Relationship between sortilin with ApoB/ApoA ratio in military personnel with arterial hypertension

Relationship between sortilin with ApoB/ApoA ratio in military personnel with arterial hypertension | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Relationship between sortilin with ApoB/ApoA ratio in military personnel with arterial hypertension Ilaha Abdurahmanova, Sona Gahramanova, Vesadet Azizov, esmira nasibova This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7031957/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background The study investigates the relationship between sortilin levels and the ApoB/ApoA ratio in military personnel with arterial hypertension. Methods A cross-sectional analytical study involving 120 male military personnel was conducted. Biochemical, hematological, and ELISA measurements were performed. Results Sortilin, ApoB, ApoB/ApoA ratio, and hs-CRP levels were significantly higher in the hypertensive group and correlated with systolic blood pressure. ROC analysis confirmed their diagnostic value. Conclusion Sortilin, ApoB, and hs-CRP are closely associated with hypertension and may serve as biomarkers for diagnosis and monitoring. Health sciences/Biomarkers Health sciences/Cardiology Health sciences/Diseases Health sciences/Medical research Health sciences/Risk factors Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Arterial hypertension (AH) is one of the most common risk factors for the development of cardiovascular diseases and premature death worldwide [ 2 , 3 , 7 ]. In recent decades, the attention of researchers has been drawn to its manifestation and development in young people, including military personnel, who are often exposed to stress, high physical activity and specific service conditions [ 4 , 8 ]. In this context, it is important to understand how AH in young men can be associated with changes in the lipid profile and inflammatory processes in the body. The lipid profile, including cholesterol levels (including total, LDL, HDL and triglycerides), has a significant impact on the state of the vascular endothelium and the development of atherosclerosis, which is a key link in the pathogenesis of arterial hypertension [ 1 , 5 ]. In turn, chronic inflammatory processes play an important role in the activation of endothelial dysfunctions and the progression of hypertension [ 11 , 12 , 13 ]. This problem is especially acute in young military personnel, as they are exposed to physical overload, prolonged stress and specific psychological stress, which can be catalysts for the development of hypertension and its complications. The higher than expected prevalence of hypertension, even in occupational groups leading an active lifestyle, such as military personnel, contradicts recent studies reporting that physical activity is associated with a reduced risk of arterial hypertension (AH). This situation increases the need for a reliable biological marker that can be a precursor to hypertension and clarify its pathophysiology, in addition to classical methods. Aim of the work The objective of this study was to investigate, for diagnostic purposes, the relationship between sortilin levels with the ApoB/ApoA ratio in hypertension detected in military personnel serving in the armed forces of Azerbaijan. Materials and methods Ethics Statement All methods were carried out in accordance with relevant guidelines and regulations. Ethical approval for this study was obtained from the Ethics Committee of the Azerbaijan Medical University (Protocol No. 13, dated 15.06.2022). • Study design The study is a single-center, observational, cross-sectional analytical study. In order to achieve the planned sample size, approximately 220 male military personnel who applied to the Medical Center of the Ministry of Emergency Situations of the Republic of Azerbaijan for a follow-up examination. After the participants were informed about the study, consent forms were obtained. After recording the demographic characteristics of the participants, visual and physical examinations were performed. Blood pressure values ​​were measured in systolic and diastolic modes using the same tonometer (Bosh + Sohn, Germany). Biochemical studies (cholesterol, triglycerides, LDL, VLDL) and hemogram were performed using these blood samples. After laboratory testing, excess serum was stored at -80°C. These sera were stored until the day of testing for ApoB,ApoA, hs-CRP, and sortilin. As a result of the examination, 55 male servicemen with arterial hypertension and 65 healthy male servicemen were randomly selected. The group of patients who were diagnosed with hypertension was selected from among the patients who had hypertension as a primary pathology. Subjects with secondary hypertension, subjects with comorbidities in addition to hypertension (such as cardiovascular, renal and liver diseases), subjects with cancer (myelodysplastic syndrome, leukemia and lymphoma arising in the blood, bone marrow and lymph nodes), rheumatic diseases affecting the levels of inflammatory markers (such as IL-6, TNF-α and hs-CRP) (such as rheumatoid arthritis, SLE, ankylosing spondylitis, acute rheumatic fever), autoimmune diseases (such as Sjogren's disease, Hashimoto's thyroiditis, celiac disease, multiple sclerosis, inflammatory bowel disease), subjects with infection or inflammation, and subjects taking anti-inflammatory or antihyperlipidemic drugs were excluded from the study. Biochemical and Hematological Measurements Hemogram measurements were performed on EDTA blood of all participants using an automatic hematology analyzer (Mindray BC-600, China). In addition, high-sensitivity C-reactive protein (hs-CRP), ApoA, ApoB, cholesterol, LDL and VLDL levels were measured in blood collected in plain tubes using a biochemistry autoanalyzer (Roche Cobas C 702, Mannheim, Germany). Inappropriate sample collections, clotted and excessively hemolyzed samples were not included in the study. Quality control studies were completed before all measurements. • ELISA Measurements BT lab brand ELISA Kits (Shangai, China) were used to measure sortilin levels. The sensitivity of the kit was 0.94 ng/L and the measurement range was 2-600 ng/L, respectively. The intra-study coefficient of variation was < 10%. Measurements in the study were performed using BIO-TEK ELx500 ELISA Reader and BIO-TEK ELx50 (USA) wash devices. Statistical Analysis SPSS Statistic Software version 25 (IBM Corp, Chicago, USA) was used for the analysis of statistical data of this study. Statistical data were collected in Microsoft Excel 2010 Office program. Bar plots were used for graphical representation of nonparametric data. Chi-square test was used for evaluation of categorical data when comparing differences between groups. Kolmogorov-Smirnov test was used to evaluate whether the study data were normally distributed. Student t test was applied for parametric data and Mann-Whitney U test was applied for nonparametric data in comparisons of independent groups consisting of two groups. Spearman and Pearson correlation test were used for nonparametric data and parametric data, respectively, to determine correlations between independent variables. Receiver operating characteristic (ROC) analysis was used for the diagnostic performance of ApoB, ApoB/ApoA, hs-CRP, sortilin tests in determining HT. AUC value was accepted as a practical measure of test performance in determining the diagnostic adequacy of the tests. For the minimum acceptable discrimination power, an AUC value of > 0.70 was accepted. If the AUC was between 0.8 and 0.9, the test was assumed to have high discrimination ability, and if AUC was > 0.9, it was assumed to have very high (excellent) discrimination ability. Results • Comparison of Demographic and Clinical Features As a result of the study, the mean ages of the control (M/F: 65/0) and hypertensive patient (M/F: 55/0) groups were 36 ± 8 (23–46) and 37 ± 8 (23–45) years, respectively; mean BMI values ​​were 23.5 ± 2.4 (17.8–29.8) and 23.6 ± 2.6 (16.8–30.8) kg/m2, respectively (Table 1). There was no difference between the groups formed from the male population in terms of age and BMI (p > 0.05) (Fig. 1). Therefore, the differences we detected between the groups in terms of other parameters were accepted to be independent of these three demographic features. Table 1 Comparison of demographic characteristics and blood pressure values ​​of the study groups Patrametrs All Groups HT Patient Group (A) Control Group (B) P-value n, E 120 55 65 - Gender, M (%) (%) 120(%100) 55(%100) 65(%100) Ø Age, years 36 ± 8 37 ± 8 36 ± 8 b 0,6235 BMI, kg/m 2 23,5 ± 2,5 23,6 ± 2,6 23,5 ± 2,4 b 0,7705 Waist circumference, sm 80 ± 8,0 82 ± 7,7 78 ± 7,7 b 0,0029* SBP, mm/Hg 129 ± 22 128(100–170) 150 ± 9 149(124–170) 111 ± 10 107(100–133) a <0,0001* DBP, mm/Hg 69 ± 9 68(48–90) 69 ± 9 68(50–87) 69 ± 9 69(48–90 a 0,3633 When the study groups were examined in terms of waist circumference (WC), WC was found to be higher in the HT patient group (p = 0.0029) (Table 1). Table 2 Comparison of biochemical parameters of groups Parametrs HT Patient Group (A) Control Group (B) p value N 55 65 - Cholesterol, mmol/L 5,79 ± 1,38 5,73(2,89 − 9,65) 4,10 ± 1,08 4,01(2,58 − 7,15) a <0,0001* Triglyceride, mmol/L 3,09 ± 2,75 2,24(0,44 − 15,04) 2,80 ± 0,80 2,82(0,91 − 4,69) a 0,1644 LDL, mmol/L 2,92 ± 1,09 2,86(0,50 − 4,83) 2,28 ± 0,72 2,10(1,20 − 4,21) a 0,0005* VLDL, mmol/L 1,4 ± 1,3 1,0(0,2–6,8) 1,2 ± 0,4 1,2(0,4 − 2,1) a 0,4512 ApoA, gr/L 1,34 ± 0,22 1,24 ± 0,20 b 0,0083* ApoB, gr/L 1,26 ± 0,23 1,28(0,66 − 1,71) 0,88 ± 0,22 0,88(0,61 − 1,52) a <0,0001* ApoB/ApoA, 0,96 ± 0,20 0,73 ± 0,22 b <0,0001* • Comparison of Biochemical Parameters When the groups were evaluated in terms of lipid profiles, cholesterol, LDL, ApoA and ApoB levels were statistically higher in the HT patient group (p < 0.01) (Fig. 1 A,B, Fig. 2 A,B). Similarly, ApoB/ApoA values, which are a calculation parameter, were also found to be higher in the HT patient group (p < 0.0001) (Fig. 2C). • Comparison of preinflammatory biomarker and sortilin levels When the groups were examined in terms of inflammatory biomarkers (Table 3), the hs-CRP of the HT patient group, and sortilin were found to be statistically significantly higher compared to the control group (Fig. 3A-B). Table 3 Comparison of inflammatory biomarker and sortilin values ​​of groups Parametrs HT Patient Group (A) Control Group (B) P value N 55 65 - Hs-CRP, mg/L 3,1 ± 1,7 1,7 ± 0,8 b <0.0001* Sortilin, ng/mL 2.2 ± 0.9 2.1(0.6–5.5) 1,6 ± 0,7 1,4(0,8 − 4,6) a <0.0001* a Mann-Whitney U Test, b Unpaired t test, * Statistical significance level p < 0.05. Nonparametric data are given as mean ± SD and median (min-max), parametric data are given as mean ± SD. SD: Standard deviation, hs-CRP: high sensitive CRP-reactive protein. According to the correlation matrix analysis results (Table 5), 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. There was a moderate positive correlation between SBP and ApoB and ApoB/ApoA levels (rs = 0.5369, 95% CI: 0.3912–0.6564; p < 0.0001 and Spearman r = 