Insulin resistance, its association with diastolic left ventricular disease and aorta elasticity in hypertensive patients
Background. The accepted threshold of insulin resistance value in arterial hypertension (AH) is absent, thus it is relevant to determine its degree in patients with AH, and to determine the interaction between the insulin resistance (IR) syndrome and the target organs injury. The purpose of our study was to set the threshold of IR in patients with AH, to define association between the IR parameters, presence of diastolic dysfunction and the state of aorta elasticity. Materials and methods. Investigation included 229 patients with AH and type 2 diabetes mellitus (DM), as well as 108 patients with the isolated AH. There were used clinical, instrumental, biochemical (HOMA-2 model, HOMA-IR indices), statistical methods. Results. The course of the isolated AH and AH with concomitant type 2 DM is associated with IR development, that it is well-proven in the model of HOMA-2 (р < 0.001). In patients with comorbid pathology the sensitiveness of peripheral tissues to insulin depends on severity of AH (р < 0.001). Presence of IR in HOMA-IR model was revealed in patients with the isolated AH in 26.6 % of cases. The level of plasma insulin grows substantially, and the tissues sensitiveness to insulin declined at the third type of diastolic dysfunction (р < 0.05). The coefficients of aorta elasticity have a reverse correlation with all parameters of НОМА-2 model determined by the levels of glucose (р < 0.001), insulin (p < 0.05), coefficient НОМА-IR (p < 0.05) and direct association with the degree of peripheral tissues sensitivity to insulin (p < 0.01). Conclusions. The threshold of IR by HOMA-2 model in patients was set at the level of 1.87; the increase of aorta inflexibility and diastolic dysfunction severity depend on IR severity.
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Dubó S, Gallegos D, Cabrera L, et al. Cardiovascular Action of Insulin in Health and Disease: Endothelial L-Arginine Transport and Cardiac Voltage-Dependent Potassium Channels. Front Physiol. 2016;7:74. doi: 10.3389%2Ffphys.2016.00074.
Rydén L, Grant PJ, Anker SD, et al. ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart Jour. 2013 Oct;34:3035-87. doi: 10.1093/eurheartj/eht108.
Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 2016;28(7):412-9. doi: 10.1007/BF00280883.
Liu L, Simon B, Shi J, et al. Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults. Worl J Diabetes. 2016;7(18):449-61. doi: 10.4239%2Fwjd.v7.i18.449.
Deng L, Liu S, Gong Y, et al. Increased Metabolic Disorders and Impaired Insulin Secretory Function in the First-Degree Relatives of Type 2 Diabetic Patients with Normal Glucose Tolerance. Metab Syndr Relat Disord. 2016;14(9):431-6. doi: 10.1089/met.2016.0002.
Ramalingam L, Menikdiwela K, LeMieux M, et al. The renin angiotensin system, oxidative stress and mitochondrial function in obesity and insulin resistance. Biochim Biophys Acta. 2017;1863(5):30187-9. doi: 10.1016/j.bbadis.2016.07.019.
Zheng R, Zhou D, Zhu Y. The long-term prognosis of cardiovascular disease and all-cause mortality for metabolically healthy obesity: a systematic review and meta-analysis. J Epidemiol Community Health. 2016;70(10):1024-31. doi: 10.1136/jech-2015-206948.
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