Application of endothelial markers detection in early target organ damage degree determination for patients with primary aldosteronism / 中国基层医药

ABSTRACT

Objective To compare plasma concentrations of biomarkers of endothelial dysfunction between patients with primary aldosteronism (PA) and essential hypertension (EH),and to determine whether elevated levels of these biomarkers could predict development of early organ damage .Methods 56 PA patients ( the observation group) and 56 EH patients(the control group) matched for age,sex,blood pressure and duration of hypertension were included in this study .The plasma levels of biomarkers reflecting endothelial dysfunction [ von Willebrand factor (vWF),soluble intercellular adhesion molecule 1(sICAM-1),oxidized low density lipoprotein(ox-LDL)]were detec-ted and compared between PA and EH patients .The left ventricular mass index ( LVMI) determined by echocardio-graphy,24-hour urinary protein quantitative determination and urinary albumin excretion rate ( UAER) were analyzed to evaluate early organ damage .Results ( 1 ) In the observation group , the plasma markers of endothelial damage vWF (133.4 ±54.9)%,sICAM-1 (412.1 ±75.2)μg/L and ox-LDL (13.7 ±9.0) U/L levels were higher than those in the control group(t=4.642,3.955,2.843,all P<0.05),and the observation group had a higher 24 h urina-ry protein(t=2.042,P<0.05) and LVMI(t=7.235,P<0.05).(2)Correlation analysis showed that LVMI was positively correlated with PAC,ox-LDL,vWF (r=0.447,0.385,0.393,P=0.020,0.046,0.029),and was nega-tively correlated with admission blood K +(r=-0.294,P<0.05).UAER was positively correlated with PAC,vWF and sICAM-1 (r=0.622,0.389,0.499,all P<0.05),and was negatively correlated with admission blood K +(r=-0.314,P<0.05).Conclusion Patients with PA have severer endothelial dysfunction reflected by multiple bio-markers and earlier organ damage than patients with EH ,and plasma aldosterone concentration and multiple endotheli-al dysfunction biomarkers could independently predict early organ damage .