Effect of interaction between serum Hcy and carotid intima-media thickness on carotid plaque formation in elderly patients with hypertension

YIN Hong-jing; YIN Hong-shan; CHEN Tao; ZHANG Fu-e; QI Qi; GAO Chun-yan

doi:10.3969/j.issn.1672-5301.2024.08.014

Abstract：Objective To investigate the relationship between homocysteine(Hcy)level and carotid intima-media thickness in elderly patients with hypertension and the effect of Hcy on carotid plaque formation.Methods A total of 259 elderly patients with hypertension were selected from March 2020 to January 2022 in Hengshui People's Hospital.According to the quartile of serum Hcy level,the patients were divided into the Hl group(＜17.81 umol/L)64 cases,H2 group(17.81～20.93 umol/L)65 cases,H3 group(20.93～24.06 umol/L)65 cases and H4 group(＞24.06umol/L)65 cases.Carotid plaque formation was observed and carotid intium-media thickness(CIMT)was measured.Patients were divided into the plaque group(n=149)and no plaque group(n=110)according to plaque formation.Pearson correlation was used to analyze the correlation between serum Hcy and CIMT;multiple linear regression was used to analyze the risk factors of CIMT;and multiple logistic regression was used to analyze the influencing factors of CIMT increase and carotid plaque formation.Results There were statistically significant differences in smoking history,drinking history,total cholesterol,low density lipoprotein,serum Hcy,CIMT and carotid plaque formation rate among the four groups(P＜0.05).The total cholesterol,CIMT and carotid plaque formation rate(78.46％)in H4 group were significantly higher than those in the other three groups(P＜0.05),and the low density lipoprotein and serum Hcy were significantly higher than those in Hl and H2 groups(P＜0.05).The total cholesterol,low density lipoprotein,serum Hcy and CIMT in the plaque group were significantly higher than those in the non-plaque group(P＜0.05).Pearson correlation analysis showed that CIMT was positively correlated with age,smoking history,total cholesterol,low density lipoprotein and serum Hcy(r=0.298,0.178,0.214,0.293,0.305,P＜0.05)and negatively correlated with high density lipoprotein(r=-0.205,P＜0.05).The results of multiple linear regression analysis showed that age,high density lipoprotein,low density lipoprotein and serum Hcy were the influencing factors of CIMT(β=0.157,-0.211,0.204,0.269,P＜0.05).Multivariate logistic regression analysis showed that age,smoking history,total cholesterol,low density lipoprotein and serum Hcy were the independent risk factors for carotid artery plaque formation(β=0.864,0.243,1.546,0.026,0.549,P＜0.05)and high density lipoprotein was independent protective factor for carotid artery plaque formation(β=-1.207,P＜0.05).Conclusions Serum Hcy level in elderly hypertensive patients is an independent risk factor for carotid plaque formation,and is positively correlated with CIMT,which can be used as a clinical auxiliary diagnostic test for atherosclerosis.