Lower Serum SFRP5 Levels Are Associated with Carotid Atherosclerosis in Patients with Essential Hypertension.

OBJECTIVE:To investigate the variation in serum secreted frizzled-related protein 5 (SFRP5) levels among individuals with essential hypertension and its association with carotid atherosclerosis. METHODS:297 subjects were included: 77 with stage 1 hypertension, 73 with stage 2, 67 with stage 3, and 80 normotensive controls. Logistic regression analyses alongside receiver operating characteristic (ROC) curve examinations were used to determine the independent relationship and predictive significance of SFRP5 in relation to carotid atherosclerosis. The primary outcome measure was serum SFRP5 level. Secondary outcome measures included levels of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), carotid intima-media thickness (CIMT), and incidence of carotid plaque. RESULTS:Serum SFRP5 levels decreased significantly with increasing hypertension severity and were lower in patients with carotid atherosclerosis (P<0.001). A strong inverse relationship was found between SFRP5 levels and carotid atherosclerosis (r = -0.67, P<0.001). Regression analysis revealed SFRP5 was an independent protective factor (adjusted OR = 0.673, 95% CI: 0.585-0.774, P<0.001) after adjusting for age, sex, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), and hypertension grade. SFRP5's predictive capability for carotid atherosclerosis was indicated by an area under ROC curve of 0.902. CONCLUSION:Lower serum SFRP5 levels are associated with hypertension severity and heightened risk of carotid atherosclerosis in hypertensive patients. SFRP5 may be a biomarker for risk assessment and may also represent a promising therapeutic target. Additional studies are required to validate these results and unravel the underlying mechanisms.