The Correlation Between Th17/Treg And Early Renal Impairment In Overweight Patients With Normal High Blood Pressure

Objective:To observe the levels of Th17/Treg,serum Cystatin C(CysC)and serum retinol binding protein(RBP)in overweight patients with normal high blood pressure,and to explore the correlation between Th17/Treg and early renal impairment.Methods:According to inclusion and exclusion criteria,a total of 288 patients were selected from the physical examination center and inpatient department of our hospital from September 2018 to November 2019.According to BMI and blood pressure,63 cases were divided into the normal control group(NC group),74 cases were divided into the simple overweight group(O group),68 cases were divided into the simple normal high blood pressure group(HP group),and 83 cases were divided into the overweight and normal high blood pressure group(HPO group).The clinical general data,Th17 cells,Treg cells,Th17/Treg,interleukin-17(il-17),interleukin-10(il-10),CysC and RBP levels of the four groups were compared with analyzing the interaction between normal high blood pressure and overweight.According to the quartile method of Th17/Treg,il-17 and il-10 levels,all the patients with normal high blood pressure were divided into 37 cases in the first Th17/Treg subgroup(0.04-0.28),38 cases in the second Th17/Treg subgroup(0.28-0.46),38 cases in the third Th17/Treg subgroup(0.46-0.72),38 cases in the fourth Th17/Treg score group(0.72-2.55),37 cases in the first il-17 score group(0.01-5.27pg/L),38 cases in the second il-17 score group(5.27-12.67 pg/L),38 cases in the third subgroup of il-17(12.67-18.27 pg/L),38 cases in the fourth subgroup of il-17(18.27-39.80 pg/L),37 cases in the first subgroup of il-10(0.98-3.20 pg/L),38 cases in the second subgroup of il-10(3.20-4.59 pg /L),38 cases in the third subgroup of il-10(4.59-5.96 pg /L),and 38 cases in the fourth subgroup of il-10(5.96-10.78 pg /L).Then the differences of CysC and RBP levels among different subgroups were compared.Correlation analysis of Th17/Treg,CysC,RBP and various influencing factors and multiple linear regression analysis of CysC and RBP levels was performed on the whole population,Using CysC > 1.03mg/L and/or RBP > 76mg/L as the criteria for predicting the existence of early renal impairment,ROC curve was used to explore the predictive value of Th17/Treg and il-17 for early renal impairment.Results:1.Th17/Treg,CysC and RBP in the HPO group,the HP group and the O group were all higher than the NC group(P < 0.05),and the HPO group was higher than the HP group and the O group(P < 0.05),while the difference between the HP group and the O group was not statistically significant(P > 0.05).Il-17 in the HPO group was higher than that in the NC group,the HP group and the O group(P < 0.05),but there was no statistically significant difference between the NC group,the HP group and the O group(P > 0.05).Il-10 in the HPO group,the HP group,and the O group were all lower than the NC group(P < 0.05),and the HPO group was lower than the HP group and the O group(P < 0.05),but there was no statistically significant difference between the HP group and the O group(P > 0.05).2.There was no interaction between overweight and normal high blood pressure in Th17/Treg,il-17,il-10,CysC and RBP.3.People with normal high blood pressure were grouped according to the quartile of Th17/Treg,il-17 and il-10 levels,and there was no statistically significant difference in CysC level among all quartile groups(P > 0.05).RBP level was higher in the fourth subgroup than the first subgroup,the second subgroup,and the third subgroup between Th17/Treg and il-17 subgroups(P < 0.05).The third score group was higher than the first score group and the second score group(P < 0.05).However,there was no significant difference between the first score group and the second score group(P > 0.05).There was no statistically significant difference in RBP level between quartile groups of il-10(P > 0.05).4.Correlation analysis showed that Th17/Treg was positively correlated with il-17 and negatively correlated with il-10.CysC and RBP level was positively correlated with Th17/Treg and il-17 and negatively correlated with il-10.5.Multiple linear regression analysis showed that Th17/Treg was the main influencing factor of CysC.Th17/Treg and il-17 were the main influencing factors of RBP.ROC curve showed that the area under the curve predicted by Th17/Treg for early renal impairment was 0.736,the optimal diagnostic threshold was 0.439,the sensitivity was 0.762,and the specificity was 0.642.The area under the curve of early renal impairment predicted by il-17 was 0.706,the optimal diagnostic threshold was 20.145 pg/L,the sensitivity was 0.452,and the specificity was 0.931.Conclusion:1.Th17/Treg,CysC and RBP all increased in normal high blood pressure or overweight,and Th17/Treg,CysC and RBP further increased when overweight was combined with normal high blood pressure.2.Th17/Treg and il-17 are risk factors for early renal impairment,while il-10 is a protective factor.Th17/Treg > 0.439 and/or il-17 > 20.145 pg/L suggest early renal impairment.