Evaluation of atherogenic index of plasma levels at hypertensive patients

Abstract

Aim: Hypertension is a major risk factor for cardiovascular system. Recent studies showed that atherogenic index of plasma (AIP) has a strong association with cardiovascular morbidity, all-cause mortality, atherosclerosis and severity of coronary artery disease. It also has a relationship with endothelial damage in hypertensive patients. With this study we aim to investigate the association between AIP and hypertension.

Methods: A total of 213 patients were enrolled for the study. Patients with previous hypertension, nephrotic syndrome, diabetes mellitus, hypotiroidism diagnosis, patients under statin treatment and patients under 18 years of age were excluded. Diagnosis of hypertension and blood pressure (BP) results were obtained with 24-hour ambulatory blood pressure monitoring (ABPM). AIP was defined as the logarithmic transformation of the triglyceride to high-density lipoprotein-cholesterol ratio.

Results: Mean age of the population was 49.2 ± 14.6 years and 41.8% (n=89) was male. According to 24-hour ABPM results, AIP was positively correlated with day-time systolic blood pressure (SBP) (r=0.244, p<0.001), day-time diastolic blood pressure (DBP) (r=0.276, p<0.001), night-time SBP (r=0.259, p<0.001), night-time DBP (r=0.299, p<0.001), average SBP (r=0.213, p=0.002) and average DBP (r=0.296, p<0.001). AIP was also increased in hypertensive patients compared to normotensive subjects (p=0.001).

Conclusion: Results of our study showed that AIP was positively correlated with blood pressure and statistically higher in patients with hypertension.

Keywords

• Atherogenic index of plasma,hypertension,blood pressure,ambulatory blood pressure monitoring

Hipertansif hastalarda plazma aterojenik indeks düzeylerinin incelenmesi

Öz

Amaç: Hipertansiyon, kardiyovasküler sistem için önemli risk faktörlerinden biridir. Son dönemde yapılan araştırmalar, plazma aterojenik indeksinin (PAİ) kardiyovasküler morbidite, tüm nedenlere bağlı ölüm, ateroskleroz ve koroner arter hastalığının ciddiyeti ile güçlü bir ilişkisi olduğu gösterilmiştir. Ayrıca hipertansif hastalarda endotel hasarı ile ilişkisi vardır. Biz bu çalışma ile PAİ ile hipertansiyon arasındaki ilişkiyi araştırmayı amaçladık.

Yöntemler: Çalışmaya toplam 213 hasta alındı. Daha önce hipertansiyon, nefrotik sendrom, diyabetes mellitus, hipotiroidizm tanısı olan, statin tedavisi alan ve 18 yaşın altındaki hastalar çalışmadan dışlandı. 24 saatlik ambulatuvar kan basıncı ölçümü ile hipertansiyon tanısı ve kan basıncı (KB) sonuçları alındı. PAİ, trigliseritin yüksek yoğunluklu lipoprotein kolesterol oranının logaritmik dönüşümü olarak tanımlandı.

Bulgular: Çalışmaya katılan hastaların yaş ortalaması 49,2 ± 14,6 yıl idi ve % 41,8'ü (n = 89) erkekti. 24 saatlik ambulatuar kan basıncı ölçümü sonuçlarına göre, PAİ, gündüz sistolik kan basıncı (SKB) (r=0,244, p<0,001), gündüz diyastolik kan basıncı (DKB) (r=0,276, p<0,001), gece SBP (r=0,259, p<0,001), gece DKB (r=0,299, p<0,001), ortalama SKB (r=0.213, p=0,002) ve ortalama DKB (r=0,296, p<0,001) ile pozitif olarak korele idi. Hipertansif hastalarda PAİ normotansif hastalara göre istatistiksel olarak anlamlı düzeyde yüksekti (p=0,001).

Sonuç: Çalışmamızın sonucunda PAİ'nin kan basıncıyla pozitif olarak korele olduğu ve PAİ değerlerinin hipertansif hastalarda istatistiksel açıdan anlamlı şekilde yüksek olduğunu saptamıştır.

