Relationship Between Carotid Intima-Media Thickness And Inflammatory Factors Of Monocyte To HDL Ratio,Platelet To HDL Ratio And Neutrophil To HDL Ratio In Young And Middle-Aged Hypertension

Objective:We aim to investigate the association of MHR,PHR,NHR and carotid intimamedia thickness in young and middle-aged hypertension,to evaluate its early predictive value for atherosclerosis.Methods:1.A retrospective study on young and middle-aged hypertensive patients(Ages≥18 years and <60 years,Systolic blood pressure≥140mm Hg and/or Diastolic blood pressure≥90mm Hg)treated in Hong Kong University Shenzhen Hospital from January2017 to December 2020.539 hypertensive patients were selected as the case group according to inclusion and exclusion criteria.In the same period,50 healthy individuals were controlled.2.Demographic and laboratory characteristics(gender,age,smoking history,height,weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood sugar,lipid profile,renal function,White blood cell(WBC)、Neutrophil(Neut)、Monocyte(Mono)、Platelet(PLT)、Hemoglobin(HGB)、Red blood cell(RBC)、Total cholesterol(CHOL)、Triglyceride(TG)、High-density lipoprotein(HDL)、Low-density lipoprotein(LDL)、Uric acid(UA)、Creatinine(CREA)、Blood glucose(GLU);carotid Intima-media thickness(c IMT),monocyte / high density lipoprotein ratio(MHR),platelet / high density lipoprotein ratio(PHR),neutrophil /high density lipoprotein ratio(NHR)and ultrasound assessment of carotid arteries of the studied groups were obtained the next day after admission.3.Analyze the relationship between MHR,PHR,NHR and c IMT in the control group and ym HT group,different levels of hypertension subgroup,quartile of hypertension subgroup.4.Statistical analysis: Independent t-test or Wilcoxon rank sum test was used for continuous variables.Results:1.Comparison of demographic and laboratory characteristics between healthy control group and ym HT group:There were no significant differences in age,BMI,smoking history,WBC,Mono,Neut,PLT,RBC,HGB,CHOL,TG,HDL,LDL,CREA,UA and GLU between ym HT group and healthy control group(P1>0.05).There were significant differences in gender,systolic blood pressure,diastolic blood pressure,c IMT,MHR,PHR and NHR(P1< 0.05).2.Pairwise comparison among the three subgroups showed that there were no significant differences in gender,age,BMI,duration of hypertension,smoking history,WBC,PTL,RBC,HGB,Neut,CHOL,TG,HDL,LDL,CREA,UA,GLU and PHR between the two groups(P2>0.05),However,there were significant differences between the two groups in the following areas: SBP,DBP,c IMT and NUET(P2< 0.001).In addition to comparison between hypertension grade 2 and grade 3 groups showed there were no statistically difference(P2>0.05)in Mono,MHR,NHR,there were statistically difference among other groups(P<0.05).3.Young and middle-aged HT group was divided into MHR quartile subgroup.there was statistically significant difference in c IMT among different MHR quartiles(P3<0.001).Binary logistic analysis showed that MHR(OR:1.388,95%CI:1.042-1.850,P5 < 0.05)was a risk factor for c IMT.4.Young and middle-aged HT group was divided into NHR quartile subgroup,there were statistically difference in c IMT among different NHR quartiles(P7<0.001).we use forward stepwise regression and binary logistic regression to analysis,the results showed that NHR(OR:1.399,95% CI:1.062-1.687,P9<0.05)was a risk factor for c IMT.5.Young and middle-aged HT group was divided into PHR quartile subgroup,there was no significantly different in c IMT among different NHR quartile groups(P10>0.05).However,when compared between Q1 and Q4 groups,c IMT was statistically different(P6<0.05).6.ROC curve analysis showed that the sensitivity and specificity of MHR were50.00 % and 71.79 %,respectively.the sensitivity and specificity of NHR were 60.00 %and 60.84 %,respectively.7.According to the MHR quartile,there was statistically difference among the subgroups of hypertension grade in group Q3(P13<0.05),and there was statistically significant difference among the subgroups of hypertension grade in group Q4(P13<0.001).According to the hypertension grade,there was a statistically significant difference in the MHR quartile subgroup of hypertension grade 3(P14<0.05)Conclusion:1.As the severity of hypertension increase,carotid intima-media thickness increase simultaneously.2.As the MHR and NHR in young and middle-aged hypertensive patients increase,the thickness of carotid intima increase,MHR and NHR are predictors of thickening of carotid intima-media.The sensitivity of MHR is weaker than NHR,and the specificity is stronger than NHR.The increase of PHR has no obvious effect on carotid intima thickness.3.The combined effect of hypertension and MHR make c IMT thicker,but the influence of hypertension is more obvious.