Gender Difference In The Influence Of Serum γ-GGT,RDW On Hypertension Left Cardiac Remodeling

Objective: To discuss the gender difference in the influence of serum γ-GGT,RDW on the left cardiac remodeling of patient with hypertension,to evaluate if it can be evidence for early heart injury and provide theory evidence for the individual treatment of hypertension.Methods: A total of 806 patients were diagnosed primary hypertension at 5th Department of Cardiology,the Second Hospital of Dalian Medical University from September 2014 to December 2015.All subjects are excluded valvular heart disease,serious arrhythmias,diabetes,hyperthyroidism,renal dysfunction,sleep apnea syndrome,alcoholism history,fatty liver,hepatitis,biliary tract diseases,hematologic diseases,rheumatism disease,malignant tumor and kinds of acute or chronic inflammation.Ultimately 312 patients enrolled this study,included 109 males and 203 females.The baseline information including age,gender,24-hour average systolic blood pressure(24h SBP),24-hour mean diastolic pressure(24h DBP),24-hour pulse pressure(PP),height,weight,calculation of body mass index(BMI),extraction of fasting venous blood to test r-GGT,RDW,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),fasting blood glucose(FPG),serum creatinine(CR),uric acid(UA),Cystatin C(Cys C),homocysteine(Hcy).All patients were scheduled to echocardiography examination and mensuration of left ventricular end-diastolic diameter(LVEDd),interventricular septal thickness(IVST),left ventricular posterior wall thickness(PWT)and left atrial end-systolic diameter(LAD),to calculate the left ventricular mass index(LVMI).Grouping was based on gender.According to the quartile level of serum γ-GGT,RDW of the male group and the female group,they were grouped into four groups and the index difference of LAD,LVMI were compared among groups.According to LVMI and LAD,the left ventricular hypertrophy group,the left ventricular normal group,the LAD hypertrophy group and the LAD normal group were divided among the male group and the female group.γ-GGT,RDW level difference of the left ventricular hypertrophy group,the left ventricular normal group,the LAD hypertrophy group and the LAD normal group were compared.Among the male group and the female group,according to their own LVMI and RWT,they were further divided into the normal geometric(NG)group,the ventricular conventric remodeling(CR)group,the eccentric hypertrophy(EH)group,the concentric hypertrophy(CH)group,the γ-GGT,RDW level difference of each left ventricular geometric were compared among groups.Results:1.The γ-GGT level of the male group with hypertension was higher than that of the female group with hypertension,and the difference had statistical significance(P<0.05).RDW level in the male group and the female group had no statistical difference(P>0.05).2.The left cardiac variable of groups with different γ-GGT and RDW levels had gender difference.In the male group,the difference in the left cardiac variables LVMI,LAD,LVID,IVST,PWT of different γ-GGT level group had statistical significance(P<0.05);but all left cardiac variables in different RDW level group had no statistical difference(P>0.05).All left cardiac variables in different γ-GGT level groups among the female group had no statistical difference(P>0.05);LVID,LVMI,PWT of RDW groups had statistical difference(P<0.05).3.γ-GGT,RDW level of the left ventricular hypertrophy group and the normal group in male patients with hypertension had no statistical difference(P>0.05);γ-GGT level of the left ventricular hypertrophy group and the normal group in female patients with hypertension had no statistical difference(P>0.05),while RDW level had statistical difference,the left ventricular hypertrophy group was higher than the normal group(P<0.05).4.The γ-GGT level of LAD hypertrophy group and the normal group in male patients with hypertension had statistical difference,the LAD hypertrophy group was higher than the normal group(P>0.05);the γ-GGT,RDW of LAD hypertrophy group and the normal group in female patients with hypertension had no statistical difference(P<0.05).5.The γ-GGT in different geometric groups of female hypertension patients had no statistical difference between groups(P > 0.05),while RWD level had statistical difference,EH group and CH group were higher than NG group(P<0.05);among the male patients,γ-GGT,RDW level of different left ventricular geometric groups had no statistical difference(P>0.05).6.The stepwise linear regression showed that RDW is an independent risk factor of LVMI,LAD for female patients with hypertension,but not for male patients with hypertension;γ-GGT is not an independent risk factor of LVMI,LAD of female and male.Conclusion: 1.The serum γ-GGT level of patients with primary hypertension has gender difference,male higher than female.2.LAD,LVMI of different γ-GGT level in patients with primary hypertension have differences;there are no difference in female.3.RDW level of patients with primary hypertension have no gender difference;The influence of RDW on left ventricle remodeling has gender difference.RDW is an independent risk factors of LAD and LVMI enlargement for female patients with hypertension.