| Objective:To compare the levels of hypersensitive C-reactive protein(hs-CRP),Framingham score(FRS)and carotid intima-media thickness(IMT)in prehypertension patients with overweight,and to analyze the risk factors of carotid intima-media thickness.To explore the relationship between hypersensitive C-reactive protein,Framingham score and carotid intima-media thickening in prehypertension.Methods:Total 257 cases were divided into 4 groups according to blood pressure and body mass index(BMI): normal control group(n = 38),prehypertension group(n = 72),overweight group(n = 69)and prehypertension with overweight group(n = 78).General clinical data,hypersensitive C-reactive protein,Framingham score and carotid intima-media thickness were compared among the four groups.The interaction between blood pressure and BMI was analyzed,and the risk factors of carotid intima-media thickness were discussed.According to the quartile method of hypersensitive C-reactive protein level,all the prehypertensive patients were divided into the first fraction group(n = 37),the second fraction group(n = 37),The third fraction group(n = 38),and the fourth fraction group(n = 38).According to Framingham score,all the prehypertensive patients were divided into FRS1 group(n = 36),FRS2 group(n = 36),FRS3 group(n =32)and FRS4 group(n = 46).Carotid intima-media thickness were compared among the four groups.Binary logistic regression analysis and ROC curve were performed to explore the predictability of hs-CRP and FRS on carotid intima-media thickening.Results:1.The levels of hs-CRP and IMT in PHO group,PH group and O group were higher than those in NC group,and that in PHO group was higher than that in PH group and O group(P < 0 05).but there was no significant difference between PH group and O group(P > 0 05).FRS in PHO group was higher than that in NC group and O group,and that in PH group was higher than that in NC group(P < 0 05),but there was no significant difference between PHO group and PH group,O group and NC group,O group and PH group(P > 0 05).2.There was no interaction between prehypertension and overweight in hypersensitive C-reactive protein,Framingham score and carotid intima-media thickness.3.The results of multiple stepwise regression showed that hs-CRP,age and HDL-C entered the regression equation,and the regression equation was Y=0.481+0.073X1+0.009X2-0.175X3(X1 was hs-CRP,X2 age,X3 was HDL-C).All independent variables VIF < 10.4.Prehypertension were grouped according to the hs-CRP quartile.The level of IMT significant increased gradually in the four groups(P < 0 05).According to the quartile of FRS,IMT in FRS4 group(1.19 ±0.20mm)was higher than that in FRS1 group(1.05 ±0.18mm),FRS2 group(1.11 ±0.15mm)and FRS3 group(1.10 ±0.12mm).There was no significant difference among FRS1 group,FRS2 group and FRS3 group.5.Carotid intima-media thickness ? 1mm was used as the standard of carotid intima-media thickening.Binary logistic regression analysis showed that hs-CRP entered the logistic regression model,the partial regression coefficient was positive,but the Framingham score could not enter the equation.Further ROC curve showed that the area under the curve of hs-CRP for predicting carotid intima-media thickening was 0.815(95%CI 0.699-0.902,P < 0.001).The diagnostic critical value was 0.935 mg / L,and the sensitivity was 0.703.The specificity was 0.864.Conclusion:1.hs-CRP and IMT are increased in prehypertension and overweight,and they are further increased in prehypertension with overweight.2.hs-CRP,age and HDL-C were significant independent influencing factors of carotid intima-media thickening.3.In prehypertension,hs-CRP was positively correlated with the risk of carotid intima-media thickening.hs-CRP > 0.935mg/L suggested a high risk of atherosclerosis.Framingham score was positively correlated with carotid intima-media thickness,however,it could not predicted the carotid intima-media thickening. |
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