Hormonal and hemodynamic changes in middle-aged urban residents with obesity depending on blood pressure

Main Article Content

E.V. Misyura
T.I. Yefimenko
I.P. Dunaieva

Abstract

Background. The relevance of the study is due to the significant spread of overweight of varying severity among the population and a significant risk of developing comorbid pathological conditions, including arterial hypertension (AH). Today, the question of hormonal-metabolic-hemodynamic differences in representatives of the Ukrainian population with obesity and AH and with obesity without AH remains unclear. Solving this issue can help optimize the algorithm of preventive measures for the development of hypertension among the Ukrainian population. Aim: to detail the features of hemodynamics, fluid compartments of the body, functioning of the renin-aldosterone system, secretion of leptin, insulin in middle-aged people with different body weights and blood pressure, taking into account the severity of chronic nonspecific inflammation. Materials and methods. We examined 273 middle-aged (56.41 ± 6.93 years) residents of Kharkiv (males/females = 56/217) who had not been treated for obesity and AH. Body mass index was calculated, waist circumference, blood pressure were measured. Body composition (fat, relative fat, lean, active cell mass) was evaluated using bioimpedance analysis; serum levels of insulin, leptin, renin, aldosterone and clusterin — by means of immunoassay. The HOMA was calculated. Results. Obese patients, regardless of the presence or absence of AH, have a probable increase in the absolute hydration of the body with a simultaneous increase in cardiac output and stroke volume compared to both healthy individuals and non-obese patients with AH. These changes are associated with a significant increase in blood renin and aldosterone levels in obese individuals. The development of obesity in patients with AH is accompanied by an increase in their circulating blood volume, total peripheral vascular resistance and mean blood pressure, the severity of insulin resistance and chronic nonspecific inflammation, increased levels of insulin-, leptin-, renin- and aldosteronemia. The levels of circulating renin and aldosterone in the serum of middle-aged persons are probably directly related to the degree of insulin-, leptin-, clusterinemia and the HOMA. Conclusions. An approximate assessment of the levels of reninemia and aldosteronemia in middle-aged urban residents of Ukraine during screening examinations can be carried out by measuring the integral body rheography to determine the parameters of the stroke index and stroke volume. The corresponding regression equations for their estimation are defined in this study.

Article Details

How to Cite
Misyura, E., T. Yefimenko, and I. Dunaieva. “Hormonal and Hemodynamic Changes in Middle-Aged Urban Residents With Obesity Depending on Blood Pressure”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 16, no. 7, Mar. 2021, pp. 534-42, doi:10.22141/2224-0721.16.7.2020.219007.
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Original Researches

References

Shariq OA, McKenzie TJ. Obesity-related hypertension: a review of pathophysiology, management, and the role of metabolic surgery. Gland Surg. 2020 Feb;9(1):80-93. doi:10.21037/gs.2019.12.03.

Jiang SZ, Lu W, Zong XF, Ruan HY, Liu Y. Obesity and hypertension. Exp Ther Med. 2016 Oct;12(4):2395-2399. doi:10.3892/etm.2016.3667.

Koval SM, Yushko KO, Snihurska IO, et al. Relations of angiotensin-(1-7) with hemodynamic and cardiac structural and functional parameters in patients with hypertension and type 2 diabetes. Arterial Hypertension (Poland). 2019;23(3):183-189. doi:10.5603/AH.a2019.0012.

Schütten MT, Houben AJ, de Leeuw PW, Stehouwer CD. The Link Between Adipose Tissue Renin-Angiotensin-Aldosterone System Signaling and Obesity-Associated Hypertension. Physiology (Bethesda). 2017 May;32(3):197-209. doi:10.1152/physiol.00037.2016.

Cabandugama PK, Gardner MJ, Sowers JR. The Renin Angiotensin Aldosterone System in Obesity and Hypertension: Roles in the Cardiorenal Metabolic Syndrome. Med Clin North Am. 2017 Jan;101(1):129-137. doi:10.1016/j.mcna.2016.08.009.

Sokolova LK, Belchina YuB, Pushkarev VV, et al. The blood level of endothelin-1 in diabetic patients depending on the characteristics of the disease. Mìžnarodnij endokrinologìčnij žurnal. 2020;16(3):204-208. doi:10.22141/2224-0721.16.3.2020.205267.

Aronow WS. Association of obesity with hypertension. Ann Transl Med. 2017 Sep;5(17):350. doi:10.21037/atm.2017.06.69.

Poirier P, Giles TD, Bray GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2006 Feb 14;113(6):898-918. doi:10.1161/CIRCULATIONAHA.106.171016.

Lu H, Boustany-Kari CM, Daugherty A, Cassis LA. Angiotensin II increases adipose angiotensinogen expression. Am J Physiol Endocrinol Metab. 2007 May;292(5):E1280-7. doi:10.1152/ajpendo.00277.2006.

