The purpose of the work was to study the effect of glypican-4 on the development of cardiovascular remodeling in patients with essential arterial hypertension. Material and methods. The study involved 56 patients with hypertension stage II and the 2nd degree (25 men and 31 women). The average age of patients was 49.8±5.4 years. The patients were divided into groups: group 1 (n = 27) included patients with hypertension and left ventricular myocardial hypertrophy; group 2 (n = 29) had patients with arterial hypertension without left ventricular myocardial hypertrophy. The control group (n = 20) was represented by practically healthy individuals comparable in age and sex. All the surveyed patients signed information consent to participate in the study. The exclusion criteria were severe somatic diseases: renal, hepatic, cardiac, respiratory failure, indications of a history of stroke, heart attack, cancer, diabetes mellitus type 1 and 2, obesity, thyroid dysfunction, primary familial hypercholesterolemia, symptomatic arterial hypertension, pregnancy. Results and discussion. Diagnosis of hypertension was carried out according to the recommendations of the European Society of Hypertension and the European Society of Cardiology (ESH / ESC, 2013), as well as the Ukrainian Association of Cardiologists on the prevention and treatment of hypertension (2013). Changes in the content of glypican-4 in the serum of patients of the examined groups were established. An increase in the level of glypican-4 in patients of the 1st group compared with that in patients of the 2nd group and controls (p <0.05) was detected. In the examined individuals with arterial hypertension and left ventricular myocardial hypertrophy, positive correlation links were also established between serum glypican-4 and insulin resistance index (r = 0.52; p <0.001), lean glycemia (r = 0.48; p <0.05), BMI (r = 0.42; p <0.05), the level of glycosylated hemoglobin (r = 0.57; p <0.01) and the total blood cholesterol (r = 0.46; p <0.05). Patients of the 1st group demonstrated a positive correlation relationship between the level of glypican-4 and the left ventricular myocardium mass (r = 0.52; p <0.001), the left ventricular myocardial mass index (r = 0.48; p <0.001), the thickness of the intima-media of the common carotid artery (r = 0.46; p <0.05). Conclusions. A significant increase in glypican-4 in serum revealed in patients with arterial hypertension and left ventricular myocardial hypertrophy indicates the effect of this hormone not only on lipid metabolism, but also on its participation in the development of structural and functional changes in the myocardium and vascular wall. Taking into account the data on the pleiotropic effects of glypican-4 on the course of hypertension when changing its content in serum, it is advisable to conduct further research in this direction.
Keywords: arterial hypertension, glypican-4, cardiovascular remodeling
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