ABSTRACT
Objective:To investigate the differences between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and insulin resistance (IR) and the relationship between Lp-PLA2 and IR and homocysteine (Hcy) levels in patients with type H and non-type H hypertension.Methods:A total of 298 patients with essential hypertension (observation group) who visited Lu′an Hospital of Traditional Chinese Medicine in Anhui Province from January 2018 to January 2020 were selected, and 564 healthy subjects were as control group. According to age, gender and body mass index (BMI), propensity score matching was conducted, and the matching relationship was determined according to 1∶1 nearest neighbor matching method. Finally, 166 cases were included in the observation group and the control group. Type H hypertension was defined as essential hypertension with an Hcy level of > 10 mol/L.Results:The smoking proportion, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FPG), fasting insulin (FINS), fibrinogen (FIB), hypersensitive C reactive protein (hs-CRP), LP-PLA2, Hcy, and homeostasis model of assessment for insulin resistance index (HOMA-IR) in the observation group were higher than those in control group: 24.7% vs. 13.9%, (5.06 ± 1.65) mmol/L vs. (4.60 ± 1.42) mmol/L, (2.92 ± 0.97) mmol/L vs. (2.62 ± 0.86) mmol/L, (5.80 ± 1.03) mmol/L vs. (5.12 ± 0.94) mmol/L, (13.06 ± 5.14) U/L vs. (9.25 ± 4.67) U/L, (3.28 ± 1.16) g/L vs. (2.17 ± 1.01) g/L, (2.00 ± 1.09) mg/L vs. (0.52 ± 0.43) mg/L, (161.98 ± 86.84) mg/L vs. (126.87 ± 56.84) mg/L, (15.00 ± 5.06) mol/L vs. (11.54 ± 3.63) mol/L and 3.49 ± 1.25 vs. 2.03 ± 1.11 ( P < 0.05), and the high density lipoprotein cholesterol (HDL-C) was lower than that in control group: (1.15 ± 0.56) mmol/L vs. (1.33 ± 0.66) mmol/L ( P < 0.05). The age, BMI, smoking ratio, TC, FPG, FINS, FIB, hs-CRP and Hcy in H-type hypertension group were higher than those in non-H-type hypertension group: (56.41 ± 11.07) years old vs. (49.61 ± 10.58) years old, (27.92 ± 4.02) kg/m 2 vs. (24.23 ± 4.11) kg/m 2, 31.1% vs. 14.3, (5.32 ± 1.54) mmol/L vs. (4.63 ± 1.24) mmol/L, (5.97 ± 1.03) mmol/L vs. (5.51 ± 0.98) mmol/L, (14.29 ± 5.04) U/L vs. (11.06 ± 4.57) U/L, (3.48 ± 1.10) g/L vs. (2.95 ± 0.83) g/L, (2.48 ± 1.21) mg/L vs. (1.22 ± 1.02) mg/L, 16.13 (12.96, 23.20) mol/L vs. 7.63 (6.58, 8.35) mol/L ( P < 0.05), and the HDL-C was lower than that in non-H-type hypertension group: (1.05 ± 0.54) mmol/L vs. (1.31 ± 0.78) mmol/L ( P < 0.05). HOMA-IR was 2.27 (1.60, 3.34) and Lp-PLA2 was 61.64 (53.25, 75.47) in patients with non-H-type hypertension. HOMA-IR was 3.34 (2.63, 443) and Lp-PLA2 was 212.25 (120.35, 278.62) in patients with type H-type hypertension. Lp-PLA2 and Lp-PLA2 were higher in patients with H-type hypertension than those in patients with non-H-type hypertension ( P < 0.05). In patients with essential hypertension, there was a strong positive correlation between Hcy and HOMA-IR and Lp-PLA2 ( r = 0.655 and 0.774, P < 0.05). Age, BMI, TC, FPG, FINS, FIB, hs-CRP, HOMA-IR and LP-PLA2 were independent risk factors for Hcy increase ( P < 0.05), while HDL-C was a protective factor for Hcy increase ( P < 0.05). Conclusions:Patients with type H-hypertension have a higher HOMA-IR and an increased level of Lp-PLA2, which is correlated with an increase in Hcy.