Relationship Between GGT,Hcy,ABI And Carotid Atherosclerosis In Patients With Essential Hypertension

Objective:Through the comparison of patients with essential hypertension and carotid atherosclerosis(CAS)and patients with essential hypertension and normal carotid artery2 Comparative analysis was conducted on Gamma-glutamyltransferase(GGT),homocysteine(Hcy),and ankle brachial index(ABI)to explore the correlation between GGT,Hcy,ABI,and CAS in patients with primary hypertension.Search for single or combined indicators to screen high-risk groups from patients with primary hypertension,guide clinical doctors in early intervention,improve patient prognosis,reduce patient mortality,and reduce social medical burden.Methods:This study collected 243 patients diagnosed with primary hypertension who were hospitalized in the General Medicine Department of Yangzhou University Affiliated Hospital from September 2021 to September 2022,including 115 males and 128 females,aged(68.98 ± 11.59)years old.Record the patient’s general information,past medical history,laboratory examination,limb blood pressure measurement results,and neck vascular ultrasound results.All enrolled patients were divided into control group(without CAS)and research group(with CAS)according to whether they were combined with CAS by cervical vascular ultrasound detection.According to the median level,the enrolled patients were divided into G0 group(low GGT group)and G1 group(high GGT group),H0 group(low Hcy group)and H1 group(high Hcy group),A0 group(low ABI group)and A1 group(high ABI group).The incidence rate of CAS was compared,and the collected data were statistically analyzed through SPSS 25.0,Compare the general information,laboratory examination results,limb blood pressure measurement results,and neck vascular ultrasound results of patients in each group.Use logistic regression analysis to evaluate the risk factors of CAS in patients with primary hypertension.Use ROC curves to evaluate the predictive efficacy of GGT,Hcy,ABI,and a three indicator combined regression model for CAS.Results:1.Compared with the control group,the study group had older patients with a higher proportion of smoking,drinking,and concurrent cerebral infarction;Compared with the control group,the study group had higher levels of blood urea nitrogen,creatinine,uric acid,fibrinogen,D-dimer,GGT,and Hcy,while serum albumin levels were lower;Compared with the control group,the study group had lower ABI.2.The incidence of CAS in the G0 and G1 groups was 60.50% and 71.20%,respectively(P=0.032),with an increase in GGT levels and an increase in CAS detection rate;The incidence of CAS in the H0 and H1 groups was 52.90% and 79.50%,respectively(P<0.001),with an increase in Hcy levels and an increase in CAS detection rate;The incidence of CAS in group A0 and group A1 was 74.20% and 58.50%,respectively(P=0.010),with an increase in ABI and a decrease in CAS detection rate.3.The final results of logistic regression analysis showed that GGT(OR=1.014,95%CI=1.001-1.028,P=0.044),Hcy(OR=1.099,95% CI=1.008-1.199,P=0.033),ABI(OR=0.026,95% CI=0.001 0.980,P=0.049),and age(OR=1.048,95% CI=1.011-1.086,P=0.010)are independent risk factors for the occurrence of CAS in patients with primary hypertension.4.The ROC curve suggests that the optimal cutoff point for GGT to predict hypertension combined with CAS is 29.50,and the area under the curve(AUC)is 0.583.At this time,the sensitivity is 44.30%,and the specificity is 69.10%;The optimal cutoff point for predicting hypertension combined with CAS by Hcy is 9.25,AUC: 0.699,with a sensitivity of 65.80% and a specificity of 66.70%;The optimal cutoff point for predicting hypertension combined with CAS by ABI is 1.084,AUC: 0.638,with a sensitivity of53.20% and a specificity of 71.60%.5.Incorporating GGT,Hcy,and ABI variables into logistic regression analysis,a joint prediction model was obtained: Logit(P)=3.28+0.014 * GGT(U/L)+0.164 * Hcy(umol/L)-4.284 ABI.According to the logistic regression analysis of multiple factors(combined Hcy,ABI,GGT),the risk factor regression model was used to draw the ROC curve.The AUC was 75.40%,P<0.001,and 95% CI was 0.690-0.817.Furthermore,the three joint Jordan indices were calculated to be 0.456,with a sensitivity of 71.50% and a specificity of 74.10%.Compared with independent predictions of GGT,Hcy,and ABI,the combined indicators showed significant improvements in sensitivity,specificity,and accuracy.Conclusions:GGT,Hcy and ABI have certain reference value in predicting primary hypertension with carotid atherosclerosis,and the combined application of the three has higher estimation value,which can be used as an auxiliary examination method for the diagnosis of carotid atherosclerosis.