-CC levels of between grouponly with LVH and group with thickening C-IMT and LVH had nostatistically significant (P>0.05).Conclusions:1.There is a significant correlation between serum cystatin C level and atherosclerosis in patients with essential hypertension, serumcystatin C level can be as a predictor for atherosclerosis of essentialhypertension patients.2. There is a significant correlation between serumcystatin C level and left ventricular hypertrophy in patients with essentialhypertension, serum cystatin C level can be as a predictor for leftventricular hypertrophy of essential hypertension patients.