Study On The Relationship Between Neutrophil/Lymphocyte Ratio,Pulse Wave Velocity And Early Renal Damage In Young And Middle-aged Patients With Essential Hypertension

Objective: To investigate the relationship between neutrophil / lymphocyte ratio(NLR),Brachial-ankle pulse wave velocity(baPWV)and early renal damage in young and middle-aged patients with essential hypertension.Methods:(1)A retrospective study was conducted on 449 young and middle-aged patients with essential hypertension who were admitted to the Fifth affiliated Hospital of Xinjiang Medical University from June 2019 to December 2019.The patients were divided into 3 groups according to the quartile of NLR: group A(NLR<1.61),B(1.61≤NLR≤2.40),C(NLR>2.40).sex,age,waist circumference,body mass index((BMI)),systolic blood pressure(SBP),diastolic blood pressure(DBP),course of disease,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),uric acid(UA),serum creatinine(SCr),urea nitrogen(BUN),cystatin C(CysC),urinary microalbumin(MAU),urinary α 1-microglobulin(α 1-MG),urinary β 2-microglobulin(β 2-MG),estimated glomerular filtration rate((eGFR)),urinary Microalbumin / creatinine(UACR)and 24-hour urinary protein were compared among the three groups.To analyze the correlation between NLR and 24-hour urinary protein,UACR,eGFR and other indexes.(2)According to the presence of arteriosclerosis,449 patients were divided into two groups: group Ⅰ:arteriosclerosis group(baPWV≥1400cm/s)and groupⅡ: non-arteriosclerosis group(baPWV < 1400cm/s).To compare the differences of the above clinical indexes between the two groups of patients.(3)Multiple linear regression analysis was carried out on the possible influencing factors of UACR.Results:(1)There were significant differences in SBP,DBP,age,TG,eGFR,UACR,urine α 1-MG,urine β 2-MG and MAU among the three groups of patients with different NLR levels.Correlation analysis showed that NLR was positively correlated with 24-hour urinary protein,UACR,urinary α 1-MG,urinary β 2-MG(r = 0.119,0.124,0.165,0.097 respectively,P < 0.05).(2)By comparing the relevant clinical indexes between groupⅠ(arteriosclerosis group)and groupⅡ(non-arteriosclerosis group),it was found that the levels of SBP,DBP,Scr and UACR in arteriosclerosis group were higher than those in non-arteriosclerosis group,while eGFR and TG were lower than those in non-atherosclerosis group.Correlation analysis showed that baPWV was positively correlated with UACR and urine β 2-MG(r = 0.169,0.396,respectively,P<0.05),and negatively correlated with eGFR(r = 0.100,P < 0.005).(3)Multiple linear regression analysis showed that age,SBP,baPWV and NLR were independent risk factors for UACR.Conclusions:(1)baPWV and NLR in young and middle-aged patients with essential hypertension can reflect the early renal damage in patients with essential hypertension.(2)baPWV was positively correlated with UACR and urinary β 2-MG,but negatively correlated with eGFR,while NLR and NLR were positively correlated with 24-hour urinary protein,UACR,urinary α 1-MG,urinary β 2-MG and eGFR.(3)baPWV and NLR may be independent risk factors of hypertensive renal damage.