Endothelial activation and insulin resistance: Comparison between essential hypertensives and hypertensive patients with Metabolic Syndrome

Background:Metabolic syndrome (MS) is a collection of cardiometabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidaemia. Insulin resistance lies at the heart of the metabolic syndrome. The purpose of this study is to study the prevalence, clinical attributes of metabolic syndrome in hypertensive subjects and to find out the correlation between prevalence, clinical attributes of metabolic syndrome and insulin resistance.Methods: About 200 diagnosed cases of hypertension as per Joint national committee 8 guidelines were included in this cross sectional single centric study. All patients were examined, history enquired and laboratory tests like lipid profile, fasting plasma glucose were done and diagnosis of metabolic syndrome made as per the National Cholesterol Education Program- Adult Treatment Panel III criteria. Insulin resistance was calculated by Homeostatic model assessment method.Results: Amongst the 200 subjects enrolled, the prevalence of metabolic syndrome in hypertensive subjects was found to be 65%. 93.07% of patients with metabolic syndrome were having blood pressure >150/90 mm hg. The prevalence of metabolic syndrome among smoker males was 54.25%. The most common co-morbidity in these subjects was raised triglycerides (96.29% in males, 90.78% in females) followed by low HDL levels (87.03% in males, 90.78% in females). Insulin resistance was found in 75 out of 130 patients who fulfilled the criteria of metabolic syndrome (57.69%), implying increased correlation of metabolic syndrome in hypertensive patients with insulin resistance (p value <0.05).Conclusions: It was found that there is increased prevalence of metabolic syndrome in hypertensive patients and it correlates with insulin resistance.

Download Full-text

ASSOCIATIONS OF IRS-1 POLYMORPHISM WITH VARIOUS COMPONENTS OF THE METABOLIC SYNDROME IN HYPERTENSIVE PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908115 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1494-1498

Author(s):

Maryna Kochuieva ◽

Valentyna Psarova ◽

Larysa Ruban ◽

Nataliia Kyrychenko ◽

Olena Alypova ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Glucose Tolerance ◽

Arterial Hypertension ◽

Abdominal Obesity ◽

Healthy Individuals ◽

Hypertensive Patients ◽

The Metabolic Syndrome

Introduction: The metabolic syndrome is one of the most discussed cross-disciplinary problems of modern medicine. Now there are various definitions and criteria of diagnostics of metabolic syndrome. The abdominal obesity is considered the main component of the metabolic syndrome, as a reflection of visceral obesity which degree is offered to be estimated on an indirect indicator – a waist circumference. Alongside with abdominal obesity, a number of classifications distinguish insulin resistance (IR) as a diagnostic criterion of metabolic syndrome. It is proved that IR is one of the pathophysiological mechanisms influencing the development and the course of arterial hypertension (AH), type 2 DM and obesity. There are two components in the development of IR: genetic (hereditary) and acquired. In spite of the fact that IR has the accurate genetic predisposition, exact genetic disorders of its appearance have not been identified yet, thus demonstrating its polygenic nature. The aim: To establish possible associations of the insulin receptor substrate-1 (IRS-1) gene polymorphism with the severity of the metabolic syndrome components in patients with arterial hypertension (AH). Materials and methods: 187 patients with AH aged 45-55 years and 30 healthy individuals. Methods: anthropometry, reactive hyperemia, color Doppler mapping, biochemical blood analysis, HOMA-insulin resistance (IR), glucose tolerance test, enzyme immunoassay, molecular genetic method. Results: Among hypertensive patients, 103 had abdominal obesity, 43 - type 2 diabetes, 131 - increased blood triglycerides, 19 - decreased high density lipoproteins, 59 -prediabetes (33 - fasting hyperglycemia and 26 - impaired glucose tolerance), 126 had IR. At the same time, hypertensive patients had the following distribution of IRS-1 genotypes: Gly/Gly - 47.9%, Gly/Arg - 42.2% and Arg/Arg - 10.7%, whereas in healthy individuals the distribution of genotypes was significantly different: Gly/Gly - 86.8% (p<0.01), Gly/ Arg - 9.9% (p<0.01) and Arg/Arg - 3.3% (p<0.05). Hypertensive patients with Arg/Arg and Gly/Arg genotypes had significantly higher HOMA-IR (p<0.01), glucose, insulin and triglycerides levels (p<0.05), than in Gly/Gly genotype. At the same time, body mass index, waist circumference, blood pressure, adiponectin, HDL, interleukin-6, C-reactive protein, degree of endothelium-dependent vasodilation, as well as the frequency of occurrence of impaired glucose tolerance did not significantly differ in IRS-1 genotypes. Conclusions: in hypertensive patients, the genetic polymorphism of IRS-1 gene is associated with such components of the metabolic syndrome as hypertriglyceridemia and fasting hyperglycemia; it is not associated with proinflammatory state, endothelial dysfunction, dysglycemia, an increase in waist circumference and decrease in HDL.

Download Full-text

Insulin resistance is linked to a specific profile of immune activation in human subjects

Scientific Reports ◽

10.1038/s41598-021-91758-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Renaud Cezar ◽

Delphine Desigaud ◽

Manuela Pastore ◽

Lucy Kundura ◽

Anne-Marie Dupuy ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Immune Activation ◽

Human Subjects ◽

Liver Steatosis ◽

Endothelial Activation ◽

Activation Profile ◽

Screening And Prevention ◽

Glutamyl Transferase ◽

T Cell Senescence

AbstractWe tested the hypothesis that a particular immune activation profile might be correlated with insulin resistance in a general population. By measuring 43 markers of immune, endothelial, and coagulation activation, we have previously shown that five different immune activation profiles may be distinguished in 150 volunteers. One of these profiles, Profile 2, characterized by CD4+ T cell senescence, inflammation, monocyte, B cell, and endothelial activation, presented elevated insulinemia, glycemia, triglyceridemia, and γ-glutamyl transferase, a marker of liver injury, in comparison with other profiles. Our data are compatible with a model in which a particular immune activation profile might favor the development of insulin resistance and metabolic syndrome. In this hypothesis, identification of this profile, that is feasible with only 3 markers with an error rate of 5%, might allow to personalize the screening and prevention of metabolic syndrome-driven morbidities as liver steatosis.

Download Full-text