0.4608, 95% CI: 0.3020–0.5947; p < 0.0001, respectively) (Fig. 4). Table 4 Correlation matrix analysis between blood pressure, lipid profiles and sortilin parameters of all study groups A: B: C: D: E: F: G: H: I: J: K: L: M: A:SBP 1.0000 B:DBP -0.0245 1.0000 C:CHol 0.5275 -0.1668 1.0000 D:TG 0.0742 -0.0310 0.3026 1.0000 E:LDL 0.3073 0.0614 0.4058 0.1397 1.0000 F:VLDL 0.0919 -0.0514 0.3215 0.9800 0.1130 1.0000 G:ApoA 0.2058 -0.0155 0.2468 -0.0951 0.1333 -0.0462 1.0000 H:ApoB 0.5703 -0.1824 0.7573 0.1719 0.3220 0.1868 0.2591 1.0000 I: ApoB/A 0.4817 -0.1766 0.5520 0.0598 0.2665 0.0467 -0.1013 0.7949 1.0000 K: Sortilin 0.4419 -0.0424 0.2827 0.0508 0.1920 0.0564 0.0096 0.2477 0.2059 0.2739 1.0000 M:hCRP 0.3702 -0.0601 0.3804 0.0867 0.2528 0.0880 -0.0174 0.3798 0.3390 0.2559 0.1731 0.4016 1.0000 In this cross-sectional study, in the relative risk (RR) analysis performed using a 2 x 2 table with Fisher's Exact Test, the RR value for serum sortilin level > 1.64 ng/mL (cutoff) in association with HT was found to be 2.63 (95% CI: 1.571–4.181; p 1.64 had a 2.563 times higher risk of having high SBP compared to those with low SBP. The RR value for ApoB cutoff value > 1 g/L was 5.318 (95% C`I: 2.967–9.534, p 2.6 mg/L was 3.519 (95% CI: 2.456–5.043, p < 0.0001). According to the odds ratio (OR) results determined in the binary logistic regression analysis, it was determined that a one-unit increase in sortilin levels increased the probability of HT by 2.639 times (p < 0.009) (Table 7). Similarly, it was calculated that a 1-unit (e.g. 1 gram) increase in ApoB and hs-CRP values ​​increased the probability of HT by 273.4 and 2.601 times, respectively (p < 0.01). When the ApoB value is expressed in mg/dL, the probability of HT will increase by 2.734 times for a 10 mg increase in ApoB (1 gram/L = 1000 mg/L = 100mg/dL for ApoB). At the best threshold value of the ApoB/ApoA ratio (> 0.8); sensitivity was found to be 90.91%, specificity was found to be 73.85% and AUC was found to be 0.834 (p 1.26 gr/L); sensitivity was determined as 65.5%, specificity as 61.5% and AUC as 0.638 (p < 0.0001). In addition, ApoB/ApoA ratio, which was determined to have sufficient discrimination ability; Since it was calculated from ApoB and ApoA values ​​and they are very similar to each other due to the high correlation between them (multicolinearity), the parameter with the highest performance will be preferred in the diagnosis of HT. In the ROC analysis performed to evaluate the diagnostic performance of ApoB, CRP and sortilin values ​​in determining HT, the best cut-off value of the ApoB test (> 0.96 g/L) was found to have sensitivity of 89.09%, specificity of 80.62% and AUC of 0.887 (p 2.6 mg/dL) was found to have sensitivity of 58.18%, specificity of 96.92% and AUC of 0.812 (p 1.64 ng/mL) was found to have sensitivity of 74.55%, specificity of 64.62% and AUC (Area Under The Curve) of 0.738 (p < 0.0001). If we summarize all statistical analysis results (statistical comparisons of groups, correlation, Binary regression and ROC analysis), it is indicated that ApoB, hs-CRP and sortilin tests show a close relationship with HT and that these tests can be used independently as predictive markers in HT prediction. In addition, it was determined that when all three were used together, they could predict HT status with approximately 86% accuracy. Therefore, using sortilin, which is known for its effects on glucose, lipid metabolism, energy, endothelial and neurological function, vascular tone, inflammation and atherosclerosis, cell communication and blood pressure, together with hs-CRP, a proinflammatory marker, and ApoB, which plays a critical role in lipid metabolism, will be useful in the diagnosis and follow-up of HT patients. Discussion Since hypertension is a multifactorial disease, it also requires investigation using various laboratory diagnostic methods due to the presence of many factors in its pathogenesis [ 14 , 16 , 18 ]. It should be noted that various methods and criteria are used in the diagnosis of hypertension, but simple laboratory parameters that can confirm these criteria are still needed [ 18 , 19 ] By now, it seems established that sortilin plays a part in the development of dyslipidemia and associated diseases, e.g, atherosclerosis. The question is in what way. Findings in separate strains of knockout mice strongly suggest that sortilin deficiency is protective and lowers the level of circulating LDL-C and cholesterol. In humans, however, low levels of sortilin (in carriers of the major haplotype/allele) are paralleled by an increased risk of developing hyperlipidemia and disease. [ 32 , 33 , 34 ]. Sortilin is a signaling and protein transport receptor that plays an important role in various cellular functions. The main ligands of sortilin are neurotensin, progranulin, and lipoprotein lipase [ 23 , 24 , 27 , 29 ]. Its main functions include intracellular transport and sorting of proteins, in particular, cellular signaling that triggers biological reactions. [ 34 , 35 ]. It promotes accurate transport and incorporation of proteins into target cellular sites in the Golgi apparatus and endosomal system [ 27 , 28 ]. It also plays an important role in endocytosis in the cell. Namely, when sortilin binds to its ligands, the resulting ligand-receptor complexes enter the cell and the process of endocytosis is initiated. In this way, signals or molecules coming from outside the cell are transmitted into the cell [ 10 , 13 ]. It regulates lipid metabolism by acting on the enzyme lipoprotein lipase and is involved in the uptake and metabolism of lipids in the cell. These various functions of sortilin are important for maintaining cellular order and homeostasis. Thus, the study of sortilin is important for understanding cellular metabolism and pathological processes, and possibly for developing treatments [ 11 , 12 ]. Sortilin is associated with many diseases and pathologies. Among them, it is associated with neurodegenerative diseases such as Alzheimer's disease, cancers such as breast cancer and pancreatic cancer, metabolic disorders such as metabolic syndrome, obesity and type 2 diabetes, as well as cardiovascular pathologies and hypertension due to the development of atherosclerosis [ 25 , 26 , 28 ]. However, no definitive conclusion has been made regarding the use of sortilin in the diagnosis of cardiovascular pathology and hypertension. In light of the above information, this study investigated the possibility of using sortilin alone or in combination with other biomarkers as a prognostic marker for understanding and diagnosing the pathophysiology of hypertension, the most common disease today. The study conducted among young and middle-aged (23–45 years) male military personnel compared the SBP and DBP values ​​in individuals diagnosed with hypertension with healthy individuals and revealed that only the SBP values ​​differed in individuals diagnosed with hypertension, which suggests that pathologies affecting the processes associated with vascular tone are more pronounced in this group of patients. In addition, the higher level of sortilin in the AH group confirms our opinion. Again, higher levels of cholesterol, ApoB and LDL, which accelerate atherosclerosis of the vascular structure and affect systolic blood pressure, were found in the AG group and were associated with the protein sortilin, which plays an important role in lipid metabolism. The results of the study conducted by Chu and colleagues (Chu X) also confirm our findings. Researchers have reported that sortilin, which plays a role in glucose and lipid metabolism, is associated with hypertension, coronary heart disease, and carotid atherosclerosis [ 18 , 19 , 20 ]. Again, some researchers have reported an association between inflammatory markers such as hs-CRP and hypertension, which is consistent with our study [ 29 , 30 ]. However, there are also studies reporting no difference between hs-CRP (or other inflammatory markers) and hypertension [ 24 , 27 ]. The possible reason for this may be due to the characteristics of the selected patient population or the lack of exclusion criteria. In our study, the detection of significant correlations between SBP and hs-CRP, cholesterol, ApoB, ApoB/ApoA, and sortilin was considered as evidence that hypertension occurs as a manifestation of a complex relationship between lipid metabolism, inflammation, and sortilin. In addition, the significant correlation of sortilin values ​​with cholesterol, ApoB/ApoA indicates the existence of this complex relationship. In other words, many factors play a role in the development of hypertension, and the impact of each factor on the development of hypertension will be different. In this study, the finding that high levels of sortilin, ApoB and CRP increase the risk of hypertension confirms our prediction above. Most of the parameters used in the diagnosis of diseases are not sufficient evidence on their own. Therefore, several additional auxiliary parameters are needed. The best evidence for this was the results of the logistic regression analysis for the prediction of pelvic organ hypertrophy. It was found that ApoB and sortilin together explained 79% of the prediction of hypertension status. This finding indicates that sortilin or ApoB markers alone may not be sufficient. Moreover, in ROC analyses, no parameter achieved sufficient diagnostic power to be used alone. Conclusion In this study, we investigated the relationship between the ApoB/ApoA ratio with sortilin, which has shown itself to be both an inflammatory and atherosclerotic factor, in hypertensive patients. The biomarkers hs-CRP, ApoB and sortilin independently demonstrate a close relationship with hypertension. It is believed 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. Declarations Author Contribution I.A. and S.G. designed the study and collected the data. I.A. performed the statistical analysis. S.G. and V.A. interpreted the results. I.A. and S.G. wrote the main manuscript text. V.A. prepared the figures and tables. E.N. supervised the project, contributed to the final revision, and approved the manuscript. All authors reviewed and approved the final manuscript. Data Availability The data that support the findings of this study are available from the corresponding author upon reasonable request. Due to ethical restrictions and confidentiality regarding military personnel, the data are not publicly available. References C.Chrysohoou, C. & Pitsavos, D. B. and C.Stefanadis, Association between prehypertension status and imflammatory markers related to atherosclerotic disease; the ATTICA Study. // Am. J. Hypertens. -2004 Vol 17.-№ 7.-pp. 568–573 . Bautista, L. E., Vera, L. M., Arenas, I. A. & Gammara, G. Independent associationn between inflammatory markers (CRP, IL-6, and TNF-α.) and essensial hypertension // Journal of Human Hypertension – 2005. - Vol. 19.- № 2 - P. 149–154. Chae, C. H. & Lee, R. T. N.Rifai and P.M.Ridker. Blood pressure and inflammation in apparently healty men // Hypertension 2001.-Vol.38.- № 3.