| Objective:To investigate the changes of serum 25-hydroxyvitamin D and parathyroid hormone levels in elderly patients with hypertension and their correlation with carotid intima-media thickness.Methods:A total of 110 patients aged 60-87 years who were diagnosed with hypertension in the outpatient and inpatient department of cardiovascular medicine of the second hospital of shanxi medical university from December 2018 to December 2019 were selected,and a corresponding age matched group of 60 patients aged 60-89 years and 37 patients aged 41-59 years were selected.The sex,age,height,weight,smoking history and drinking history of the patients were recorded,their systolic blood pressure and diastolic blood pressure were measured,the levels of serum liver function,renal function,blood glucose,blood lipid,calcium and phosphorus were measured by automatic biochemical instrument,the level of parathyroid hormone was detected by double antibody sandwich method,the level of 25-hydroxyvitamin D was detected by electrochemiluminescence,and the level of intima-media thickness was measured by ultrasound.To analyze the general information of the elderly hypertension group,the elderly control group and the middle-aged control group,as well as the differences in the levels of 25-hydroxyvitamin D,parathyroid hormone and intima-media thickness.The elderly hypertension group was further divided into grade 1 hypertension group(n=35),grade 2 hypertension group(n=43),and grade 3 hypertension group(n=32)according to the blood pressure classification.The differences in general information and levels of 25-hydroxyvitamin D,parathyroid hormone,and intima-media thickness were analyzed.According to intima-media thickness,the elderly patients with hypertension were further divided into A1 group(IMT<1.0mm,n=30),A2 group(1.0mm≤IMT<1.5mm,n=41)and A3 group(IMT≥1.5mm,n=39).The general data and the differences of 25-hydroxyvitamin D and parathyroid hormone levels were analyzed to explore whether 25-hydroxyvitamin D and parathyroid hormone were related to intima-media thickness and blood pressure.Furthermore,multiple linear regression analysis was performed to determine whether 25-hydroxyvitamin D and parathyroid hormone were risk factors for hypertension in the elderly.Results:1.Compared with the elderly control group and the middle-aged control group,the level of 25-hydroxyvitamin D in the elderly hypertension group was lower than that in the elderly control group,and that in the elderly control group was lower than that in the middle-aged control group.There were significant differences(P<0.05)between the elderly hypertension group and the elderly control group,between the elderly hypertension group and the middle-aged control group,and between the elderly hypertension group and the middle-aged control group.2.Compared with the elderly control group and the middle-aged control group,the level of parathyroid hormone in the elderly hypertension group was higher than that in the elderly control group,and that in the elderly hypertension group was higher than that in the middle-aged control group.There were significant differences(P<0.05)of PTH’s level between the elderly hypertension group and the elderly control group,between the elderly hypertension group and the middle-aged control group,and between the elderly hypertension group and the middle-aged control group.3.Compared with the elderly control group and the middle-aged control group,the level of intima-media thickness in the elderly hypertension group was higher than that in the elderly control group,and that in the elderly hypertension group was higher than that in the middle-aged control group.There were significant differences(P<0.05)between the elderly hypertension group and the elderly control group,between the elderly hypertension group and the middle-aged control group,and between the elderly hypertension group and the middle-aged control group.4.The level of 25-hydroxyvitamin D was compared among hypertension grade 1 group,hypertension grade 2 group and hypertension grade 3 group.The 25-hydroxyvitamin D level of the hypertension grade 1 group was higher than that of the hypertension grade 2 group,and the 25-hydroxyvitamin D level of the hypertension grade 2 group was higher than that of the hypertension grade 3 group,and there was no significant difference(P>0.05)among the three groups.5.The value of parathyroid hormone was compared among hypertension grade 1 group,hypertension grade 2 group and hypertension grade 3 group.The parathyroid hormone value of the hypertension grade 1 group was lower than that of the hypertension grade 2 group,and the parathyroid hormone value of the hypertension grade 2 group was lower than that of the hypertension grade 3 group,and there was significant difference(P<0.05)among the three groups.6.The value of intima-media thickness was compared among hypertension grade 1 group,hypertension grade 2 group and hypertension grade 3 group.The intima-media thickness value of hypertension grade 1 group was lower than that of hypertension grade 2 group,and the intima-media thickness value of hypertension grade 1 group was lower than that of hypertension grade 3 group,and the difference was not statistically significant(P>0.05).7.25-hydroxyvitamin D values were compared among A1,A2 and A3 groups.The value of 25-hydroxyvitamin D in group A1 was higher than that in group A2,and the value of 25-hydroxyvitamin D in group A2 was higher than that in group A3,but there was no significant difference between groups(P>0.05).8.The comparison of parathyroid hormone values among A1,A2 and A3 groups.The parathyroid hormone value of A1 group was lower than that of A2 group,and there were significant differences(P<0.05).The parathyroid hormone value of A2 group was lower than that of A3 group,and there were also significant differences(P<0.05).But there were no significant differences(P>0.05)between A1 group and A2 group.9.The correlation analysis of Pearson in the elderly hypertension group showed that parathyroid hormone was positively correlated with systolic blood pressure and intima-media thickness,and the correlation coefficients were 0.557 and 0.336(P<0.01).Parathyroid hormone was also positively correlated with height,weight and creatinine,and the correlation coefficients were 0.206,0.189 and 0.201(P<0.05).10.Multiple linear regression analysis showed that parathyroid hormone was a significant influencing factor of systolic blood pressure in the elderly,the regression coefficient was 0.432,the standard error was 0.062,the standard coefficient was 0.557 and t value was 6.963(P<0.001).At the same time,parathyroid hormone was a significant influencing factor of intima-media thickness,the regression coefficient was 0.006,the standard error was 0.002,the standard coefficient was 0.336 and the t value was 3.713(P<0.001).Conclusion:1.The levels of 25(OH)D and PTH in elderly patients with hypertension are significantly different from those in healthy people,and the two may be risk factors of hypertension in the elderly,and the relationship between PTH and hypertension in the elderly may be closer than that in 25(OH)D.2.Parathyroid hormone is positively correlated with carotid intima-media thickness in elderly patients with hypertension,which may be involved in the damage of carotid intima-media in elderly patients with hypertension. |
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