Study On The Correlation Between Homocysteine,Cystatin C And Hypertension And Left Ventricular Hypertrophy

Objective :(1)To investigate the relationship between serum homocysteine(Hcy)level,serum cystatin C level and left ventricular hypertrophy in patients with hypertension.(2)To study the relationship between serum homocysteine(Hcy)level,serum cystatin C(Cysc)level and hypertension.Methods:296 patients with essential hypertension,including 160 males and 136 females,were admitted to the Department of Cardiovascular Medicine and Department of Senior Cadres,First Affiliated Hospital of Medical College of Shihezi University from December 2016 to April 2018.The average age was 52.87±8.28 years.According to the level of serum homocysteine,79 patients with essential hypertension were divided into non-H-type hypertension group(Hcy<10μmol/L)and 217 patients with H-type hypertension group(Hcy <10μmol/L);83 patients were divided into left ventricular hypertrophy group and 213 patients into left ventricular non-hypertrophy group according to whether left ventricular hypertrophy occurred or not.The general clinical data,blood biochemical indicators and cardiac color Doppler ultrasound related indicators of the two groups were analyzed and compared.Results:In addition to Hcy,triglyceride and uric acid in H-type hypertension group were also higher than those in non-H-type hypertension group(P<0.05),and there was no significant difference in other aspects between the two groups.(2)BMI,systolic blood pressure,Hcy,Cysc and uric acid in hypertrophic group were higher than those in nonhypertrophic group(P< 0.05),and there was no significant difference in other aspects between the two groups.(3)IVST,LVPWT,LVM and LVMI in H-type hypertension group were significantly higher than those in non-H-type hypertension group(P<0.05).There was no significant difference in LVEDD,LVEF and RWT between the two groups(P>0.05).(4)IVST,LVPWT,LVM,LVMI,RWT,LVEDD and LVEF in hypertrophic group were significantly higher than those in non-hypertrophic group(P<0.05).The differences of IVST,LVPWT,LVM,LVMI,RWT between hypertrophic group and non-hypertrophic group were more significant(P<0.01).(5)The average level of serum Hcy was(13.61±5.63)μmol/L,and the average level of serum Cysc was(0.86±0.19)mg/L.The correlation analysis showed that r= 0.136,P=0.019,the difference was statistically significant(P<0.05);(6)Hcy was correlated with IVST,LVPWT,LVM,LVMI;Cysc was only correlated with LVMI(r=0.199,P<0.01),but not with ST,VPT,LVMWT and LVMI.Serum Hcy and Cysc were correlated with systolic blood pressure,but not with diastolic blood pressure.(7)Univariate logistic regression analysis showed that obesity,hyperhomocysteine,cystatin C and high systolic pressure were risk factors for left ventricular hypertrophy(OR>1,P<0.05).(8)Multivariate logistic regression analysis showed that Hcy(OR=2.906,P=0.003),Cysc(OR=2.076,P=0.026),systolic pressure(OR=1.898,P=0.019)were still risk factors for left ventricular remodeling after adjusting for age,sex,BMI,smoking and drinking history,LDL-C,HDL-C,TC,TG and Glu.(9)Multivariate logistic regression analysis showed that there was no synergistic effect between serum Hcy and Cysc on left ventricular hypertrophy in patients with hypertension(P=0.156).Conclusion:1.Serum levels of Hcy and Cysc in patients with hypertension are significantly correlated with left ventricular hypertrophy.Regular monitoring of serum levels of Hcy and Cysc in patients with hypertension is of great significance for early prevention and treatment of left ventricular hypertrophy.2.Serum Hcy and Cysc were correlated with systolic blood pressure,but not with diastolic blood pressure.