-P. 339–403. Interleukin-6 inhibition. attenuates hypertension and associated renal damage in Dahl salt-sensitive rats / S/Hashmat [et al] // Am. J. Physiol. Renal Physiol – 2016. Sep. Vol 311 N3-P F555-F561. Staessen, J. A. et al. Essent. Hypertens. Lancet ; 361 :1629–1641. (2003). Saxena, T., Ali, A. O. & Saxena, M. Pathophysiology of essential hypertension: an update. Expert Rev. Cardiovasc. Ther. 16 , 879–887 (2018). Allegra, B. et al. Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach. High Blood Press Cardiovasc Prev.;0.1007/s40292-015-0114-3. (2015). Katherine, T. M. et al. Global Disparities of Hypertension Prevelance and control. A. Systematic Analysis of Population Based Studies From 90 Countries // Circulation,-2016.-134.-P. 441–450 . Niklas, A. et al. Prevalence, awareness, treatment and control of hypertension in the adult Polish populationMulti-center National Population Health Examination SurveysWOBASZ studies. Arch. Med. Sci. 14 , 951–961 (2018). Harrison, D. G. et al. Weyand. Inflammation, Immunity and Hypertension // Hypertension.-2011.-57.-pp. 132–140. Mortensen, R. F. and W.Zhong, Regulation of phagocytic leukocyte activities by CRP // Journal of leukocyte Biology.-2000.-Vol .67-№4.-p.495–500 V.Pasceri, J. T. & Yeh, E. T. H. Direct proinflammatory effect of CRP on human endothelial cells. //Circulation -2000.-102.-№18.-p. 2165–2168 . Bautista, L. E., Vera, L. M., Arenas, I. A. & Gammara, G. Independent associationn between inflammatory markers (CRP, IL-6, and TNF-α.) and essensial hypertension // Journal of Human Hypertension – 2005. - Vol. 19.- № 2 - P. 149–154. Zhao, S., Li, Q. & Liu, L. Z.Xu and J.Xiao Simvastatin reduces interleukin-1 beta secretion by peripherial blood mononuclear cells in patients with essensial hypertension. // Clin. China Acta -Vol 334 . - № 1.-P.195–200. 25, C. H. and P.M.Ridker. Blood pressure and inflammation in apparently healty men // Hypertension 2001.-38.- № 3.-P. 339–403 . X.Yu, Z. Y. and M.Yu, Correlation of tumor necrosis factor alpha and Il-6 with hypertensive renal damage. //Renal Failure.- Vol 39.- № 4. P. 475–479. Цитокины и артериальная гипертензия / Л.Е. Шинетова и др. // Вест. Каз. НМУ- 2017-№1-С. 264–268. 2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) Bryan Williams, Giuseppe Mancia, Wilko Spiering, Enrico Agabiti Rosei, Michel Azizi, Michel Burnier, Denis L et al. Saxena, T., Ali, A. O. & Saxena, M. Pathophysiology of essential hypertension: an update. Expert Rev. Cardiovasc. Ther. 16 , 879–887 (2018). HDE, Hinkle, D. E., Wiersma, W. & Jurs, S. G. Applied Statistics for the Behavioral Sciences 5th edn (Houghton Mifflin, 2003). Chu, X. et al. The association of plasma sortilin with essential hypertension and subclinical carotid atherosclerosis: A cross-sectional study. Front. Cardiovasc. Med. 9 , 966890. 10.3389/fcvm.2022.966890 (2022). Wians, F. H. Clinical laboratory tests: which, why, and what do the results mean? Lab. Med. 40 , 105–113 (2009). Faraggi, D. & Reiser, B. Estimation of the area under the ROC curve. Stat. Med. 21 , 3093–3106 (2002). Obuchowski, N. A., Lieber, M. L. & Wians, F. H. ROC curves in clinical chemistry: uses,misuses, and possible solutions. Clin. Chem. 50 , 1118–1125 (2004). Applied Logistic Regression. 2nd Ed. Chapter 5. John Wiley and Sons, New York, NY2000: 160–164. Kjolby, M. et al. Sort1, encoded by the cardiovascular risk locus 1p13.3,is a regulator of hepatic lipoprotein export. Cell. Metab. 12 , 213–223. 10.1016/j.cmet.20 (2010). Strong, A. et al. Hepaticsortilin regulates both apolipoprotein B secretion and LDL catabolism. J. ClinInvest . 122 , 2807–2816. 10.1172/JCI63563 (2012). Vaegter, C. B. et al. Sortilin associates with Trk receptors to enhance anterograde transport and neurotrophin signaling. Nat. Neurosci. 14 , 54–63. 10.1038/nn.2689 (2011). Angelakopoulou, A. et al. Comparative analysis of genome-wide association studies signals for lipids, diabetes, and coronary heart disease: cardiovascular biomarker genetics collaboration. Eur. Heart J. 33 , 393–407 (2012). Hu, F. et al. Sortilin-mediated endocytosis determines levels of the frontotemporal dementia protein. progranulin Neuron . 68 , 654–667 (2010). Klinger, S. C. et al. SorLA regulates the activity of lipoprotein lipase by intracellular trafficking. J Cell Sci. 2011. (2011) ed. Mortensen, M. B. et al. Targeting sortilin in immune cells reduces proinflammatory cytokines and atherosclerosis. J Clin Investig. ;124: 5317–22. First paper to show that lack of sortilin in bone marrow derived cells alone (e.g., T-cells and macrophages) attenuates the development of atherosclerosis. (2014). Smith, J. G. et al. Association of low-density lipoprotein cholesterol-related genetic variants with aortic valve calcium and incident aortic stenosis. JAMA 312 , 1764–1771 (2014). Sortilin Encoded by the Cardiovascular Risk Gene SORT1, and Its Suggested Functions in Cardiovascular Disease. Kjolby, M., Nielsen, M. S. & Petersen, C. M. Sortilin, encoded by the cardiovascular risk gene SORT1 , and its suggested functions in cardiovascular disease. Curr. Atheroscler Rep. 17 , 496. 10.1007/s11883-0150496-7 (2015). Corresponding author: Esmira Nasibova. Email [email protected] . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 26 Nov, 2025 Reviews received at journal 22 Nov, 2025 Reviewers agreed at journal 14 Nov, 2025 Reviews received at journal 06 Nov, 2025 Reviewers agreed at journal 04 Nov, 2025 Reviewers agreed at journal 04 Nov, 2025 Reviewers invited by journal 04 Nov, 2025 Editor assigned by journal 29 Oct, 2025 Editor invited by journal 25 Jul, 2025 Submission checks completed at journal 22 Jul, 2025 First submitted to journal 22 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7031957","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":540973750,"identity":"d63394cd-daa3-497e-8d8c-b1a7b2a13d0c","order_by":0,"name":"Ilaha Abdurahmanova","email":"","orcid":"","institution":"Azerbaijan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Ilaha","middleName":"","lastName":"Abdurahmanova","suffix":""},{"id":540973751,"identity":"e6e047c3-52a4-4da5-80f8-d3173d3dc50b","order_by":1,"name":"Sona Gahramanova","email":"","orcid":"","institution":"Azerbaijan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Sona","middleName":"","lastName":"Gahramanova","suffix":""},{"id":540973752,"identity":"6dc28162-e090-4111-b9eb-d17574278731","order_by":2,"name":"Vesadet Azizov","email":"","orcid":"","institution":"Azerbaijan Medical University","correspondingAuthor":false,"prefix":"","firstName":"Vesadet","middleName":"","lastName":"Azizov","suffix":""},{"id":540973753,"identity":"5453bf8e-c691-4846-9b44-02c3b6135631","order_by":3,"name":"esmira nasibova","email":"data:image/png;base64,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","orcid":"","institution":"Azerbaijan Medical University","correspondingAuthor":true,"prefix":"","firstName":"esmira","middleName":"","lastName":"nasibova","suffix":""}],"badges":[],"createdAt":"2025-07-02 18:23:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7031957/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7031957/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":95947065,"identity":"41aeee28-5661-4dc6-ad1d-3e5291d6e7f5","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1338310,"visible":true,"origin":"","legend":"","description":"","filename":"ScientificReportsRevisedwithEthicsCLEAN.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/d41bb70be62ce5442ccc2cd6.docx"},{"id":95947061,"identity":"adf18b7d-d758-45a6-ab62-89682448b270","added_by":"auto","created_at":"2025-11-14 18:02:52","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5241,"visible":true,"origin":"","legend":"","description":"","filename":"403f7390c3e243e384512589d435c4a4.json","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/d42fe2c76b0f64225bd52887.json"},{"id":96244677,"identity":"8e1cfee1-4616-47d6-9376-22a0ec6896a6","added_by":"auto","created_at":"2025-11-19 07:19:04","extension":"png","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":222700,"visible":true,"origin":"","legend":"","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/b3de89a2b013c41a11adb969.png"},{"id":96244799,"identity":"dc4c6818-6085-4f2d-94d9-b8871d399146","added_by":"auto","created_at":"2025-11-19 07:19:16","extension":"png","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":218549,"visible":true,"origin":"","legend":"","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/4f7cd3425cabc1ed6f576ed0.png"},{"id":96246189,"identity":"554248b2-d6ff-43ab-8155-842eeb754f1c","added_by":"auto","created_at":"2025-11-19 07:25:00","extension":"png","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":26695,"visible":true,"origin":"","legend":"","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/15c207d3e98bae4c6e78e537.png"},{"id":96245219,"identity":"b66fa293-f1da-4e1c-9241-9854b13c7e8e","added_by":"auto","created_at":"2025-11-19 07:20:05","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":386001,"visible":true,"origin":"","legend":"","description":"","filename":"Figure4.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/c3fd1cbbd13429f9ee80b367.docx"},{"id":96244866,"identity":"b7906424-bf5b-44b5-a10f-bda7a3b8bbb6","added_by":"auto","created_at":"2025-11-19 07:19:26","extension":"jpg","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":230878,"visible":true,"origin":"","legend":"","description":"","filename":"Figure5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/ac4bf0762f66061157914388.jpg"},{"id":96244362,"identity":"c0f7843d-cd41-4a21-adcc-bed1abd076a7","added_by":"auto","created_at":"2025-11-19 07:18:13","extension":"docx","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16591,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/f76ff2093f7896f194914dd8.docx"},{"id":95947075,"identity":"7f90cd3b-1901-4dd7-825a-6fbbed140226","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"docx","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":15778,"visible":true,"origin":"","legend":"","description":"","filename":"Table3.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/7685d159b7e0ad10f7e566e1.docx"},{"id":96244374,"identity":"f8a9db65-b0c9-4490-92ee-e0caaed09fd6","added_by":"auto","created_at":"2025-11-19 07:18:17","extension":"docx","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16526,"visible":true,"origin":"","legend":"","description":"","filename":"Table4.