Abstract
BACKGROUND: Hypertension is a chronic cardiovascular disease characterized by persistently elevated arterial blood pressure. It is not only a significant risk factor for cardiovascular and cerebrovascular diseases (such as myocardial infarction and stroke) but also closely related to multiple organ damages (such as kidney disease and retinopathy), imposing a heavy health and economic burden on individuals and society. AIM: To investigate the expression differences and relationships of endothelin-1 (ET-1), interleukin-6 (IL-6), stem cell factor (SCF), and its receptor (c-kit) in hypertensive patients with or without depression. METHODS: A retrospective analysis was conducted on the clinical data of 163 hypertensive patients admitted to our hospital from March 2022 to January 2024. Based on the presence of depression, patients were divided into Group A (n = 77, with depression) and Group B (n = 86, without depression). Serum levels of ET-1 and IL-6 were measured using radioimmunoassay, while serum levels of SCF and c-kit were measured using ELISA. The differences in ET-1, IL-6, SCF, and c-kit levels between Groups A and B were compared. Additionally, the differences in these biomarkers among patients with varying degrees of depression in Group A were analyzed. Pearson correlation analysis was used to examine the relationship between ET-1, IL-6, SCF, c-kit levels, and Hamilton depression rating scale (HAMD) scores. Multivariate logistic regression analysis was performed to identify factors influencing hypertension with depression. The diagnostic efficacy of individual and combined biomarkers was analyzed using receiver operating characteristic (ROC) curves. Comparative statistical analysis of the area under the curve (AUC) values was performed using DeLong's test to assess the superiority of combined biomarker detection. RESULTS: The levels of ET-1 and IL-6 in Group A were significantly higher than those in Group B, while the levels of SCF and c-kit were significantly lower in Group A compared to Group B (P < 0.05). In the severe depression subgroup, ET-1 and IL-6 levels were higher than those in the mild-to-moderate depression subgroup, while SCF and c-kit levels were lower (P < 0.05). Pearson correlation analysis showed that ET-1 and IL-6 levels were positively correlated with HAMD scores (r = 0.442, 0.463, P < 0.05), while SCF and c-kit levels were negatively correlated with HAMD scores (r = -0.429, -0.394, P < 0.05). Multivariate logistic regression analysis revealed that high ET-1, high IL-6, low SCF, and low c-kit were independent influencing factors for hypertension with depression (P < 0.05). ROC analysis revealed AUCs of 0.746 (ET-1), 0.801 (IL-6), 0.732 (SCF), 0.779 (c-kit), and 0.884 (combination). The combined diagnosis demonstrated significantly higher AUC than individual markers (DeLong's test, P < 0.01), with superior sensitivity (90.24%) and specificity (85.37%). CONCLUSION: Compared to patients with hypertension alone, patients with hypertension and depression exhibited higher serum levels of ET-1 and IL-6 and lower levels of SCF and c-kit. High ET-1, high IL-6, low SCF, and low c-kit were independent influencing factors for hypertension with depression. The combination of ET-1, IL-6, SCF, and c-kit demonstrated significant diagnostic value for hypertension with depression.