Correlation Analysis Of NLR,UA And Left Ventricular Hypertrophy In Hypertensive Patients

Objective: To investigate the relationship between serum levels of neutrophil lymphocyte ratio(NLR),uric acid(UA)and left ventricular hypertrophy(LVH)in patients with essential hypertension(EH)),To investigate their association with LVH and to assess their value in the diagnosis and prognosis of LVH.Methods: 463 essential hypertension patients admitted to The second hospital affiliated to dalian medical university from September 2015 to December 2017 were enrolled,including 212 males and 251 females.Exclusion of secondary hypertension,heart failure,severe arrhythmia,coronary heart disease,cardiomyopathy,valvular heart disease,sleep apnea syndrome,diabetes,hyperthyroidism,renal insufficiency,hepatic insufficiency,severe biliary disease,blood Systemic diseases,rheumatic diseases,various acute and chronic inflammation,malignant tumors and other recent and ongoing use of anti-inflammatory drugs.The patient's gender,age,height,weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP)Fasting venous blood samples were collected for testing of precursor B-type natriuretic peptide(pro-BNP),white blood cells(WBC),Neutrophil percentage(NEUT),lymphocyte percentage Serum creatinine(Scr),total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C)HDL-C,FPG,Hs-CRP,Homocysteine,Hcy)and other laboratory indicators.All patients underwent routine echocardiography after admission.The interventricular septal thickness(IVST),left ventricular posterior wall thickness(PWT),left ventricular end-diastolic dimension(LVEDd)),Left ventricular mass index(LVMI)and relative wall thickness(RWT)were calculated.Study Group:(1)Divided into LVH group and non-LVH group according to LVMI.Compare the general data and UA,NLR between the two groups for statistical significance.(2)There were no statistically significant differences in blood NLR and UA levels.(3)Serum NLR,UA levels were divided into four groups,each group divided into four groups,comparing the different groups IVST,PWT,LVMI and other indicators of differences.(4)Pearson correlation analysis of influencing factors of LVH in EH patients.(5)To explore if NLR and UA are independent risk factors of LVH by binary multivariate Logistic stepwise regression analysis.(6)ROC curve assessment of blood UA,NLR levels of EH with LVH prediction value.(7)LVMI and RWT can be divided into four types of left ventricular configuration: Normal geometric(NG),concentric remodeling(CR),concentric hypertrophy(CH),Eccentric hypertrophy(Eccentric hypertrophy,EH).,and the difference of NLR and UA between the left ventricular configuration groups were compared.Results:1.The differences of NLR,UA,age,gender,SBP,BMI,pro-BNP,Scr,Hs-CRP,Hcy and FPG in LVH group were statistically significant(p <0.05)There were no significant differences in WBC,NEUT,LYMPH,TC,TG,HDL-C and LDL-C(p> 0.05).2.In the LVH group,the NLR level of the male group was higher than that of the female group.In the non-lvh group,the blood NLR level of the male group was also higher than that of the female group.LVH patients were divided into the normal group and the hyperuricemia group(UA greater than 420 umol/L for males and 360 umol/L for females).The percentage of hyperuricemia in males was higher than that in females,and the difference was statistically significant(p<0.05).3.The quartiles of UA were divided into four groups: A,B,C and D.The differences of IVST,PWT,LVEDd and LVMI between the four groups were statistically significant(P <0.05).The PWT of group D was higher than that of group A,the IVST was higher than that of group A,group B,LVEDd was higher than group A,and LVMI was higher than group A and group B.The PWT in group C was higher than that in group A,theIVST was higher than that in group A,the LVEDd was higher than that in group A,and the LVMI was higher than that in group A.The PWT in group B was higher than that in group A,the IVST was higher than that in group A,and the LVMI was higher than that in group A(P <0.05),indicating that the LVH hypertrophy also increased.4.According to the level of blood NLR,the quartiles were divided into four groups: A,B,C and D.The differences of IVST and LVMI between the four groups were statistically significant(P <0.05)Group B.IVST in group C was higher than that in group B,LVMI was higher than group A and group B.The LVMI of group B was higher than that of group A,the difference was statistically significant(p <0.05),indicating that with the increase of blood NLR,LVMI also increased.PWT,LVEDd difference was not statistically significant(p> 0.05).5.There was a positive correlation between SBP,BMI,pro-BNP,UA,NLR and EH with LVH(r = 0.314,0.298,0.345,0.331,0.410,all P <0.05).6.Logistic regression analysis further adjusted for cardiovascular risk factors such as age,sex,DBP,TC,TG,HDL-C and LDL-C,blood UA,P <0.05).The results showed that blood UA and NLR may be independent risk factors for LVH in hypertensive patients.7.The area under the curve of blood UA level was 0.673,the area under> 0.5,the significance p = 0.000 <0.05,the difference was statistically significant,indicating that blood UA had some significance for the diagnosis of EH complicated with LVH.The area under the blood NLR curve was 0.551,Area under the> 0.5,but significant NLR p= 0.71> 0.05,the difference was not statistically significant.8.The differences of UA and NLR between different groups of left ventricular configuration were compared.The levels of UA in CR group were higher than those in EH and NG groups,higher in EH group than in EH group,and higher in CH group than those in EH,CR and NG groups There was statistical significance(P <0.05).NLR levels in the left ventricular configuration group differences were not statistically significant(p> 0.05).Conclusion:1.Blood NLR level is positively correlated with EH combined with LVH,which is an independent risk factor for LVH.2.There was a gender difference in the serum UA level of EH combined with LVH,with males higher than females.Serum UA level is positively correlated with EH combined with LVH,which is an independent risk factor for LVH.Blood UA has certain significance in diagnosing EH complicated with LVH.Serum UA level may have an effect on the left cardiac configuration of EH patients.