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/b6ad6ee7bb3616d638b763ca.docx"},{"id":96244819,"identity":"7a66e2c5-9e7a-4e6f-8ee1-72ba77f7ced3","added_by":"auto","created_at":"2025-11-19 07:19:21","extension":"docx","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":16375,"visible":true,"origin":"","legend":"","description":"","filename":"Tablo1.docx","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/1f17911b06782ef1e00fb3df.docx"},{"id":96244873,"identity":"294387ab-33c4-4d2e-a47b-7e34bb8683d7","added_by":"auto","created_at":"2025-11-19 07:19:27","extension":"xml","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":95084,"visible":true,"origin":"","legend":"","description":"","filename":"403f7390c3e243e384512589d435c4a41enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/8b2c6b5a8e49c821cb86fb2e.xml"},{"id":96244522,"identity":"012cf6ca-306f-4272-9a4a-477454414aa5","added_by":"auto","created_at":"2025-11-19 07:18:44","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":249422,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/79dbc9a408882f717a22a75b.png"},{"id":96244334,"identity":"6b5ed8b3-11b8-4e1d-96e0-55c4f3b6c50b","added_by":"auto","created_at":"2025-11-19 07:18:12","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":247494,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/3386c9f0ddd5eca7be1d7ee8.png"},{"id":96245171,"identity":"92c2bc4e-1ec3-478c-a4ef-b36153156d03","added_by":"auto","created_at":"2025-11-19 07:20:00","extension":"jpeg","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":120278,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/da5b353f7a791aad2a418423.jpeg"},{"id":96244970,"identity":"33de0d66-4c7a-43e2-9ec1-fb94bc2e7a6a","added_by":"auto","created_at":"2025-11-19 07:19:39","extension":"jpeg","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":452879,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/38da0fde748b41427e0ae91e.jpeg"},{"id":96244450,"identity":"dcf31c29-b896-43f0-9e61-d6a045d227e8","added_by":"auto","created_at":"2025-11-19 07:18:29","extension":"jpeg","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":230878,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/41d21e6e271d790bf654e8e5.jpeg"},{"id":96244698,"identity":"cb8dffdf-1604-419f-b561-0ff35178c804","added_by":"auto","created_at":"2025-11-19 07:19:06","extension":"jpeg","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":4974,"visible":true,"origin":"","legend":"","description":"","filename":"groupimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/225f1c4e088402a9eafa652d.jpeg"},{"id":95947069,"identity":"ecf2f038-8d6b-440c-841b-d213de061870","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"jpeg","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5021,"visible":true,"origin":"","legend":"","description":"","filename":"groupimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/d16ec98551cf7539b1fff0a3.jpeg"},{"id":95947088,"identity":"614e09ee-5592-4c24-bba4-1b0f5bd5cc10","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"png","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":30480,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/ee4572817e45d4e8ec4cca74.png"},{"id":95947072,"identity":"0226e7d7-0dd0-4600-b959-4c248b83ea27","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"png","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":30614,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/3e2f9ee4c59430ed0fbbf0ad.png"},{"id":95947079,"identity":"839b5563-1b78-41b7-8709-90ded444ecc2","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":32346,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/87e9d0c310299093ec5cff63.png"},{"id":95947086,"identity":"a140e163-ea39-4465-9189-b7b7de43126a","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":104659,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/9dd765cd552d2018316ab64a.png"},{"id":96245715,"identity":"fc8b117c-92ca-4a0c-a21f-64710d1a3c59","added_by":"auto","created_at":"2025-11-19 07:22:02","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":87687,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/d096e2931461aad05aeaf4ea.png"},{"id":96244453,"identity":"2ecc1de7-5d54-4ecf-aca2-db2e9d0fb5c2","added_by":"auto","created_at":"2025-11-19 07:18:29","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":3598,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinegroupimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/94b0e0093aab9774353a177d.png"},{"id":95947085,"identity":"efad6d10-db36-465c-8dfd-571c9971ebe8","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":3393,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinegroupimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/f8064ba28122b44f52e46fe8.png"},{"id":95947089,"identity":"5caae599-b746-4d37-bfa4-315ecb3c0388","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"xml","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":91742,"visible":true,"origin":"","legend":"","description":"","filename":"403f7390c3e243e384512589d435c4a41structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/10d89060185be3fba6f072fc.xml"},{"id":95947087,"identity":"7778ff18-6503-47bd-acb4-37c6c2dc3d2b","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"html","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":104361,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/b4b168a170e348046b8973ce.html"},{"id":95947059,"identity":"5e03a4ce-292a-46d1-ba3b-aa93efd0674f","added_by":"auto","created_at":"2025-11-14 18:02:52","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":54905,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph representing cholesterol, LDL and VLDL levels of normal and hypertensive patient groups. Cholesterol and LDL levels are seen to be higher in the hypertensive patient group. a Mann Whitney U test.\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/db3b5c2ed76b6f08f3c92a17.jpg"},{"id":96244762,"identity":"e1b07e79-daf7-40e4-bb8e-b7dcd3067e5b","added_by":"auto","created_at":"2025-11-19 07:19:12","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":53461,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph representing ApoA, ApoB and ApoB/ApoA levels of normal and hypertensive patient groups. It is seen that ApoA, ApoB and ApoB/ApoA values ​​are higher in the hypertensive patient group. a Mann Whitney U test, b Unpaired t test\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/6113e4b43deb8efeeebcf466.jpg"},{"id":96246142,"identity":"b924f3b4-dbcc-4906-b491-49f7370d4874","added_by":"auto","created_at":"2025-11-19 07:24:45","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":37354,"visible":true,"origin":"","legend":"\u003cp\u003eBox-plot graph representing Hs-CRP and sortilin levels in normal and hypertensive patient groups. It is seen that IL-6 and sortilin levels are higher in the hypertensive patient group. a Mann Whitney U test\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/58da11fd1d916e160d1e6c74.jpg"},{"id":96244581,"identity":"5dc9591a-6e9b-47e3-9dbd-bbc5fb5b3478","added_by":"auto","created_at":"2025-11-19 07:18:54","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":104590,"visible":true,"origin":"","legend":"\u003cp\u003eSpearman correlation graph representing the relationship between SBP and ApoA, ApoB and ApoB/ApoA levels in all case groups. SBP values ​​show the highest correlation with ApoB levels. rs: Spearman correlation.\u003c/p\u003e","description":"","filename":"4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/2d6839852e38ade34047999a.jpg"},{"id":95947067,"identity":"51f7b23a-a0ef-4fca-897d-63063ca890dc","added_by":"auto","created_at":"2025-11-14 18:02:53","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":139417,"visible":true,"origin":"","legend":"\u003cp\u003eROC analysis results to determine the diagnostic value of ApoB, hs-CRP and sortilin tests in detecting hypertension status. ApoB and sortilin are seen to have very high sensitivity and specificity, respectively.\u003c/p\u003e","description":"","filename":"5.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/81ba30d9860534f45251a1f4.jpg"},{"id":96453011,"identity":"93787538-c609-40cd-b80b-a881fcf8638a","added_by":"auto","created_at":"2025-11-21 09:57:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1203673,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7031957/v1/9ffbaf6b-26cf-4368-af78-34df66017e0a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Relationship between sortilin with ApoB/ApoA ratio in military personnel with arterial hypertension","fulltext":[{"header":"Introduction","content":"\u003cp\u003eArterial hypertension (AH) is one of the most common risk factors for the development of cardiovascular diseases and premature death worldwide [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. In recent decades, the attention of researchers has been drawn to its manifestation and development in young people, including military personnel, who are often exposed to stress, high physical activity and specific service conditions [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. In this context, it is important to understand how AH in young men can be associated with changes in the lipid profile and inflammatory processes in the body. The lipid profile, including cholesterol levels (including total, LDL, HDL and triglycerides), has a significant impact on the state of the vascular endothelium and the development of atherosclerosis, which is a key link in the pathogenesis of arterial hypertension [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In turn, chronic inflammatory processes play an important role in the activation of endothelial dysfunctions and the progression of hypertension [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This problem is especially acute in young military personnel, as they are exposed to physical overload, prolonged stress and specific psychological stress, which can be catalysts for the development of hypertension and its complications. The higher than expected prevalence of hypertension, even in occupational groups leading an active lifestyle, such as military personnel, contradicts recent studies reporting that physical activity is associated with a reduced risk of arterial hypertension (AH). This situation increases the need for a reliable biological marker that can be a precursor to hypertension and clarify its pathophysiology, in addition to classical methods.\u003c/p\u003e\u003cp\u003e\u003cb\u003eAim of the work\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe objective of this study was to investigate, for diagnostic purposes, the relationship between sortilin levels with the ApoB/ApoA ratio in hypertension detected in military personnel serving in the armed forces of Azerbaijan.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cp\u003eEthics Statement\u003c/p\u003e\u003cp\u003e All methods were carried out in accordance with relevant guidelines and regulations. Ethical approval for this study was obtained from the Ethics Committee of the Azerbaijan Medical University (Protocol No. 13, dated 15.06.2022).\u003c/p\u003e\u003cp\u003e\u0026bull; \u003cb\u003eStudy design\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study is a single-center, observational, cross-sectional analytical study. In order to achieve the planned sample size, approximately 220 male military personnel who applied to the Medical Center of the Ministry of Emergency Situations of the Republic of Azerbaijan for a follow-up examination. After the participants were informed about the study, consent forms were obtained. After recording the demographic characteristics of the participants, visual and physical examinations were performed. Blood pressure values ​​were measured in systolic and diastolic modes using the same tonometer (Bosh\u0026thinsp;+\u0026thinsp;Sohn, Germany). Biochemical studies (cholesterol, triglycerides, LDL, VLDL) and hemogram were performed using these blood samples. After laboratory testing, excess serum was stored at -80\u0026deg;C. These sera were stored until the day of testing for ApoB,ApoA, hs-CRP, and sortilin.