Relationship between non-specific inflammatory markers and sortilin with ApoB/ApoA ratio in young patients with arterial hypertension

Introduction

The fact that hypertension is more common than expected even among professional groups with an active lifestyle, such as military personnel, athletes, and young activists, contradicts studies in recent years indicating that physical activity reduces the risk of hypertension (HT). This situation increases the need for a reliable biological marker, beyond classical methods, that could signal hypertension and clarify its pathophysiology.

Aim of the work

The objective of this study was to investigate, for diagnostic purposes, the relationship between non-specific inflammatory markers, and sortilin levels with the ApoB/ApoA ratio in hypertension detected in young men of Azerbaijan.

Materials and methods

A total of 120 randomly selected male patients, 55 hypertensive and 65 healthy, aged 23-45, who applied for a follow-up examination between 2023-2024 were assessed. The group of patients who were diagnosed with hypertension was selected from among the patients who had hypertension as a primary pathology. The study groups were randomly selected from people of approximately the same age (23–45 years). Subjects with secondary hypertension, subjects with comorbidities in addition to hypertension, cancer, rheumatic diseases, autoimmune diseases, subjects with infection or inflammation, and subjects taking anti-inflammatory or antihyperlipidemic drugs were excluded from the study.

Results

According to the correlation matrix analysis results, while no correlation was detected between DBP and the available parameters, a low to moderate positive correlation was observed between SBP values ​​and cholesterol, LDL, ApoB, ApoB/ApoA, hs-CRP, and sortilin levels. (Table 1)

ApoB, hs-CRP, and sortilin levels were found to be statistically significantly higher in the HT group compared to the control group (1.26±0.23 versus 0.88±0.22 g/L, 3.1±1.7 versus 1.7±0.8 mg/L, and 2.2±0.9 versus 1.6±0.7 ng/mL; p<0.01). It was determined that there were significant positive correlations between SBP values and ApoB, hs-CRP, and sortilin levels (rs = 0.5201, rs = 0.5369, and rs = 0.4823; p <0.0001). In the ROC analysis for the diagnosis of HT, the performance of ApoB (cutoff >0.96 g/L), hs-CRP (>2.6 mg/dL) and sortilin (>1.64 ng/mL); Its sensitivity was 89.09%, 58.18% and 74.55%, its specificity was 80.62%, 96.92%, and 64.62%, and its AUC value was 0.887, 0.812 and 0.738, respectively (p<0.0001) (Figure 2).

Conclusion

Biomarkers ApoB, especially ( ApoB/ApoA ratio), hs-CRP, and sortilin independently demonstrate a close relationship with hypertension. It was found that sortilin, which causes various metabolic effects by triggering biological reactions in the cell, hs-CRP, which is an indicator of the proinflammatory process, and ApoB, which is involved in lipid metabolism, can be effectively used in the diagnosis and monitoring of arterial hypertension when used together.