Correlation Between New Body Surface Measurement Indexes And Target Organ Damage In Patients With Obesity-related Hypertension

Objective: To observe the correlation between body surface measurement indexes and target organ damage in patients with obesity-related hypertension,and to explore the advantage of new body surface measurement indexes conicity index(CI),weight-adjusted-waist index(WWI)and a body shape index(ABSI)in evaluating target organ damage of obesity-related hypertension,so as to provide basis for providing evidence for early prevention and treatment of target organ damage in obesity-related hypertension.Methods: 585 obesity-related hypertension patients were selected from the Department of Cardiology,the Second Hospital of Dalian Medical University from October 2018 to January 2020.Records:(1)general data: including gender,age,smoking history,family history,diabetes history,blood pressure,heart rate(HR);(2)body surface measurement indexes: weight,height,waist circumference(WC)and hip circumference were measured,and the new body surface measurement indexes conicity index(CI),a body shape index(ABSI),weight-adjusted-waist index(WWI)and the traditional body surface measurement indexes body mass index(BMI),waist-to-hip ratio(WHR),waist-to-height ratio(WHt R)were calculated;(3)biochemical indexes: serum creatinine(SCR),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),serum uric acid(SUA),fasting blood glucose(FBG);(4)carotid ultrasound and cardiac ultrasound.The patients with obesity-related hypertension were divided into different groups according to different target organ damage,and compared the new body surface measurementindexes CI,WWI,ABSI and the traditional body surface measurement indexes BMI,WC,WHR,WHt R with those without corresponding target organ damage.Spearman correlation analysis was used to analyze the correlation between body surface measurement indexes and left ventricular mass index(LVMI),carotid intima-media thickness(c IMT)and estimated glomerular filtration rate(e GFR),Logistic regression analysis was used to analyze the relationship between different body surface measurement indexes and target organ damage,ROC curve was used to analyze the appropriate cut-off value of different body surface measurement indexes to predict the target organ damage of obesity-related hypertension.Results: 1.Correlation study between body surface measurement indexes and left ventricular hypertrophy in obesity-related hypertension: the new body surface measurement indexes CI,WWI and ABSI were significantly higher in left ventricular hypertrophy group than those in non-left ventricular hypertrophy group(P<0.05),WHt R in the traditional body surface measurement indexes was significantly higher than that in non-left ventricular hypertrophy group(P<0.05),but there was no statistically significant difference in BMI,WC and WHR(P>0.05).Correlation analysis showed that LVMI was positively correlated with the new body surface measurement indexes CI,WWI and ABSI(P<0.05),and LVMI was also positively correlated with WHR and WHt R in the traditional body surface measurement indexes(P<0.05),but not correlated with BMI and WC.Multivariate Logistic regression analysis showed that the new body surface measurement indexes CI(OR=2.380,95%CI:1.321-4.289,P=0.004),WWI(OR=2.580,95%C1:1.457-4.568,P=0.001),ABSI(OR=2.380,95%CI:1.343-4.220,P=0.003)were independent risk factors of left ventricular hypertrophy in obesity-related hypertension.ROC curve analysis showed that:(1)CI in the new body surface measurement indexes had predictive value for left ventricular hypertrophy of obesity-related hypertension in men,when the cutoff value of CI was 1.31,the diagnostic efficiency was the best,sensitivity was 90.5%,specificity was 38.6%,while WWI and ABSI had no predictive value for left ventricular hypertrophy of obesity-related hypertension in men(P>0.05);(2)The new body surface measurementindexes WWI,ABSI and CI had predictive value for left ventricular hypertrophy of obesity-related hypertension in women,and WWI was the best.When the cutoff value of WWI was 11.43,the diagnostic efficiency was the best,sensitivity was 63.5%,specificity was 56.8%;when the cutoff value of ABSI was 0.0892,the diagnostic efficiency was the