| Objective: To analysis the relationship between serum free fatty acid(FFA)and early renal injury in hypertension,and to explore the predictive value of FFA for early renal injury in elderly patients with hypertension.Methods: Select 140 elderly hypertensive patients who met the inclusion and exclusion criteria in the Department of General Medicine of the affiliated hospital of Inner Mongolia Medical University from November 2019 to January 2021.The glomerular filtration rate was calculated by the MERD formula,and according to GFR level to divid the 140 elderly hypertensive patients into the early renal injury group(60ml/min≤GFR﹤90ml/min)68 cases(33males and 35females),with an average age of 68.06±5.05 years,the simple hypertension(GFR≥90ml/min)72 cases(28males and 44females),with an average age of 68.83±5.51 years,and select non-hypertensive elderly(GFR≥90ml/min)who were admitted to the hospital at the same time 74 cases(32males and 42 females)served as the control group,the average age of the control group was 68.83±5.51 years old.And then to collect for general data,make standardized blood pressure measurement,and detect the related indicators,such as fast blood-glucose(FBG),fasting insulin(FINS),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein(HDL),FFA,serum creatinine(SCr),serum Cystatin C(Cys C)and other biochemical indicators,for the 214 subjects included in the study.Using SPSS 20.0 software for statistical analysis: 1.Compare the differences in general data between the three groups.2.Compare the differences in biochemical data between the three groups.3.Using Logistic regression analysis to explore the relationship between FFA,Cys C and SCr and early renal function damage.4.Using spearman correlation analysis to explore the correlation between FFA and various clinical data.5.Using ROC curve to compare the predictive value of FFA,Cys C and SCr in the early diagnosis of renal injury in elderly hypertension.Results: 1.Comparison of clinical characteristics between the groups,the early renal injury group FINS,HOMA-ir,FFA,SCr,Cys C,SBP,the course of disease is higher than the simple hypertension group,e GFR is lower than the simple hypertension group,the early renal injury group TC,TG,LDL-C,FINS,HOMA-ir,FFA,SCr,e GFR,Cys C,SBP,DBP,BMI are higher than the normal control group,TC,TG,LDL-C,HOMA-ir,FFA,SBP,simple hypertension group DBP was higher than the control group,and the difference between the groups was statistically significant(P<0.05).There was no significant difference in SCr,Cys C,e GFR between the simple hypertension group and the control group(P>0.05).2.The logistic regression analysis of the relationship between FFA,Cys-C and SCr and early renal injury of hypertension corrected for gender,age,BMI,waist circumference,course of disease,insulin resistance index,TG,TC,LDL-C,e GFR and other indicators.FFA increased the risk of early renal injury,the difference was statistically significant(OR=3.05,95%CI 1.7-5.74,P<0.001),Cys C increased the risk of early renal injury,the difference was statistically significant(OR=1.71,95%CI 1.08-2.70,P=0.023),and Cr has no significant relationship with early renal injury(P<0.05).3.The analysis of the correlation between FFA and clinical indicators shows that FFA has no correlation with waist circumference and HDL-C(r=0.016,-0.089,P>0.05),but positive correlation with BMI,TG,TC,LDL-C(r=0.239,0.154,0.329,0.237,P<0.05),FFA is negatively correlated with GFR(r=-0.584,P<0.001),and positively correlated with Cys C,HOMA-ir,SBP,DBP,and SCr(r =0.594,0.654,0.525,0.201,0.154,P<0.05).4.ROC curve analysis shows that the best cut-off point for FFA to diagnose early renal injury in elderly hypertension is 0.68mmol/l,the sensitivity is 94.12%,the specificity is 84.72%,and the area under the ROC curve is 0.92.The diagnostic value of FFA for early renal injury of elderly hypertension is higher than that of Cys C and SCr.Conclusion: 1.FFA can increase the risk of early renal injury on the basis of hypertension.And removal of other influencing factors suggests that FFA is a risk factor for early renal injury in elderly hypertensive patients.2.Serum FFA level is related to blood pressure level,insulin resistance and the severity of kidney injury,which indicated that the higher the FFA level,the more severe the insulin resistance,the higher the blood pressure,and the more severe the kidney injury.3.Compared with Cys C and SCr,FFA has higher sensitivity and specificity in the detection of early renal injury in elderly hypertension,which represent that FFA has better predictive value for early renal injury in elderly patients with hypertension. |
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