\u003c/p\u003e\u003cp\u003eAs a result of the examination, 55 male servicemen with arterial hypertension and 65 healthy male servicemen were randomly selected. The group of patients who were diagnosed with hypertension was selected from among the patients who had hypertension as a primary pathology. Subjects with secondary hypertension, subjects with comorbidities in addition to hypertension (such as cardiovascular, renal and liver diseases), subjects with cancer (myelodysplastic syndrome, leukemia and lymphoma arising in the blood, bone marrow and lymph nodes), rheumatic diseases affecting the levels of inflammatory markers (such as IL-6, TNF-α and hs-CRP) (such as rheumatoid arthritis, SLE, ankylosing spondylitis, acute rheumatic fever), autoimmune diseases (such as Sjogren's disease, Hashimoto's thyroiditis, celiac disease, multiple sclerosis, inflammatory bowel disease), subjects with infection or inflammation, and subjects taking anti-inflammatory or antihyperlipidemic drugs were excluded from the study.\u003c/p\u003e\u003cp\u003e\u003cb\u003eBiochemical and Hematological Measurements\u003c/b\u003e\u003c/p\u003e\u003cp\u003eHemogram measurements were performed on EDTA blood of all participants using an automatic hematology analyzer (Mindray BC-600, China). In addition, high-sensitivity C-reactive protein (hs-CRP), ApoA, ApoB, cholesterol, LDL and VLDL levels were measured in blood collected in plain tubes using a biochemistry autoanalyzer (Roche Cobas C 702, Mannheim, Germany). Inappropriate sample collections, clotted and excessively hemolyzed samples were not included in the study. Quality control studies were completed before all measurements.\u003c/p\u003e\u003cp\u003e\u0026bull; \u003cb\u003eELISA Measurements\u003c/b\u003e\u003c/p\u003e\u003cp\u003eBT lab brand ELISA Kits (Shangai, China) were used to measure sortilin levels. The sensitivity of the kit was 0.94 ng/L and the measurement range was 2-600 ng/L, respectively. The intra-study coefficient of variation was \u0026lt;\u0026thinsp;10%. Measurements in the study were performed using BIO-TEK ELx500 ELISA Reader and BIO-TEK ELx50 (USA) wash devices.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eSPSS Statistic Software version 25 (IBM Corp, Chicago, USA) was used for the analysis of statistical data of this study. Statistical data were collected in Microsoft Excel 2010 Office program. Bar plots were used for graphical representation of nonparametric data. Chi-square test was used for evaluation of categorical data when comparing differences between groups. Kolmogorov-Smirnov test was used to evaluate whether the study data were normally distributed. Student t test was applied for parametric data and Mann-Whitney U test was applied for nonparametric data in comparisons of independent groups consisting of two groups. Spearman and Pearson correlation test were used for nonparametric data and parametric data, respectively, to determine correlations between independent variables. Receiver operating characteristic (ROC) analysis was used for the diagnostic performance of ApoB, ApoB/ApoA, hs-CRP, sortilin tests in determining HT. AUC value was accepted as a practical measure of test performance in determining the diagnostic adequacy of the tests. For the minimum acceptable discrimination power, an AUC value of \u0026gt;\u0026thinsp;0.70 was accepted. If the AUC was between 0.8 and 0.9, the test was assumed to have high discrimination ability, and if AUC was \u0026gt;\u0026thinsp;0.9, it was assumed to have very high (excellent) discrimination ability.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003e\u0026bull; Comparison of Demographic and Clinical Features\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAs a result of the study, the mean ages of the control (M/F: 65/0) and hypertensive patient (M/F: 55/0) groups were 36\u0026thinsp;\u0026plusmn;\u0026thinsp;8 (23\u0026ndash;46) and 37\u0026thinsp;\u0026plusmn;\u0026thinsp;8 (23\u0026ndash;45) years, respectively; mean BMI values ​​were 23.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4 (17.8\u0026ndash;29.8) and 23.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6 (16.8\u0026ndash;30.8) kg/m2, respectively (Table\u0026nbsp;1). There was no difference between the groups formed from the male population in terms of age and BMI (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Fig.\u0026nbsp;1). Therefore, the differences we detected between the groups in terms of other parameters were accepted to be independent of these three demographic features.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of demographic characteristics and blood pressure values ​​of the study groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatrametrs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAll Groups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHT Patient Group (A)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eControl Group\u003c/p\u003e\u003cp\u003e(B)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003en, E\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender, M (%) (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e120(%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55(%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e65(%100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026Oslash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge, years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u0026thinsp;\u0026plusmn;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e37\u0026thinsp;\u0026plusmn;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e36\u0026thinsp;\u0026plusmn;\u0026thinsp;8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 0,6235\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23,5\u0026thinsp;\u0026plusmn;\u0026thinsp;2,5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23,6\u0026thinsp;\u0026plusmn;\u0026thinsp;2,6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23,5\u0026thinsp;\u0026plusmn;\u0026thinsp;2,4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 0,7705\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWaist circumference, sm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80\u0026thinsp;\u0026plusmn;\u0026thinsp;8,0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e82\u0026thinsp;\u0026plusmn;\u0026thinsp;7,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e78\u0026thinsp;\u0026plusmn;\u0026thinsp;7,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 0,0029*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSBP, mm/Hg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e129\u0026thinsp;\u0026plusmn;\u0026thinsp;22\u003c/p\u003e\u003cp\u003e128(100\u0026ndash;170)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e150\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\u003cp\u003e149(124\u0026ndash;170)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e111\u0026thinsp;\u0026plusmn;\u0026thinsp;10\u003c/p\u003e\u003cp\u003e107(100\u0026ndash;133)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u0026lt;0,0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDBP, mm/Hg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e69\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\u003cp\u003e68(48\u0026ndash;90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e69\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\u003cp\u003e68(50\u0026ndash;87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e69\u0026thinsp;\u0026plusmn;\u0026thinsp;9\u003c/p\u003e\u003cp\u003e69(48\u0026ndash;90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e 0,3633\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eWhen the study groups were examined in terms of waist circumference (WC), WC was found to be higher in the HT patient group (p\u0026thinsp;=\u0026thinsp;0.0029) (Table\u0026nbsp;1).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of biochemical parameters of groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParametrs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHT Patient Group\u003c/p\u003e\u003cp\u003e(A)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl Group\u003c/p\u003e\u003cp\u003e(B)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ep value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCholesterol, mmol/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,79\u0026thinsp;\u0026plusmn;\u0026thinsp;1,38\u003c/p\u003e\u003cp\u003e5,73(2,89\u0026thinsp;\u0026minus;\u0026thinsp;9,65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4,10\u0026thinsp;\u0026plusmn;\u0026thinsp;1,08\u003c/p\u003e\u003cp\u003e4,01(2,58\u0026thinsp;\u0026minus;\u0026thinsp;7,15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e \u0026lt;0,0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTriglyceride, mmol/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3,09\u0026thinsp;\u0026plusmn;\u0026thinsp;2,75\u003c/p\u003e\u003cp\u003e2,24(0,44\u0026thinsp;\u0026minus;\u0026thinsp;15,04)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2,80\u0026thinsp;\u0026plusmn;\u0026thinsp;0,80\u003c/p\u003e\u003cp\u003e2,82(0,91\u0026thinsp;\u0026minus;\u0026thinsp;4,69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e 0,1644\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL, mmol/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2,92\u0026thinsp;\u0026plusmn;\u0026thinsp;1,09\u003c/p\u003e\u003cp\u003e2,86(0,50\u0026thinsp;\u0026minus;\u0026thinsp;4,83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2,28\u0026thinsp;\u0026plusmn;\u0026thinsp;0,72\u003c/p\u003e\u003cp\u003e2,10(1,20\u0026thinsp;\u0026minus;\u0026thinsp;4,21)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e 0,0005*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVLDL, mmol/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,4\u0026thinsp;\u0026plusmn;\u0026thinsp;1,3\u003c/p\u003e\u003cp\u003e1,0(0,2\u0026ndash;6,8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,2\u0026thinsp;\u0026plusmn;\u0026thinsp;0,4\u003c/p\u003e\u003cp\u003e1,2(0,4\u0026thinsp;\u0026minus;\u0026thinsp;2,1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e 0,4512\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eApoA, gr/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,34\u0026thinsp;\u0026plusmn;\u0026thinsp;0,22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,24\u0026thinsp;\u0026plusmn;\u0026thinsp;0,20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e 0,0083*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eApoB, gr/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,26\u0026thinsp;\u0026plusmn;\u0026thinsp;0,23\u003c/p\u003e\u003cp\u003e1,28(0,66\u0026thinsp;\u0026minus;\u0026thinsp;1,71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,88\u0026thinsp;\u0026plusmn;\u0026thinsp;0,22\u003c/p\u003e\u003cp\u003e0,88(0,61\u0026thinsp;\u0026minus;\u0026thinsp;1,52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u0026lt;0,0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eApoB/ApoA,\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0,96\u0026thinsp;\u0026plusmn;\u0026thinsp;0,20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0,73\u0026thinsp;\u0026plusmn;\u0026thinsp;0,22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e\u0026lt;0,0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e\u0026bull; Comparison of Biochemical Parameters\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWhen the groups were evaluated in terms of lipid profiles, cholesterol, LDL, ApoA and ApoB levels were statistically higher in the HT patient group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) (Fig.