best,sensitivity was 33.3%,specificity was 89.1%;when the cutoff value of CI was 1.37,the diagnostic efficiency was the best,sensitivity was 44.4%,specificity was 74.2%.2.Correlation between body surface measurement indexes and carotid artery damage in obesity-related hypertension: the new body surface measurement indexes CI,WWI and ABSI were significantly higher in the carotid artery damage group than those in the non-carotid artery damage group(P<0.05),BMI in the traditional body surface measurement indexes was significantly lower than that of non-carotid artery damage group(P<0.05),but there was no significant difference in WC,WHR and WHt R(P>0.05).Correlation analysis showed that c IMT was positively correlated with the new body surface measurement indexes CI,WWI and ABSI(P<0.05),and c IMT was positively correlated with WC,WHR and WHt R in the traditional body surface measurement indexes(P<0.05),but negatively correlated with BMI(P<0.05).Multivariate Logistic regression analysis showed that the new body surface measurement indexes CI,WWI,ABSI and the traditional body surface measurement indexes BMI,WC,WHR,WHt R were not independent factors of carotid artery damage in obesity-related hypertension(P>0.05).3.Correlation between body surface measurement indexes and renal damage in obesity-related hypertension: the new body surface measurement indexes CI,WWI and ABSI in the renal damage group were significantly higher than those in the non-renal damage group(P<0.05),the traditional body surface measurement indexes WC and WHt R in the renal damage group were significantly higher than those in the non-renal damage group(P<0.05),but there was no significant difference in WHR and BMI(P>0.05).Correlation analysis showed that e GFR was negatively correlated with CI and ABSI in the new body surface measurement indexes(P<0.05)and had no correlationwith WWI(P>0.05),while e GFR had no correlation with traditional body surface measurement indexes BMI,WC,WHR and WHt R(P>0.05).Multivariate Logistic regression analysis showed that CI(OR = 2.632,95%CI: 1.065-6.506,P = 0.036)and ABSI(OR = 2.500,95%CI: 1.030-6.067,P = 0.043)in the new body surface measurement indexes were independent risk factors for renal damage in obesity-related hypertension.ROC curve analysis shows that:(1)The new body surface measurement indexes CI and ABSI had predictive value for renal damage of obesity-related hypertension in men,When the cutoff value of CI was 1.38,the diagnostic efficiency was the best,sensitivity was 53.3%,specificity was 78.8%;When the cutoff value of ABSI was 0.0865,the diagnostic efficiency was the best,sensitivity was 60.0%,specificity was 77.7%;(2)The new body surface measurement indexes CI and ABSI had predictive value for renal damage of obesity-related hypertension in women,when the cutoff value of CI was 1.31,the diagnostic efficiency was the best,sensitivity was89.5%,specificity was 42.1%;when the cutoff value of ABSI was 0.0820,the diagnostic efficiency was the best,sensitivity was 89.5%,specificity was37.7%.Conclusion:1.The new body surface measurement indexes CI,WWI and ABSI had more advantages than the traditional body surface measurement indexes BMI,WC,WHR and WHt R in evaluating the correlation between obesity degree and target organ damage(left ventricular hypertrophy and renal damage)of obesity-related hypertension.2.The increase of new body surface measurement indexes CI,WWI and ABSI were independent risk factors of left ventricular hypertrophy in obesity-related hypertension,and the increase of CI and ABSI were also independent risk factors of renal damage in obesity-related hypertension.3.There were gender differences in the predictive value of new body surface measurement indexes in predicting target organ damage in patients with obesity-related hypertension.CI had predictive value for the occurrence of left ventricular hypertrophy and renal damage in obesity-related hypertensive patients of different genders,ABSI had predictive value for obesity-related hypertension kidney damage of different genders and female obesity-related hypertension left ventricular hypertrophy,whileWWI only had predictive value for the occurrence of left ventricular hypertrophy in female patients with obesity-related hypertension.