scholarly journals Role of immunological disorders, endothelial dysfunction and hemostatic disorders in the genesis of arterial hypertension in the metabolic syndrome

2020 ◽  
Vol 22 (2) ◽  
pp. 221-230
Author(s):  
E. I. Polozova ◽  
E. V. Puzanova ◽  
A. A. Seskina
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Endothelial Dysfunction ◽  
Arterial Hypertension ◽  
Immune Cells ◽  
Metabolic Disorders ◽  
Vascular Wall ◽  
Immunological Disorders ◽  
Hemostatic Disorders

Mortality from diseases of the circulatory system is a challenge for the modern health care. Arterial hypertension (AH) mostly contributes to development of cardiovascular complications. It often proceeds against the background of metabolic disorders. Pathogenesis of hypertension is currently being considered a multifactorial disease. Pathogenesis of hypertension certainly has distinct features in presence of metabolic disorders,. Therefore, it is relevant to summarize current literature on the role of immunological disorders, endothelial dysfunction and hemostatic disorders in AH genesis during metabolic syndrome (MS). Most authors agree with existence of several mechanisms that determine relationships between AH and insulin resistance. Development of hypertension in MS patients with is a consequence of immunometabolic processes. Abdominal obesity is an important component of MS. It is associated with chronic inflammation of visceral adipose tissue, its excessive infiltration by immune cells, and increased production of adipokines and cytokines (TNFα, IL-6) with hypertension. AH is associated with a significant increase in T cells, that mediate endothelial dysfunction (ED) and provide a link between hypertension and subsequent atherosclerosis. T lymphocytes trigger a cascade of reactions. IL-17 is the end product of these events It is involved not only in increasing blood pressure, but also contributes to the development of vascular wall stiffness in АН patients. Thus, the relationship between several types of immune cells leads to inflammatory reactions, including those of vascular wall, initiating endothelial dysfunction. Chronic non-specific inflammation in MS, supported by the cytokine system, is a triggering mechanism for ED progression. Excessive production of endothelin-1 and inhibition of nitric oxide production are the classic markers of ED. Immune damage leads to imbalance in the production of vasoconstrictor and vasodilating substances, proliferative and antiproliferative factors in endothelium. It was shown that ED is an integral aspect of the insulin resistance syndrome in pathogenesis of arterial hypertension associated with metabolic disorders, and contributes to its worsening, increased vascular reactivity and further AH development. According to modern studies, it has been shown that excessive synthesis of pro-inflammatory cytokines introduces disturbances in the system of vascular hemostasis. When studying the effects of metabolic disorders upon hemostatic system, we may conclude that activation of fibrinolytic and plasma chains occurs in the same way for both men and women, with small gender characteristics of individual components. The rheological properties of the blood are also changed with developing MS. Systematization of the available literature data on the issue under study can serve as a basis for determining prognostic criteria of hypertension progression and risk of thrombotic complications.

scholarly journals Relationship between endothelial dysfunction and development of complications of metabolic syndrome

2018 ◽  
Vol 99 (5) ◽  
pp. 784-791
Author(s):  
A G Mustafaeva
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Endothelial Dysfunction ◽  
Smooth Muscles ◽  
Circulatory System ◽  
Vascular Wall ◽  
Vascular Walls ◽  
Increased Risk ◽  
Normal Tone ◽  
Almost All

The article presents the analysis of literature data on the pathogenetic role of endothelial dysfunction (ED) in the development of complications of metabolic syndrome (MS). There are two main signs of MS development - abdominal obesity (AO) and primary insulin resistance (IR). IR and concomitant hyperinsulinemia have both direct and indirect atherogenic effects on vascular walls, lead to the development of dyslipidemia, a number of hormonal and metabolic disorders, activation of the sympathoadrenal system, ie, are the basis of almost all components of MS. Despite the high margin of safety of the circulatory system, there comes a time when, due to frequent vasoconstrictor effects thickening of the walls of resistive vessels occurs to limit local perfusion. The thickening of the walls of arteries develops, that is, the modeling of the vascular wall occurs, leading to an increase of the total peripheral vascular resistance with normal tone of smooth muscles. Currently, the concept of ED is formulated as a key link of insulin resistance and atherogenesis in MS. Methods for studying endothelial function have been created and are introduced into clinical practice. New approaches to directed correction of endothelial dysfunction are being developed. Prospective studies have shown that the degree of endothelial dysfunction may be important in predicting cardiovascular events in patients with or without identified vascular disease. Probably, ED may also be related to the pathogenesis of diabetes mellitus type 2 (DM2). Since all components of MS can have an adverse effect on endothelium, ED can be an extremely common phenomenon in patients with metabolic syndrome and can act as a predictor of increased risk of cardiovascular diseases and DM2 in this population.