\u0026nbsp;1 A,B, Fig.\u0026nbsp;2 A,B). Similarly, ApoB/ApoA values, which are a calculation parameter, were also found to be higher in the HT patient group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) (Fig.\u0026nbsp;2C).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e\u0026bull; Comparison of preinflammatory biomarker and sortilin levels\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWhen the groups were examined in terms of inflammatory biomarkers (Table\u0026nbsp;3), the hs-CRP of the HT patient group, and sortilin were found to be statistically significantly higher compared to the control group (Fig.\u0026nbsp;3A-B).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of inflammatory biomarker and sortilin values ​​of groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParametrs\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHT Patient Group\u003c/p\u003e\u003cp\u003e(A)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl Group\u003c/p\u003e\u003cp\u003e(B)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHs-CRP, mg/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3,1\u0026thinsp;\u0026plusmn;\u0026thinsp;1,7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,7\u0026thinsp;\u0026plusmn;\u0026thinsp;0,8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e\u0026lt;0.0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSortilin, ng/mL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e\u003cp\u003e2.1(0.6\u0026ndash;5.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1,6\u0026thinsp;\u0026plusmn;\u0026thinsp;0,7\u003c/p\u003e\u003cp\u003e1,4(0,8\u0026thinsp;\u0026minus;\u0026thinsp;4,6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003csup\u003ea\u003c/sup\u003e\u0026lt;0.0001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e\u003cp\u003ea Mann-Whitney U Test, b Unpaired t test,\u003c/p\u003e\u003cp\u003e* Statistical significance level p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Nonparametric data are given as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD and median (min-max), parametric data are given as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD. SD: Standard deviation, hs-CRP: high sensitive CRP-reactive protein.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAccording to the correlation matrix analysis results (Table\u0026nbsp;5), 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.\u003c/p\u003e\u003cp\u003eThere was a moderate positive correlation between SBP and ApoB and ApoB/ApoA levels (rs\u0026thinsp;=\u0026thinsp;0.5369, 95% CI: 0.3912\u0026ndash;0.6564; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001 and Spearman r\u0026thinsp;=\u0026thinsp;0.4608, 95% CI: 0.3020\u0026ndash;0.5947; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001, respectively) (Fig.\u0026nbsp;4).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation matrix analysis between blood pressure, lipid profiles and sortilin parameters of all study groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"14\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eA:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eB:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eC:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eD:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eE:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eF:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eG:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eH:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003eI:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c11\"\u003e\u003cp\u003eJ:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c12\"\u003e\u003cp\u003eK:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c13\"\u003e\u003cp\u003eL:\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c14\"\u003e\u003cp\u003eM:\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eA:SBP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eB:DBP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.0245\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eC:CHol\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.5275\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.1668\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eD:TG\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.0742\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.0310\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.3026\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eE:LDL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.3073\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.0614\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.4058\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.1397\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eF:VLDL\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.0919\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.0514\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.3215\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.9800\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.1130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eG:ApoA\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.2058\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.0155\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.2468\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.0951\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.1333\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-0.0462\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eH:ApoB\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.5703\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.1824\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.7573\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.1719\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003e0.3220\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.1868\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.2591\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eI: ApoB/A\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.4817\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.1766\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.5520\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0598\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.2665\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0467\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.1013\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e0.7949\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eK: Sortilin\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.4419\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.0424\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.2827\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0508\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.1920\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0564\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0.0096\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e0.2477\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.2059\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.2739\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eM:hCRP\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e0.3702\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.0601\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e0.3804\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0867\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.2528\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.0880\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e-0.0174\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003e0.3798\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u003cb\u003e0.3390\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e0.2559\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003e0.1731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003e0.4016\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003e1.0000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eIn this cross-sectional study, in the relative risk (RR) analysis performed using a 2 x 2 table with Fisher's Exact Test, the RR value for serum sortilin level\u0026thinsp;\u0026gt;\u0026thinsp;1.64 ng/mL (cutoff) in association with HT was found to be 2.63 (95% CI: 1.571\u0026ndash;4.181; p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). In other words, it was found that patients with sortilin level\u0026thinsp;\u0026gt;\u0026thinsp;1.64 had a 2.563 times higher risk of having high SBP compared to those with low SBP. The RR value for ApoB cutoff value\u0026thinsp;\u0026gt;\u0026thinsp;1 g/L was 5.318 (95% C`I: 2.967\u0026ndash;9.534, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). The RR value for the cutoff value of hs-CRP\u0026thinsp;\u0026gt;\u0026thinsp;2.6 mg/L was 3.519 (95% CI: 2.456\u0026ndash;5.043, p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). According to the odds ratio (OR) results determined in the binary logistic regression analysis, it was determined that a one-unit increase in sortilin levels increased the probability of HT by 2.639 times (p\u0026thinsp;\u0026lt;\u0026thinsp;0.009) (Table\u0026nbsp;7). Similarly, it was calculated that a 1-unit (e.g. 1 gram) increase in ApoB and hs-CRP values ​​increased the probability of HT by 273.4 and 2.601 times, respectively (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). When the ApoB value is expressed in mg/dL, the probability of HT will increase by 2.734 times for a 10 mg increase in ApoB (1 gram/L\u0026thinsp;=\u0026thinsp;1000 mg/L\u0026thinsp;=\u0026thinsp;100mg/dL for ApoB). At the best threshold value of the ApoB/ApoA ratio (\u0026gt;\u0026thinsp;0.8); sensitivity was found to be 90.91%, specificity was found to be 73.85% and AUC was found to be 0.834 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). At the best threshold value of the ApoA test (\u0026gt;\u0026thinsp;1.26 gr/L); sensitivity was determined as 65.5%, specificity as 61.5% and AUC as 0.638 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). In addition, ApoB/ApoA ratio, which was determined to have sufficient discrimination ability; Since it was calculated from ApoB and ApoA values ​​and they are very similar to each other due to the high correlation between them (multicolinearity), the parameter with the highest performance will be preferred in the diagnosis of HT.