| Objective:This study investigated the relationship among homocysteine(Hcy),uric acid(UA),serum cystatin C(Cyst-C)and primary hypertension with left ventricular hypertrophy in the middle aged and elderly patients.The purpose was to look for simple serological indicators to determine left ventricular hypertrophy.Methods:A total of 342 patients with primary hypertension diagnosed and treated in the first hospital of Shanxi Medical University from September 2016 to September 2019 were collected.The patients' general data,including smoking history,family history of hypertension,blood pressure grade,level of blood pressure on admission and course of disease,were collected.Hcy,UA,Cyst-C,creatinine(CRE),urea nitrogen(BUN),fasting blood glucose(FBG),and other biochemical indicators were recorded.Relevant indicators with echocardiography were collected and left ventricular mass index(LVMI)was calculated.All patients were divided into left ventricular hypertrophy group(i.e.HLVM group,n=107)and non-left ventricular hypertrophy group(i.e.NLVM group,n=235)according to the diagnostic criteria of left ventricular hypertrophy.Statistical analysis was performed to determine the difference of clinical indicators between the two groups,to analysis the independent risk factors for primary hypertension with left ventricular hypertrophy,and to clarify the value of blood biochemical indicators in judging left ventricular hypertrophy.Results:Between different groups,there were no significant differences in gender,blood pressure grade,smoking history,family history of hypertension,course of disease,BMI,CRE,BUN,FBG,HDL-C,LDL-C,TG,TC and DBP(P>0.05).but there were obviously significant differences in age,UA,Cyst-C,Hcy,LVEF,SBP and pulse pressure(P<0.05).The binary logistic regression results showed that UA(P = 0.011,OR = 1.007),Cyst-C(P= 0.015,OR = 6.539),Hcy(P = 0.002,OR = 1.056),pulse pressure(P <0.001,OR = 1.055)were independent risk factors for left ventricular hypertrophy;LVEF(P = 0.006,OR =0.943)was an independent protective factor for left ventricular hypertrophy.The area under the ROC curve of UA,Cyst-C,and Hcy in the judging of left ventricular hypertrophy was0.633,0.660,and 0.687,respectively.The area under the ROC curve of the joint value of the three indexes in the judging of left ventricular hypertrophy was 0.726.Conclusion:Serum UA,Cyst-C,and Hcy were independent risk factors for primary hypertension with left ventricular hypertrophy in the middle aged and elderly patients.Compared with UA and Cyst-c,Hcy had more value of judging primary hypertension with left ventricular hypertrophy.Compared with single index,the combination of the three indexes had the highest value in judging left ventricular hypertrophy,which was expected to be an effective index to evaluate whether the patients with primary hypertension were combined with left ventricular hypertrophy. |
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