scholarly journals The role of metabolic disorders in the progression of renal dysfunction in patients with metabolic syndrome and arterial hypertension

2019 ◽  
pp. 170-175
Author(s):  
E. I. Polozova ◽  
N. N. Sorokina ◽  
E. V. Puzanova ◽  
A. A. Seskina
Keyword(s):  
Metabolic Syndrome ◽  
Glomerular Filtration Rate ◽  
Arterial Hypertension ◽  
Renal Dysfunction ◽  
Cystatin C ◽  
Filtration Rate ◽  
Metabolic Disorders ◽  
Functional Changes ◽  
Group I

The clinical study enrolled 120 patients, who were hospitalized to the Therapeutic Department of Republican Clinical Hospital No.  5 of Saransk. The patients were divided into 2 groups: Group I (n = 60) included patients with metabolic syndrome; Group II (n = 60)  included patients with arterial hypertension. The paper presents data on the assessment of the functional state of kidneys in the  analysed groups, defines the role of metabolic disorders in the progression of renal dysfunction in patients with metabolic syndrome  and arterial hypertension. It is noted that more pronounced functional changes in the kidneys (microalbuminuria, increased cystatin  C levels, decreased glomerular filtration rate) are detected in patients with arterial hypertension and metabolic syndrome, as compared with patients without metabolic disorders. Cystatin C and microalbuminuria have been shown to be one of the earliest markers of kidney damage in hypertension, especially in combination with metabolic disorders. Cystatin C and microalbuminuria level is  significantly higher in patients with arterial hypertension and metabolic syndrome, as compared with patients with arterial hypertension, who have no metabolic disorders. Significant correlations were found between cystatin C, microalbuminuria levels and lipid  and carbohydrate metabolism in patients with arterial hypertension in combination with metabolic disorders. 

scholarly journals An approach to the etiology of metabolic syndrome

2013 ◽  
pp. 57-63 ◽  
Author(s):  
Angélica M Muñoz ◽  
Gabriel Bedoya ◽  
Claudia Velásquez
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Signal Transduction ◽  
Intracellular Signaling ◽  
Metabolic Disorders ◽  
Biochemical Responses ◽  
The World ◽  
Prevalence Of Obesity ◽  
Genetic Mechanisms

Increased prevalence of obesity in the world, especially accumulation of abnormal amounts of visceral fat predisposes to insulina resistance, which is the central role of metabolic syndrome (MS). Obesity can deregulate the intracellular signaling of insulina due to the production of inflammatory substances, chemo attractant proteins, adipokines and molecules that trigger hormonal mediator potentials for destabilization of signal transduction, leading to metabolic disorders such as hyperglycemia, hypertension, and dyslipidemia. The complexity of the MS and of the genetic mechanisms involved in its etiology derives from the combination of variants on genes involved and environmental factors that predispose it. The purpose of this paper is to review the effects of obesity in molecular and biochemical responses that trigger insulin resistance and its relation to some candidate genes and the ancestral component of the population.

scholarly journals AB0083 STUDY OF THE ROLE OF ANGIOPOIETIN-LIKE PROTEIN TYPE 4 IN METABOLIC DISORDERS CAUSED BY INFLAMMATION IN RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1341.2-1341
Author(s):  
A. Aleksandrov ◽  
V. Aleksandrov ◽  
L. Shilova
Keyword(s):  
Rheumatoid Arthritis ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Blood Serum ◽  
Disease Activity ◽  
Metabolic Disorders ◽  
Healthy Individuals

