Relationship Between Monocyte Count/High Density Lipoprotein Ratio And Target Organ Damage In Essential Hypertension

Objective Inflammation and oxidative stress are the main pathological mechanisms of target organ damage(TOD)in hypertension.The ratio of monocyte to HDL cholesterol(MHR)in peripheral blood is a newly discovered indicator of Inflammation and oxidative stress.The purpose of this study was to investigate the association between peripheral blood MHR and TOD in patients with essential hypertension(EH).Methods 304 p atients who met the criterias of enrollment were enrolled in the hypertension group(EH)from January 2017 to August 2018 in the cardiovascular ward of the Affiliated Hospital of Guilin Medical College for EH treatment。While 80 healthy volunteers were selected as the control group(contr ol).Carotid artery intima-media thickness(cIMT)was measured by color Doppler ultrasonography in all cases.In the hypertension group,cIMT<0.9mm was defined as non-carotid atherosclerosis group(non-cas)with a total of 134 cases,and cIMT0.9≥mm or plaque formation was defined as carotid atherosclerosis group(CAS)with a total of 170 cases.According to the estimated glomerular filtration rate(eGFR)<90ml/(min·1.73m2),a total of 185 cases were diagnosed as renal damage(RD)in the renal damage group,and 119 cases were diagnosed as non-renal damage(non-RD)in the group with eGFR>90ml/(min·1.73m2);According to the degree of TOD,no carotid artery and kidney injury were defined as TOD(-)group,with a total of 63 cases,and carotid artery(and/or)kidney injury were defined as TOD(+)group,with a total of 241 cases.The basic clinical data were recorded,Meanwhile,fasting elbow venous blood was collected to detect the leukocyte count and its classification,blood lipid,total bilirub in(TBiL),uric acid(UA),serum creatinine(SCr)and other laboratory in dicators.The baseline data and indicators were compared among groups.The receiver operating characteristic curve(ROC curve)was performed to evaluate the diagnostic value of MHR in EH patients with concurrent CAS and RD.Spearman correlation was used to analyze the relationship among MHR and variables,cIMT and eGFR.Binary logistic regression was used to analyze the independent risk factors of CAS in EH patients.Results The values of MHR increase in CAS group compared with non-CAS group.MHR was positively correlated with cIMT(r=0.160;p=0.03).The ROC curve showed that the area under curve(AUC)of MHR in diagnosis of EH combined with CAS was 0.685,the cut-off value was 0.35,the sensitivity was 67.4%,and the specificity was 67.2%.Bivariate logistic regression analysis showed that age(OR:1.037,95% CI:1.012-1.063,p=0.004),smoking(OR:2.187,95% CI:1.230-3.899,p=0.006),serum uric acid(OR:1.004,95%CI:1.001-1.006,p=0.004),MHR≥0.35(OR:3.647,95% CI:2.196-6.058,p<0.001)were independent risk factors of CAS.The MHR in RD group was significantly higher than that in non-RD group(p=0.014).MHR was negatively correlated with eGFR(r=-0.228,p<0.001).The ROC curve showe that the AUC of MHR in diagnosis of EH combined with RD was 0.583,the cut-off value was0.34,the sensitivity was 60%,and the specificity was 54%.The MHR in TOD(+)group was higher than that in TOD(-)group and control group(p<0.001).Conclusion(1)MHR is elevated in the target organs(carotid and/or kidney)of the patients with essenti al hypertension;(2)MHR may be an independent risk factor for hypertension CAS,and has certain value for CAS diagnosis;(3)MHR is negatively correlated with eGFR,which may be reflect the renal damage in essential hypertension.