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIn the ROC analysis performed to evaluate the diagnostic performance of ApoB, CRP and sortilin values ​​in determining HT, the best cut-off value of the ApoB test (\u0026gt;\u0026thinsp;0.96 g/L) was found to have sensitivity of 89.09%, specificity of 80.62% and AUC of 0.887 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001) (Fig.\u0026nbsp;5). The best cut-off value of the CRP test (\u0026gt;\u0026thinsp;2.6 mg/dL) was found to have sensitivity of 58.18%, specificity of 96.92% and AUC of 0.812 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). The best cut-off value of the sortilin test (\u0026gt;\u0026thinsp;1.64 ng/mL) was found to have sensitivity of 74.55%, specificity of 64.62% and AUC (Area Under The Curve) of 0.738 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e\u003cp\u003eIf we summarize all statistical analysis results (statistical comparisons of groups, correlation, Binary regression and ROC analysis), it is indicated that ApoB, hs-CRP and sortilin tests show a close relationship with HT and that these tests can be used independently as predictive markers in HT prediction. In addition, it was determined that when all three were used together, they could predict HT status with approximately 86% accuracy.\u003c/p\u003e\u003cp\u003eTherefore, using sortilin, which is known for its effects on glucose, lipid metabolism, energy, endothelial and neurological function, vascular tone, inflammation and atherosclerosis, cell communication and blood pressure, together with hs-CRP, a proinflammatory marker, and ApoB, which plays a critical role in lipid metabolism, will be useful in the diagnosis and follow-up of HT patients.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eSince hypertension is a multifactorial disease, it also requires investigation using various laboratory diagnostic methods due to the presence of many factors in its pathogenesis [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. It should be noted that various methods and criteria are used in the diagnosis of hypertension, but simple laboratory parameters that can confirm these criteria are still needed [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eBy now, it seems established that sortilin plays a part in the development of dyslipidemia and associated diseases, e.g, atherosclerosis. The question is in what way. Findings in separate strains of knockout mice strongly suggest that sortilin deficiency is protective and lowers the level of circulating LDL-C and cholesterol. In humans, however, low levels of sortilin (in carriers of the major haplotype/allele) are paralleled by an increased risk of developing hyperlipidemia and disease. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Sortilin is a signaling and protein transport receptor that plays an important role in various cellular functions. The main ligands of sortilin are neurotensin, progranulin, and lipoprotein lipase [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Its main functions include intracellular transport and sorting of proteins, in particular, cellular signaling that triggers biological reactions. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. It promotes accurate transport and incorporation of proteins into target cellular sites in the Golgi apparatus and endosomal system [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. It also plays an important role in endocytosis in the cell. Namely, when sortilin binds to its ligands, the resulting ligand-receptor complexes enter the cell and the process of endocytosis is initiated. In this way, signals or molecules coming from outside the cell are transmitted into the cell [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. It regulates lipid metabolism by acting on the enzyme lipoprotein lipase and is involved in the uptake and metabolism of lipids in the cell. These various functions of sortilin are important for maintaining cellular order and homeostasis. Thus, the study of sortilin is important for understanding cellular metabolism and pathological processes, and possibly for developing treatments [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Sortilin is associated with many diseases and pathologies. Among them, it is associated with neurodegenerative diseases such as Alzheimer's disease, cancers such as breast cancer and pancreatic cancer, metabolic disorders such as metabolic syndrome, obesity and type 2 diabetes, as well as cardiovascular pathologies and hypertension due to the development of atherosclerosis [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. However, no definitive conclusion has been made regarding the use of sortilin in the diagnosis of cardiovascular pathology and hypertension. In light of the above information, this study investigated the possibility of using sortilin alone or in combination with other biomarkers as a prognostic marker for understanding and diagnosing the pathophysiology of hypertension, the most common disease today.\u003c/p\u003e\u003cp\u003eThe study conducted among young and middle-aged (23\u0026ndash;45 years) male military personnel compared the SBP and DBP values ​​in individuals diagnosed with hypertension with healthy individuals and revealed that only the SBP values ​​differed in individuals diagnosed with hypertension, which suggests that pathologies affecting the processes associated with vascular tone are more pronounced in this group of patients. In addition, the higher level of sortilin in the AH group confirms our opinion. Again, higher levels of cholesterol, ApoB and LDL, which accelerate atherosclerosis of the vascular structure and affect systolic blood pressure, were found in the AG group and were associated with the protein sortilin, which plays an important role in lipid metabolism. The results of the study conducted by Chu and colleagues (Chu X) also confirm our findings. Researchers have reported that sortilin, which plays a role in glucose and lipid metabolism, is associated with hypertension, coronary heart disease, and carotid atherosclerosis [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Again, some researchers have reported an association between inflammatory markers such as hs-CRP and hypertension, which is consistent with our study [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. However, there are also studies reporting no difference between hs-CRP (or other inflammatory markers) and hypertension [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The possible reason for this may be due to the characteristics of the selected patient population or the lack of exclusion criteria. In our study, the detection of significant correlations between SBP and hs-CRP, cholesterol, ApoB, ApoB/ApoA, and sortilin was considered as evidence that hypertension occurs as a manifestation of a complex relationship between lipid metabolism, inflammation, and sortilin.\u003c/p\u003e\u003cp\u003eIn addition, the significant correlation of sortilin values ​​with cholesterol, ApoB/ApoA indicates the existence of this complex relationship. In other words, many factors play a role in the development of hypertension, and the impact of each factor on the development of hypertension will be different. In this study, the finding that high levels of sortilin, ApoB and CRP increase the risk of hypertension confirms our prediction above. Most of the parameters used in the diagnosis of diseases are not sufficient evidence on their own. Therefore, several additional auxiliary parameters are needed. The best evidence for this was the results of the logistic regression analysis for the prediction of pelvic organ hypertrophy. It was found that ApoB and sortilin together explained 79% of the prediction of hypertension status. This finding indicates that sortilin or ApoB markers alone may not be sufficient. Moreover, in ROC analyses, no parameter achieved sufficient diagnostic power to be used alone.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn this study, we investigated the relationship between the ApoB/ApoA ratio with sortilin, which has shown itself to be both an inflammatory and atherosclerotic factor, in hypertensive patients. The biomarkers hs-CRP, ApoB and sortilin independently demonstrate a close relationship with hypertension. It is believed 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.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eI.A. and S.G. designed the study and collected the data. I.A. performed the statistical analysis. S.G. and V.A. interpreted the results. I.A. and S.G. wrote the main manuscript text. V.A. prepared the figures and tables. E.N. supervised the project, contributed to the final revision, and approved the manuscript. All authors reviewed and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request. Due to ethical restrictions and confidentiality regarding military personnel, the data are not publicly available.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eC.Chrysohoou, C. \u0026amp; Pitsavos, D. B. and C.Stefanadis, Association between prehypertension status and imflammatory markers related to atherosclerotic disease; the ATTICA Study. \u003cem\u003e// Am. J. Hypertens. -2004 Vol\u003c/em\u003e 17.-№ 7.-pp. 568\u0026ndash;573 .\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBautista, L. E., Vera, L. M., Arenas, I. A. \u0026amp; Gammara, G. Independent associationn between inflammatory markers (CRP, IL-6, and TNF-α.) and essensial hypertension // Journal of Human Hypertension \u0026ndash;\u0026thinsp;2005. - Vol. 19.- № 2 - P. 149\u0026ndash;154.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChae, C. H. \u0026amp; Lee, R. T. N.Rifai and P.M.Ridker. Blood pressure and inflammation in apparently healty men // Hypertension 2001.-Vol.38.- № 3.-P. 339\u0026ndash;403.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eInterleukin-6 inhibition. attenuates hypertension and associated renal damage in Dahl salt-sensitive rats / S/Hashmat [et al] // Am. J. Physiol. Renal Physiol \u0026ndash;\u0026thinsp;2016. Sep. Vol 311 N3-P F555-F561.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStaessen, J. A. et al. \u003cem\u003eEssent. Hypertens. Lancet\u003c/em\u003e ;\u003cb\u003e361\u003c/b\u003e:1629\u0026ndash;1641. (2003).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSaxena, T., Ali, A. O. \u0026amp; Saxena, M. Pathophysiology of essential hypertension: an update. \u003cem\u003eExpert Rev. Cardiovasc. Ther.\u003c/em\u003e \u003cb\u003e16\u003c/b\u003e, 879\u0026ndash;887 (2018).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAllegra, B. et al. Hypertension in Young People: Epidemiology, Diagnostic Assessment and Therapeutic Approach. High Blood Press Cardiovasc Prev.;0.1007/s40292-015-0114-3. (2015).