The Relationship Between Serum Endocan Level and Aortic Elastic Properties in Patients With Newly Diagnosed Essential Hypertension

Abstract

Endothelial dysfunction plays role in the generation of both essential hypertension (EH) and aortic stiffness. We evaluated the relationship between serum endocan level and aortic elastic properties (AEPs) assessed with the aortic strain, aortic distensibility, and aortic stiffness index by echocardiography. Newly diagnosed EH patients (n = 67) and controls (n = 70) were included in the study. The EH group was subdivided into stage 1 and 2 EH groups. A higher endocan level was found in the EH group, compared to the controls (34.2 ± 13.0 vs 24.1 ± 7.3 ng/mL, respectively, P < .001). All the AEP parameters were worse in the EH group, compared to the controls. Further, endocan levels correlated with aortic distensibility ( r = −0.305, P < .001) and aortic strain ( r = −0.181, P = .038), but not with aortic stiffness index ( r = 0.162, P = .064) in the whole study population. Aortic elastic properties deteriorate and serum endocan level increases in patients with EH. Moreover, serum endocan level shows a correlation with deteriorated AEPs, and hence may a surrogate marker of escalating aortic stiffness in patients with newly diagnosed EH.

Endocan at the Crossroads: A Vasculoprotective Molecule or Inflammatory Marker?

“…Recently, the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to high-density lipoprotein cholesterol (MHR) have also been used as inflammatory biomarkers and have been shown to be independent risk factors for aortic stiffness, atherosclerosis, and cardiovascular events. [6][7][8][9][10][11] In the study by Ç elik et al, 1 it was clear that the patients in the EH group had higher WBC and platelet counts as well as endocan compared to the control group. However, the study did not mention the combinations of these inflammatory biomarkers including NLR, PLR, and MHR.…”

“…In conclusion, serum endocan as a novel indicator of systemic inflammation may have a predictive role in both EH and aortic stiffness. However, it cannot be concluded from the Çelik et al 1 study that endocan is a surrogate marker of escalating aortic stiffness in patients with newly diagnosed EH.…”

“…However, there was no significant correlation of serum endocan level either with aortic strain, aortic stiffness (b) index, and aortic distensibility or the other echocardiographic and demographic parameters within the EH group. 1 Endocan is a vasculoprotective molecule in normal physiological conditions; it protects the endothelium from migration and proliferation of inflammatory cells. 2 However, if the endothelium is inflamed, the secretion of endocan into the bloodstream is significantly enhanced.…”

“…Çelik et al 1 reported higher levels of endothelial cell–specific molecule 1 (endocan) in patients with essential hypertension (EH) compared to controls. They also demonstrated a positive correlation of serum endocan level with serum triglyceride, hemoglobin, white blood cell (WBC) count, and platelet counts within the EH group.…”

“…However, there was no significant correlation of serum endocan level either with aortic strain, aortic stiffness (β) index, and aortic distensibility or the other echocardiographic and demographic parameters within the EH group. 1…”