Metabolic Characteristics Of Plasma Amino Acids Level In Essential Hypertensive Patients And Correlation With Carotid Atherosclerosis

Objective:We detect of plasma amino acids level in patients with essential hypertension(EH),and observe the metabolic characteristics of plasma amino acids level in patients with EH,analyze the relationship between plasma amino acids level and carotid intima-media thickness(c IMT),and look for new risk factors for carotid atherosclerosis formation in EH.It may provide theoretical basis for the prevention,treatment and intervention of carotid atherosclerosis formation in EH.Methods:A total of 399 cases of EH patients were selected from August 2018 to September 2019,and 49 healthy volunteers were selected as the control group.The general data of gender,age,smoking history,drinking history,medication history,height,weight,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP)were recorded,and the biochemical indicators such as serum creatinine(Cr),blood urea nitrogen(BUN),blood uric acid(UA),total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),high-sensitivity C-reactive protein(Hs-CRP),fasting plasma glucose(FPG),glycated hemoglobin(Hb A1c).Tandem mass spectrometry was used to detect plasma amino acids level in all patients,the neck vascular ultrasound to determine the c IMT.The metabolic characteristics of plasma amino acids level in EH patients were analyzed,and the differences in plasma amino acids level between different genders of EH patients were compared.According to c IMT,the patients were divided into 220 cases plaque positive group and 179 cases plaque negative group,further analyzed the differences of plasma amino acid levels in EH patients with carotid atherosclerosis positive group and negative group.Divided into three groups according to the level of BMI:A1 group(BMI<24Kg/m2),A2 group(24Kg/m2?BMI<28Kg/m2),A3 group(BMI?28Kg/m2),compared the differences in BCAAs between the three groups.Divided into four groups according to the quartile of plasma BCAAs level: B1 group(BCAAs?223.47?mol/L),B2 group(223.47?mol/L <BCAAs?257.13?mol/L),B3 group(257.13?mol/L<BCAAs?296.03?mol/L),B4 group(BCAAs>296.03?mol/L),compared the differences in c IMT between the four groups.Spearman was used to analyze the correlation between different plasma amino acids level and carotid atherosclerosis,and through the binary multivariate Logistic stepwise regression analysis to determine which plasma amino acid is an independent risk factor for carotid plaque formation in EH patients.Mapping Roc curve to evaluate the predictive value of BCAAs for carotid atherosclerosis in EH.Results:1.The plasma amino acids had the following distribution characteristics in the EH patients group,to compared with the healthy control group:asparagine,citrulline,leucine,phenylalanine,valine,branched chain amino acids,aromatic amino acids,branched chain amino acids/aromatic amino acids were higher than the control group,and arginine was lower than the control group,the difference was statistically significant(P<0.05).2.There were gender differences with plasma amino acids level in EH patients,among which asparagine,leucine,methionine,phenylalanine,proline,valine,branched chain amino acids,branched chain amino acids/aromatic amino acids were higher in male group than female group,and piperonamide was lower than female group,the difference was statistically significant(P <0.05).3.Plasma alanine,asparagine,leucine,phenylalanine,proline,valine,branched chain amino acids,aromatic amino acids,branched chain amino acids/aromatic amino acids level in patients with EH in the plaque positive group were higher than those in the plaque negative group,the difference was statistically significant(P<0.05).4.There were differences in BCAAs level between different BMI groups.A3 group BCAAs(277.29±55.54?mol/L)was higher than A1 group(242.72±43.25?mol/L),the difference was statistically significant(P<0.05).5.There were differences in c IMT level between different BCAAs groups.B4 group(1.659±1.150mm)was higher than that B1 group(1.074±1.104mm),the difference was statistically significant(P<0.05).6.Spearman correlation analysis the carotid atherosclerosis,and found that carotid atherosclerosis is related to leucine(r = 0.184),valine(r = 0.154),branched chain amino acids(r = 0.194)and branched chain amino acids/aromatic amino acids(r = 0.102)were positively correlated,the difference was statistically significant(P<0.05).7.Binary logistic regression analysis showed that increased age(OR = 1.032),elevated SBP(OR = 1.017),elevated branched chain amino acids(OR = 1.008),and diabetes(OR = 2.173)were the risk factors for carotid plaque formation in patients with EH.Female(OR = 0.464)and elevated HDL-C(OR = 0.394)were protective factors for carotid plaque formation in patients with EH.8.The area under the curve of BCAAs level was 0.631,calculate the BCAAs Yordon index corresponding to critical value was 262.86?mol/L,the difference was statistically significant(P<0.05).Conclusion:1.The plasma level of asparagine,citrulline,leucine,phenylalanine,valine,branched chain amino acids,aromatic amino acids,branched chain amino acids/aromatic amino acids in patients with EH were increased,and arginine level was low.Increased level of alanine,asparagine,leucine,phenylalanine,proline,valine,branched chain amino acids,aromatic amino acids,branched chain amino acids/aromatic amino acids and carotid plaque formation in patients with EH closely related.There were gender differences in plasma amino acids level in EH patients,among male asparagine,leucine,methionine,phenylalanine,proline,valine,branched chain amino acids,branched chain amino acids/aromatic amino acids were significantly higher than women,piperonamide level was lower than women.2.There was a positive correlation between BMI and plasma BCAAs in EH patients,and a positive correlation between plasma BCAAs and c IMT.Plasma BCAAs were an independent risk factor for carotid plaque formation in patients with EH.3.BCAAs>262.86?mol/L is a cut-off point for diagnosis of carotid atheromatous plaque formation in patients with EH,and has certain clinical application value for predicting carotid plaques in patients with EH.