Anahtar Kelimeler

• Plazma aterojenik indeksi,hipertansiyon,kan basıncı,24 saatlik ambulatuar kan basıncı ölçümü

Kaynakça

1. 1. Kwiterovich PO Jr. Lipoprotein heterogeneity: diagnostic and therapeutic implications. Am J Cardiol. 2002;90:1i-10i.
2. 2. NIH Consensus conference. Triglyceride, high-density lipoprotein, and coronary heart disease. NIH Consensus Development Panel on Triglyceride, High-Density Lipoprotein, and Coronary Heart Disease. JAMA. 1993;269:505–10.
3. 3. Shen S, Lu Y, Qi H, Li F, Shen Z, Wu L, et al. Association between ideal cardiovascular health and the atherogenic index of plasma. Medicine (Baltimore). 2016;95:e3866.
4. 4. Niroumand S, Khajedaluee M, Khadem-Rezaiyan M, Abrishami M, Juya M, Khodaee G, et al. Atherogenic index of plasma (AIP):a marker of cardiovascular disease. Med J Islam Repub Iran. 2015;29:240.
5. 5. Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001;34:583–8.
6. 6. Dobiasova M. AIP-atherogenic index of plasma as a significant predictor of cardiovascular risk: from research to practice. Vnitr Lek. 2006;52:64–71.
7. 7. Zhu XW, Deng FY, Lei SF. Meta-analysis of atherogenicindex of plasma and other lipid parameters in relation to risk of type2 diabetes mellitus. Prim Care Diabetes. 2015;9:60–7.
8. 8. Moura Rdo S, Vasconcelos DF, Freitas E, Moura FJ, Rosa TT, Veiga JP. Cystatin C, CRP, log TG/HDLc and metabolic syndrome are associated with microalbuminuria in hypertension. Arq Bras Cardiol. 2014;102:54-9.

9. 9. Onat A, Can G, Kaya H, Hergenç G. "Atherogenic index of plasma" (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. .J Clin Lipidol. 2010;4:89-98.
10. 10. Connelly PW, Petrasovits A, Stachenko S, MacLean DR, Little JA, Chockalingam A. Prevalence of high plasma triglyceride combined with low HDL-C levels and its association with smoking, hypertension, obesity, diabetes, sedentariness and LDL-C levels in the Canadian population. Canadian Heart Health Surveys Research Group. Can J Cardiol. 1999;15:428-33.
11. 11. Gaziano JM, Hennekens CH, O’Donnell CJ, Breslow JL, Buring JE. Fasting triglycerides, high-density lipoprotein and the role of myocardial infarction. Circulation. 1997;96:2520–5.
12. 12. McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139:802–9.
13. 13. Yildiz G, Duman A, Aydin H, Yilmaz A, Hür E, Mağden K, et al. Evaluation of association between atherogenic index of plasma and intimamedia thickness of the carotid artery for subclinic atherosclerosis in patients on maintenance hemodialysis. Hemodial Int. 2013;17:397–405.
14. 14. Dobiásová M, Frohlich J, Sedová M, Cheung MC, Brown BG. Cholesterol esterification and atherogenic index of plasma correlate with lipoprotein size and findings on coronary angiography. J Lipid Res. 2011;52:566–71.
15. 15. Grammer TB, Kleber ME, März W, Silbernagel G, Siekmeier R, Wieland H, et al. Low-density lipoprotein particle diameter and mortality:The Ludwigshafen risk and cardiovascular health study. Eur Heart J. 2015;36:31–8.
16. 16. Robles NR, Macias JF. Hypertension in elderly. Cardiovasc Hematol Agents Med Chem. 201512:136-45.
17. 17. Shimizu Y, Nakazato M, Sekita T, Kadota K, Arima K, Yamasaki H, et al. Association between the hemoglobin levels and hypertension in relation to the BMI status in a rural Japanese population: the Nagasaki Islands Study. Intern Med. 2014;53:435-40.
18. 18. Krishnamoorthy P, Gopalakrishnan A, Mittal V, Kalla A, Slipczuk L, Rangaswami J, et al. Gaisböck syndrome (polycythemia and hypertension) revisited: results from the national inpatient sample database. J Hypertens. 2018;36:2420-4.
19. 19. Huisman A, Aarnoudse JG. Increased 2Nd Trimester Hemoglobin Concentration in Pregnancies Later Complicated by Hypertension and Growth Retardation: Early Evidence of a Reduced Plasma Volume. Acta Obstet Gynecol Scand. 1986;65:605-8.