ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 14 of 57
Up
JMBS 2020, 5(1): 96–102
https://doi.org/10.26693/jmbs05.01.096
Clinical Medicine

Peculiarities of Metabolic Factors of Cardiovascular Risk in Essential Hypertension Patients depending on Body Weight and Gender

Bek N. S., Radchenko O. M., Olenych L. V.
Abstract

The article presents the results of the study on the features of metabolic factors of cardiovascular risk in patients with essential arterial hypertension depending on body weight and gender. Material and methods. The study included 103 essential arterial hypertension patients and 55 patients in the comparison and control groups. In addition to the general examination prescribed by order No. 436, the survey included also anthropometry, testing the levels of uric acid in serum and leptin, and lipidogram. Results and discussion. The study results showed that in general, patients with essential arterial hypertension had it combined with obesity or overweight presented with impaired renal function, with a decrease in the glomerular filtration rate, which was accompanied by higher levels of uric acid and creatinine, dyslipidaemia and higher levels of C-reactive protein as an indicator of systemic inflammation. In particular, in case of essential arterial hypertension combined with obesity, there were observed significantly higher levels of uric acid and C-reactive protein and proatherogenic dyslipidaemia, in contrast to overweight. Certain gender differences were found: men had higher levels of triglycerides and very low density lipoprotein cholesterol and lower levels of high density lipoprotein cholesterol than women, which caused an increase in the atherogenic index. Both dyslipidaemia and hyperuricemia were more commonly observed in men, who had better kidney function than women. Regardless of gender, in case of obesity, higher levels of uricemia were diagnosed as compared to overweight. In men it was accompanied by dyslipidaemia; in women with obesity, higher uricemia was accompanied by a decrease in glomerular filtration rate and an increase in C-reactive protein levels. We found direct correlations between uric acid and PSA levels and anthropometric indicators (body weight, body mass index, waist and thigh circumferences) both in men and in women with obesity. We also revealed a direct correlation of uric acid with C-reactive protein and creatinine and an inverse correlation with glomerular filtration rate. Conclusion. The obtained results proved that in patients with essential arterial hypertension and obesity, leptin levels were higher than in the case of overweight. In women, both in terms of overweight and obesity, leptin levels exceeded the values in men in whom it depended on the body weight. We observed direct significant associations of leptin levels with uric acid and C-reactive protein in women.

Keywords: hypertension, body weight, uric acid, leptin, C-reactive protein

Full text: PDF (Ukr) 228K

References
  1. Flegal KM, Kit BK, Graubard BI. Body Mass Index Categories in Observational Studies of Weight and Risk of Death. Am J Epidemiol. 2014; 180(3): 288‒96. PMID: 24893710. PMCID: PMC4732880. https://doi.org/10. 1093/aje/kwu111
  2. Barnes A. Overweight versus Obese: Different Risk and Different Management. Tex Heart Inst J. 2015; 42(3): 237‒8. PMID: 26175636. PMCID: PMC4473617. https://doi.org/10.14503/THIJ-15-5096
  3. Tsai JP. The association of serum leptin levels with metabolic diseases. Tzu Chi Med J. 2017; 29(4): 192‒6. PMID: 29296046. PMCID: PMC5740690. https://doi.org/10.4103/tcmj.tcmj_123_17
  4. Lu Y, Hajifathalian K, Rimm EB, Ezzaty M, Danaei G. Mediators of the Effect of Body Mass Index on Coronary Heart Disease: Decomposing Direct and Indirect Effects. Epidemiology 2015; 26(2): 153‒62. PMID: 25643095. https://doi.org/10.1097/EDE.0000000000000234
  5. Bespalova ID, Kalyuzhyn VV, Medyantsev YuA. Bessimptomnaya giperurikemiya kak komponent metabolicheskogo sindroma [Asymptomatic hyperuricemia as a component of the metabolic syndrome]. Byulleten' sibirskoy meditsiny 2012; 3: 14‒7. [Russian] https://doi.org/10.20538/1682-0363-2012-3-14-17
  6. Kang DH, Park SK, Lee IK, Johnson RJ. Uric acid induced C-reactive protein expression: implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005; 16(12): 3553‒3562. PMID: 16251237. https://doi.org/10.1681/ASN.2005050572
  7. Boss CJ. Is a hypertension an inflammatory process? Cur Pharm Des. 2006; 12(13): 1623‒35. PMID: 16729874. https://doi.org/10.2174/138161206776843313
  8. Tomiyama H, Higashi Y, Takase B, Node K, Sata M, Inoue T [et al.] Relationships among hyperuricemia, metabolic syndrome and endothelian function. Am J Hypertens. 2011; 24(7): 770‒4. PMID: 21490690. https://doi.org/10.1038/ajh.2011.55
  9. Lee JM, Kim HC, Cho HM, Oh SM, Choi DP, Suh I. Association between serum uric acid level and metabolic syndrome. J Prev Med Public Health. 2012; 45(3): 181‒7. PMID: 22712045. PMCID: PMC3374968. https://doi.org/10.3961/jpmph.2012.45.3.181
  10. Iwashima Y, Horio T, Kamide K, Rakuqi H, Ogihara T, Kawano Y. Uric acid, left ventricular mass index, and risk of cardiovascular disease in essential hypertension. Hypertension 2006; 47(2): 195‒202. PMID: 16380520. https://doi.org/10.1161/01/HYP.0000200033.14574.14
  11. Bek NS. Metabolichni faktory kardiovaskulyarnoho ryzyku u khvorykh na hypertonichnu khvorobu na foni nadmirnoyi masy tila ta ozhyrinnya [Metabolic factors of cardiovascular risk in patients with hypertension on the background of overweight and obesity]. Aktual'ni problemy suchasnoyi medytsyny: Visnyk Ukr med stomat akademii (Poltava). 2012; 12(3): 12‒5. [Ukrainian]
  12. Puig JG, Martinez MA. Hyperuricemia, gout and metabolic syndrome Curr Opin Rheumatol. 2008; 20(2): 187–91. PMID: 18349749. https://doi.org/10/1097/BOR.0b013e3282f4b1ed
  13. Pytets'ka NI, Koval'ova OM. Henderni osoblyvosti aktyvnosti leptynu u khvorykh na arterial'nu hipertenziyu [Gender features of leptin activity in patients with arterial hypertension]. Klin ta eksperyment patolohiya. 2011; 2(2): 82‒5. [Ukrainian]
  14. Bedir A, Topbas M, Tanyeri F, Alvur M, Arik N. Leptin might be a regulator of serum uric acid concentration in humans Jpn Heart J. 2003; 44(4): 527‒36. PMID: 12906034. https://doi.org/10.1536/jhj.44.527
  15. Korda M, Kubant R, Patton S, Malinski T. Leptin-induced endothelial dysfunction in obesity Am J Physiol Heart Circ Physiol. 2008; 295(4): 1514‒21. PMID: 18689498. PMCID: PMC2593507. https://doi.org/10.1152/ajpheart.00479.2008
  16. Serkova VK, Kobrinchuk YL, Romanova VA. Leptin u bol'nykh ishemicheskoy bolezn'yu serdtsa v sochetanii s sakharnym diabetom [Leptin in patients with coronary heart disease in combination with diabetes mellitus]. Ukrainian Cardiolog J. 2011; 3: 19‒23. [Ukrainian]