Lastra-Lastra G, Sowers JR, Restrepo-Erazo K, Manrique-Acevedo C, Lastra-González G. Role of aldosterone and angiotensin II in insulin resistance: an update. Clin Endocrinol (Oxf). 2009 Jul;71(1):1-6. doi:10.1111/j.1365-2265.2008.03498.x.

Guzik TJ, Hoch NE, Brown KA, et al. Role of the T cell in the genesis of angiotensin II induced hypertension and vascular dysfunction. J Exp Med. 2007 Oct 1;204(10):2449-24 60. doi:10.1084/jem.20070657.

Kravchun NO, Misiura KV. Peculiarities of changes in body fluid sectors in obesity, found by studying its structure. Mìžnarodnij endokrinologìčnij žurnal. 2017;13(1):97-103. doi:10.22141/2224-0721.13.1.2017.96761. (in Ukrainian).

Cancello R, Henegar C, Viguerie N, et al. Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes. 2005 Aug;54(8):2277-2286. doi:10.2337/diabetes.54.8.2277.

Huber J, Kiefer FW, Zeyda M, et al. CC chemokine and CC chemokine receptor profiles in visceral and subcutaneous adipose tissue are altered in human obesity. J Clin Endocrinol Metab. 2008 Aug;93(8):3215-3221. doi:10.1210/jc.2007-2630.

Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr. Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003 Dec;112(12):1796-1808. doi:10.1172/JCI19246.

Clément K, Viguerie N, Poitou C,et al. Weight loss regulates inflammation-related genes in white adipose tissue of obese subjects. FASEB J. 2004 Nov;18(14):1657-1669. doi:10.1096/fj.04-2204com.

Cancello R, Tordjman J, Poitou C, et al. Increased infiltration of macrophages in omental adipose tissue is associated with marked hepatic lesions in morbid human obesity. Diabetes. 2006 Jun;55(6):1554-1561. doi:10.2337/db06-0133.

Nishimura S, Manabe I, Nagasaki M, et al. In vivo imaging in mice reveals local cell dynamics and inflammation in obese adipose tissue. J Clin Invest. 2008 Feb;118(2):710-721. doi:10.1172/JCI33328.

Cancello R, Clément K. Is obesity an inflammatory illness? Role of low-grade inflammation and macrophage infiltration in human white adipose tissue. BJOG. 2006 Oct;113(10):1141-1147. doi:10.1111/j.1471-0528.2006.01004.x.

Sell H, Dietze-Schroeder D, Eckel J. The adipocyte-myocyte axis in insulin resistance. Trends Endocrinol Metab. 2006 Dec;17(10):416-422. doi:10.1016/j.tem.2006.10.010.

Bell BB, Rahmouni K. Leptin as a Mediator of Obesity-Induced Hypertension. Curr Obes Rep. 2016 Dec;5(4):397-404. doi:10.1007/s13679-016-0231-x.

Lim K, Jackson KL, Sata Y, Head GA. Factors Responsible for Obesity-Related Hypertension. Curr Hypertens Rep. 2017 Jul;19(7):53. doi:10.1007/s11906-017-0750-1.

Savji N, Meijers WC, Bartz TM, et al. The Association of Obesity and Cardiometabolic Traits With Incident HFpEF and HFrEF. JACC Heart Fail. 2018 Aug;6(8):701-709. doi:10.1016/j.jchf.2018.05.018.

Morimoto A, Kadoya M, Kakutani-Hatayama M, et al. Subclinical decrease in cardiac autonomic and diastolic function in patients with metabolic disorders: HSCAA study. Metabol Open. 2020 Jan 22;5:100025. doi:10.1016/j.metop.2020.100025.

Ye S, Zhu C, Wei C, et al. Associations of Body Composition with Blood Pressure and Hypertension. Obesity (Silver Spring). 2018 Oct;26(10):1644-1650. doi:10.1002/oby.22291.

Omura-Ohata Y, Son C, Makino H, et al. Efficacy of visceral fat estimation by dual bioelectrical impedance analysis in detecting cardiovascular risk factors in patients with type 2 diabetes. Cardiovasc Diabetol. 2019 Oct 22;18(1):137. doi:10.1186/s12933-019-0941-y.

Taing KY, Farkouh ME, Moineddin R, Tu JV, Jha P. Comparative associations between anthropometric and bioelectric impedance analysis derived adiposity measures with blood pressure and hypertension in India: a cross-sectional analysis. BMC Obes. 2017 Dec 1;4:37. doi:10.1186/s40608-017-0173-1.

Vaziri Y, Bulduk S, Shadman Z, et al. Lean Body Mass as a Predictive Value of Hypertension in Young Adults, in Ankara, Turkey. Iran J Public Health. 2015 Dec;44(12):1643-1654.

Jia A, Xu S, Ming J, et al. Body fat percentage cutoffs for risk of cardiometabolic abnormalities in the Chinese adult population: a nationwide study. Eur J Clin Nutr. 2018 May;72(5):728-735. doi:10.1038/s41430-018-0107-0.