Study On The Relationship Between CIMT And TSH,MHR,PP In Patients With Hypertension In Xining Area

Objective:To analyze the relationship among carotid intima-media thickness,thyroid-stimulating hormone,monocyte to high density lipoprotein ratio,and pulse pressure in patients suffering from hypertension in Xining area,we found that there is a possibility to explore the effects of TSH,MHR and PP on carotid atherosclerosis in patients mentioned above,and furthermore,to provide clues for the diagnosis and prevention of early atherosclerosis.Methods:A total of 156 patients with hypertension in Cardiology Department of the affiliated Hospital of Qinghai University from December2020 to December 2021 were selected as the case group,meanwhile 117healthy people in the medical examination center of the hospital were selected as the control group.The case group was divided into three parts:52 cases of normal CIMT group,49 cases of CIMT thickening group and 55 cases of plaque formation group respectively according to the size of CIMT.General data were collected from all subjects in the case group and the control group,and during the next morning,they experienced the following medical exams:collecting fasting blood,and testing for blood routine,blood biochemistry and thyroid function.The patients in the case group underwent 24-hour ambulatory blood pressure monitoring and carotid artery color Doppler ultrasound.And then compare and analyze whether there were differences in TSH,MHR,PP between the case group and the control group,and further explore the relationship between CIMT and TSH,MHR,PP in the case group.Results:1.Comparing the case group and the control group,it was found that the levels of TG,TSH,PP,and MHR in the case group were higher than those in the control group(P<0.05),while the HDL-C level in the case group was lower than that in the control group(P<0.05).And there is no statistical difference between the two groups in gender,age,smoking history,BMI,TC,Cr,BUN,NE,LY,FT3,FT4,TT3,TT4(P>0.05).2.The comparison between the subgroups of the case group showed that there were significant differences in TG,HDL-C,TSH,PP,and MHR among the normal CIMT group,the thickening CIMT group,and the plaque group(P<0.05).Further multiple comparisons between groups showed that the level of TG in the plaque group was higher than that in the normal CIMT group(P<0.05),and there was no significant difference in TG among the other groups(P>0.05);the level of HDL-C in the normal CIMT group was higher than that in the CIMT thickening group and plaque group(P<0.05),the level of HDL-C in the CIMT thickening group was higher than that in the plaque group(P<0.05);The levels of TSH and MHR in the normal CIMT group were lower than those in the CIMT plaque group(P<0.05),the levels of TSH and MHR in the thickening group were lower than those in the plaque group(P<0.05).There was no significant difference in TSH and MHR between the normal CIMT group and the CIMT thickening group(P>0.05).The level of PP in the normal CIMT group was lower than that in the CIMT thickening group,plaque group(P<0.05),the level of PP in the CIMT thickening group was lower than plaque group(P<0.05).3.The correlation analysis of TSH,PP,MHR and CIMT indicated that CIMT was positively correlated with TSH(r_s=0.387,P<0.001);CIMT was positively correlated with PP(r_s=0.487,P<0.001);CIMT was positively correlated with MHR(r_s=0.426,P<0.001).4.Logistic regression of carotid atherosclerosis(CAS)risk factors attested that TSH,PP,and MHR were risk factors for CAS(P<0.05).5.When evaluating the diagnostic value of TSH,MHR,and PP for CAS in patients with hypertension by ROC curve,it was found that the areas under the three curves of TSH,MHR,and PP were 0.696,0.705,and0.749,respectively(P<0.001).When TSH=2.81μIU/m L,its diagnostic efficiency reached the highest,with a sensitivity of 69.2%and a specificity of 65.4%;when MHR=0.477,its diagnostic efficiency reached the highest,with a sensitivity of 63.5%and a specificity of 69.2%;when PP=53.50mm Hg,its diagnostic efficiency reached the highest,with a sensitivity of58.7%and a specificity of 80.8%.Conclusions:1.CIMT in patients with hypertension in Xining area is correlated with the levels of TSH,MHR,and PP.CIMT increases with the levels of TSH,MHR,and PP,and the levels of the three can reflect the evolution and severity of CAS.Meanwhile,all of the three were risk factors for CAS.2.When TSH>2.81μIU/m L,MHR>0.477,and PP>53.50mm Hg in patients with hypertension in Xining area,the probability of CIMT thickening is higher,and the three have certain clinical value for the early identification and severity determination of CAS in patients with hypertension.