The study of C reactive protein, plasma fibrinogen, urinary albumin creatinine ratio and superoxide dismutase as biomarkers in hypertension
Journal Title: Medpulse International Journal of Biochemistry - Year 2018, Vol 8, Issue 2
Abstract
Objective: To study four biomarkers from distinct biological pathways that lead to hypertension, namely high sensitivity C reactive protein (hs CRP), fibrinogen, urinary albumin Creatinine ratio(UACR) and superoxide dismutase(SOD). Methods and Results: This was a retrospective study for a period of 3 months of 100 new hypertensive subjects of 30 to 45 age were compared to 50 age matched controls at a tertiary care hospital. After Univariate analysis of logistic regression, age and gender wise, male beyond 36 years shows a high risk for hypertension; hs CRP rise (odds ratio [OR]=23.91,sensitivity 75%,specificity 100%; p=0.000) was identified as the best diagnostic biomarker with a 23.9 folds risk of hypertension ,fibrinogen (OR=11.93 sen 52%,sp 98%; p=0.000), UACR (OR=11.93,sen 50%,sp 94%;p=0.000) and SOD (OR=2.44 sen 21%,sp 98%;p=0.005) in the order were significantly associated with development of hypertension. The highest discriminative value for diagnosis of hypertension was observed with raising levels of hs CRP(area under receiver operating characteristic curve [AUC]= 0.863), fibrinogen (AUC=0.832) and UACR (AUC=0.888). SOD levels were of lower significance (AUC=0.640) as compared to controls(p=0.014) and the enzyme activity was actually plummeted in severe hypertension, making this as a weak biomarker for the disease. ROC curve analysis gives a best cutoff levels for the diagnosis of hypertension as hs CRP >1.35mg/L; fibrinogen 445mg/dL; UACR >34.35 µg/mg Cr; and SOD >144.25 U/g protein. Multiple comparisons by post HOC tests for the 3 groups (stage1 and2 hypertension subjects and controls) reveal that hs CRP and UACR values rose significantly from normal to disease but not further whereas for fibrinogen, the levels further increased with raise in blood pressure. SOD was of lower significance when compared to the other 3 biomarkers in this study. Conclusion: Biomarkers of different pathophysiology mechanisms of development of hypertension, which are easily available for lab testing, can be used to predict ‘on track’ hypertensives for a routine health screen along with monitoring of blood pressure.
Authors and Affiliations
Pavani Kiranmai Thandu, Suresh Babu Ganji, Ravirala Tagore
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