The Correlation Between Homocysteine And Ambulatory Arterial Stiffness Index And That Between The Two And Early Renal Damage In Hypertensive Patients

Objective:The investigation is to study the correlation between blood Homocysteine(Hcy)and ambulatory arterial stiffness index(AASI)in hypertension patients,and to further discuss the correlation between the two and the early renal damage,and ascetain the existence of correlation between blood Homocysteine(Hcy)& ambulatory arterial stiffness index(AASI)and early renal damage in hypertension patients It provided some guidance of prediction and clinical diagnosis for the early target organ damage in hypertension patients.Methods:Selected 50 healthy people from the Medical Examination Center as control group.Also selected 200 cases of patients with primary hypertension in the same period as the control group in conformtiey with the Prevention and Control of Hypertension Guidelines(2010 revision)as objects of study.According to the level of Hcy,theses 200 patients with hypertension were divided into four groups with 50 as a group,and the specific group criteria as follows: the first group of Hcy blood for 5.0-10.0?mol/L(namely pure hypertension group),the second group of Hcy blood of 10-15.0?mol/L,the third group blood Hcy is 15.0-23.0?mol/L,the fourth group blood Hcy is 23.0 to 30.0?mol/L.Recorded the gender,age,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure,fasting plasma glucose(FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDLC),high-density lipoprotein cholesterol(HDL-C),24 h ambulatory blood pressure,Hcy,urinary inhibition C(Cys-C),blood beta 2 micro globulin(?2-MG)in each group.Using a series of systolic and diastolic blood pressure data obtained by 24 h dynamic blood pressure monitoring,the scatter diagram was made with systolic blood pressure as the independent variable and diastolic blood pressure as the dependent variable.A straight line was obtained by regression analysis with statistical software,and the slope of the line was calculated.AASI was defined as 1-?.General clinical data of the five groups of patients were compared.Pearson correlation was used to analyze the relationship between blood Hcy,AASI and other indicators.The levels of Cys-C and ?2-MG were used as dependent variables to conduct multiple stepwise regression to predict the risk factors of renal damage.Results:1.The age,SBP,DBP and mean arterial pressure of the patients in each group were compared,and the differences were statistically significant(P < 0.05).FPG,TG,TC,LDL-C,HDL-C,the difference was not statistically significant(P > 0.05).2.Hcy,AASI,Cys-C and ?2-MG of the patients in each group were significantly higher than those in the healthy control group,the first group,the second group and the third group,with statistically significant differences(P<0.05).AASI,Hcy,Cys-C and ?2-MG in the third group were significantly higher than those in the healthy control group,the first group and the second group,with statistically significant differences(P<0.05).AASI,Hcy,Cys-C and ?2-MG in the second group were significantly higher than those in the healthy control group and the first group,with statistically significant differences(P<0.05).AASI,Hcy,Cys-C and ?2-MG in the first group were significantly higher than those in the healthy control group,with statistically significant differences(P<0.05).3.Pearson correlation analysis results showed that there was a significant positive correlation between AASI and Hcy(r>,0,P<0.05).AASI and Cys-C is positively correlated(r>0,P<0.05).AASI and ?2-MG has a significant positive correlation(r> 0,P<0.05).There was a significant positive correlation between Hcy and Cys-C(r>0,P<0.05).Hcy and ?2-MG is positively correlated(r>0,P<0.05).4.Multiple stepwise regression analysis was conducted with Cys-C and ?2-MG as dependent variables and gender,age,SBP,DBP,mean arterial pressure,FPG,TG,TC,LDL-C,HDL-C,AASI and Hcy as independent variables.There was a significant linear correlation between cys-c level and Hcy content(?=0.014,P<0.05)and average arterial pressure(?= 0.020,P<0.05).There was a significant linear correlation between ?2-MG level and Hcy content(?=0.083,P<0.05)and average arterial pressure(?=0.018,P<0.05).Conclusion:1.With the increase of blood Hcy level in patients with hypertension,AASI significantly increases,indicating that blood Hcy plays a certain role in atherosclerosis.2.In patients with hypertension Hcy level,Cys-C and ?2-MG are higher than those with normal blood Hcy level,indicating that the increase of blood Hcy level in patients with hypertension may accelerate the process of renal damage.3.The level of Hcy and average arterial pressure in patients with hypertension are significantly linearly correlated with blood Cys-C and ?2-MG,indicators of renal damage,proving that Hcy and degree of arteriosclerosis are independent risk factors for early renal damage.