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKatherine, T. M. et al. Global Disparities of Hypertension Prevelance and control. A. Systematic Analysis of Population Based Studies From 90 Countries // Circulation,-2016.-134.-P. 441\u0026ndash;450 .\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNiklas, A. et al. Prevalence, awareness, treatment and control of hypertension in the adult Polish populationMulti-center National Population Health Examination SurveysWOBASZ studies. \u003cem\u003eArch. Med. Sci.\u003c/em\u003e \u003cb\u003e14\u003c/b\u003e, 951\u0026ndash;961 (2018).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHarrison, D. G. et al. Weyand. Inflammation, Immunity and Hypertension // Hypertension.-2011.-57.-pp. 132\u0026ndash;140.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMortensen, R. F. and W.Zhong, Regulation of phagocytic leukocyte activities by CRP // Journal of leukocyte Biology.-2000.-Vol\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.67-№4.-p.495\u0026ndash;500\u003c/span\u003e\u003cspan address=\"http://.67-№4.-p.495\u0026ndash;500\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eV.Pasceri, J. T. \u0026amp; Yeh, E. T. H. Direct proinflammatory effect of CRP on human endothelial cells. \u003cem\u003e//Circulation\u003c/em\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e-2000.-102.-№18.-p.\u003c/span\u003e\u003cspan address=\"http://-2000.-102.-№18.-p.\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e2165\u0026ndash;2168 .\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBautista, L. E., Vera, L. M., Arenas, I. A. \u0026amp; Gammara, G. Independent associationn between inflammatory markers (CRP, IL-6, and TNF-α.) and essensial hypertension // Journal of Human Hypertension \u0026ndash;\u0026thinsp;2005. - Vol. 19.- № 2 - P. 149\u0026ndash;154.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhao, S., Li, Q. \u0026amp; Liu, L. Z.Xu and J.Xiao Simvastatin reduces interleukin-1 beta secretion by peripherial blood mononuclear cells in patients with essensial hypertension. \u003cem\u003e// Clin. China Acta -Vol\u003c/em\u003e \u003cb\u003e334\u003c/b\u003e. - № 1.-P.195\u0026ndash;200.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e25, C. H. and P.M.Ridker. Blood pressure and inflammation in apparently healty men // Hypertension 2001.-38.- № 3.-P. 339\u0026ndash;403 .\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eX.Yu, Z. Y. and M.Yu, Correlation of tumor necrosis factor alpha and Il-6 with hypertensive renal damage. //Renal Failure.- Vol 39.- № 4. P. 475\u0026ndash;479.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eЦитокины и артериальная гипертензия / Л.Е. Шинетова и др. // Вест. Каз. НМУ- 2017-№1-С. 264\u0026ndash;268.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) Bryan Williams, Giuseppe Mancia, Wilko Spiering, Enrico Agabiti Rosei, Michel Azizi, Michel Burnier, Denis L et al.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSaxena, T., Ali, A. O. \u0026amp; Saxena, M. Pathophysiology of essential hypertension: an update. \u003cem\u003eExpert Rev. Cardiovasc. Ther.\u003c/em\u003e \u003cb\u003e16\u003c/b\u003e, 879\u0026ndash;887 (2018).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHDE, Hinkle, D. E., Wiersma, W. \u0026amp; Jurs, S. G. \u003cem\u003eApplied Statistics for the Behavioral Sciences\u003c/em\u003e 5th edn (Houghton Mifflin, 2003).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChu, X. et al. The association of plasma sortilin with essential hypertension and subclinical carotid atherosclerosis: A cross-sectional study. \u003cem\u003eFront. Cardiovasc. Med.\u003c/em\u003e \u003cb\u003e9\u003c/b\u003e, 966890. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fcvm.2022.966890\u003c/span\u003e\u003cspan address=\"10.3389/fcvm.2022.966890\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2022).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWians, F. H. Clinical laboratory tests: which, why, and what do the results mean? \u003cem\u003eLab. Med.\u003c/em\u003e \u003cb\u003e40\u003c/b\u003e, 105\u0026ndash;113 (2009).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFaraggi, D. \u0026amp; Reiser, B. Estimation of the area under the ROC curve. \u003cem\u003eStat. Med.\u003c/em\u003e \u003cb\u003e21\u003c/b\u003e, 3093\u0026ndash;3106 (2002).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eObuchowski, N. A., Lieber, M. L. \u0026amp; Wians, F. H. ROC curves in clinical chemistry: uses,misuses, and possible solutions. \u003cem\u003eClin. Chem.\u003c/em\u003e \u003cb\u003e50\u003c/b\u003e, 1118\u0026ndash;1125 (2004).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eApplied Logistic Regression. 2nd Ed. Chapter 5. John Wiley and Sons, New York, NY2000: 160\u0026ndash;164.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKjolby, M. et al. Sort1, encoded by the cardiovascular risk locus 1p13.3,is a regulator of hepatic lipoprotein export. \u003cem\u003eCell. Metab.\u003c/em\u003e \u003cb\u003e12\u003c/b\u003e, 213\u0026ndash;223. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.cmet.20\u003c/span\u003e\u003cspan address=\"10.1016/j.cmet.20\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2010).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStrong, A. et al. Hepaticsortilin regulates both apolipoprotein B secretion and LDL catabolism. \u003cem\u003eJ. ClinInvest\u003c/em\u003e. \u003cb\u003e122\u003c/b\u003e, 2807\u0026ndash;2816. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1172/JCI63563\u003c/span\u003e\u003cspan address=\"10.1172/JCI63563\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2012).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVaegter, C. B. et al. Sortilin associates with Trk receptors to enhance anterograde transport and neurotrophin signaling. \u003cem\u003eNat. Neurosci.\u003c/em\u003e \u003cb\u003e14\u003c/b\u003e, 54\u0026ndash;63. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/nn.2689\u003c/span\u003e\u003cspan address=\"10.1038/nn.2689\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2011).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAngelakopoulou, A. et al. Comparative analysis of genome-wide association studies signals for lipids, diabetes, and coronary heart disease: cardiovascular biomarker genetics collaboration. \u003cem\u003eEur. Heart J.\u003c/em\u003e \u003cb\u003e33\u003c/b\u003e, 393\u0026ndash;407 (2012).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHu, F. et al. Sortilin-mediated endocytosis determines levels of the frontotemporal dementia protein. \u003cem\u003eprogranulin Neuron\u003c/em\u003e. \u003cb\u003e68\u003c/b\u003e, 654\u0026ndash;667 (2010).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKlinger, S. C. et al. SorLA regulates the activity of lipoprotein lipase by intracellular trafficking. J Cell Sci. 2011. (2011) ed.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMortensen, M. B. et al. Targeting sortilin in immune cells reduces proinflammatory cytokines and atherosclerosis. J Clin Investig. ;124: 5317\u0026ndash;22. First paper to show that lack of sortilin in bone marrow derived cells alone (e.g., T-cells and macrophages) attenuates the development of atherosclerosis. (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSmith, J. G. et al. Association of low-density lipoprotein cholesterol-related genetic variants with aortic valve calcium and incident aortic stenosis. \u003cem\u003eJAMA\u003c/em\u003e \u003cb\u003e312\u003c/b\u003e, 1764\u0026ndash;1771 (2014).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSortilin Encoded by the Cardiovascular Risk Gene SORT1, and Its Suggested Functions in Cardiovascular Disease.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKjolby, M., Nielsen, M. S. \u0026amp; Petersen, C. M. Sortilin, encoded by the cardiovascular risk gene \u003cem\u003eSORT1\u003c/em\u003e, and its suggested functions in cardiovascular disease. \u003cem\u003eCurr. Atheroscler Rep.\u003c/em\u003e \u003cb\u003e17\u003c/b\u003e, 496. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s11883-0150496-7\u003c/span\u003e\u003cspan address=\"10.1007/s11883-0150496-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2015).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCorresponding author: Esmira Nasibova.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEmail [email protected].\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7031957/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7031957/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe study investigates the relationship between sortilin levels and the ApoB/ApoA ratio in military personnel with arterial hypertension.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional analytical study involving 120 male military personnel was conducted. Biochemical, hematological, and ELISA measurements were performed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eSortilin, ApoB, ApoB/ApoA ratio, and hs-CRP levels were significantly higher in the hypertensive group and correlated with systolic blood pressure. ROC analysis confirmed their diagnostic value.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eSortilin, ApoB, and hs-CRP are closely associated with hypertension and may serve as biomarkers for diagnosis and monitoring.\u003c/p\u003e","manuscriptTitle":"Relationship between sortilin with ApoB/ApoA ratio in military personnel with arterial hypertension","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-14 18:02:48","doi":"10.21203/rs.3.rs-7031957/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-26T13:01:10+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-22T13:02:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"168371566717426909677070356009466564692","date":"2025-11-14T07:37:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-06T12:00:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12442620322009381594090662649167368044","date":"2025-11-04T20:25:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"245081117690284873419900176128534749865","date":"2025-11-04T12:34:19+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-04T10:20:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-29T04:27:52+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-25T07:47:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-22T05:34:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-07-22T05:31:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1a7364ec-7975-4fa4-ad10-7d7449125676","owner":[],"postedDate":"November 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":57548986,"name":"Health sciences/Biomarkers"},{"id":57548987,"name":"Health sciences/Cardiology"},{"id":57548988,"name":"Health sciences/Diseases"},{"id":57548989,"name":"Health sciences/Medical research"},{"id":57548990,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-04-30T07:09:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-14 18:02:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7031957","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7031957","identity":"rs-7031957","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}