Background:Objectives:To assess the potential role of angiopoietin-like protein type 4 (ANGPTL4) in metabolic disorders caused by inflammation in rheumatoid arthritis (RA).Methods:The study included 88 patients with significant RA, 64 patients with other rheumatic diseases (RD) (36 patients with osteoarthritis (OA); 28 patients with psoriatic arthritis (PsA); 17 patients with ankylosing spondylitis (AS)) and 32 healthy individuals. Estimation of ANGPTL4 was carried out by enzyme immunoassay using the commercial test system “RayBio Human ANGPTL4 ELISA Kit” (RayBiotech, USA) in blood serum. Levels of ESR, CRP, RF, antibodies to cyclic citrullinated peptide (anti-CCP) and modified vimentin (anti-MCV) in the ELISA test were determined for all patients with RA.Results:The level of ANGPTL4 in the blood serum of patients with RA was significantly higher than in healthy people (p <0.001) and patients with other RD (p = 0.012 compared with OA; p = 0.046 with PsA; p = 0.008 with AS). ANGPTL4 indices in patients with RA correlated with the age of onset of RA (r = -0.658, p <0.001), disease activity according to DAS-28 (r = 0.449, p = 0.001), level of education (r = 0.235, p = 0.029), dose of glucocorticoid hormones (r = 0.321, p = 0.009) and methotrexate (r = -0.496, p = 0.05), the presence of osteopenia (r = 0.44), signs of kidney damage - proteinuria (r = 0.309, p = 0.037) and hypoalbuminemia (r = 0.386, p = 0.022), as well as with CRP levels (r = 0.488, p = 0.003), ESR (r = 0.458, p = 0.002), serum vitamin D (r = -0.417) and urinary calcium when recalculated to creatinine (r = 0.797, p = 0.032).Patients with RA showed a high frequency of insulin resistance (according to the HOMA-IR index) (1.27 [0.84–1.62] in patients with RA; 0.76 [0.44–1.02] in healthy individuals; p <0.001) and the presence of coronary heart disease, as well as a positive correlation between disease activity (according to DAS-28) and insulin resistance (according to the HOMA-IR index) (p = 0.033).Higher values of C-reactive protein (p = 0.04) and serum ANGPTL4 levels (p = 0.042, compared with patients with RA without type 2 diabetes; p = 0.026, compared with healthy individuals) were determined in the group of patients with RA with the presence of type 2 diabetes. ANGPTL4 acts as an inhibitor of lipoprotein lipase. His contribution to the development of dyslipidemia in RA can be demonstrated by the results we obtained when comparing groups of patients with / without signs of metabolic syndrome (MS). A positive correlation between ANGPTL4 and triglyceride levels (r = 0.42, p = 0.018) was found. An increase in the level of ANGPTL4 in blood serum of patients with RA with MS (p = 0.027 compared with RA without MS) can predict the development of cardiac pathology in this group of patients.Conclusion:ANGPTL4 is directly involved in the regulation of glucose homeostasis, lipid metabolism, and insulin sensitivity. Cardiovascular diseases associated with atherosclerosis, insulin resistance and metabolic syndrome are known as the most common extraarticular manifestations of RA; the study of the role of ANGPTL4 in metabolic disorders caused by inflammation can show a new direction in the development of laboratory and therapeutic technologies in RA.Disclosure of Interests:None declared

scholarly journals Monitoring of metabolic syndrome and its main criterions rate in children

2014 ◽  
Vol 18 (3 (71)) ◽  
Author(s):  
N. M. Hromnatska
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Lipid Metabolism ◽  
Arterial Hypertension ◽  
Carbohydrate Metabolism ◽  
Abdominal Obesity ◽  
Metabolic Disorders ◽  
Total Population ◽  
High Density Lipoproteins ◽  
High Concentration

Objective. To study the rate of metabolic syndrome and its main criterions in children.Material and methods. Among 1520 children of total population 90 children with metabolic syndrome aged from 9 to 18 years were selected. Diagnosing of metabolic syndrome was provided according to International Diabetic Federation recommendations (2007).Results. It was established that the rate of metabolic syndrome in children of Lviv was 5,9%. The most spread and therefore primary criterion of metabolic syndrome in children was abdominal obesity, which was diagnosed both in overweight (36,6%) and in generalized obesity (63,4) (p=0,039) and was identified in all children with metabolic syndrome (100,0%). Insulin resistance as a sign of carbohydrate metabolism changes was identified in fewer children (41,8%), which means the primacy of abdominal obesity in relation to insulin resistance in metabolic syndrome criterions formation. Hyperglycemia and hypoalphacholesterolemia were almost of the same frequency, which suggests the likelihood of metabolic syndrome development both toward carbohydrate metabolism changes with hyperinsulinemia and hyperglycemia and to lipid metabolism with lowered cholesterol level in high density lipoproteins as well as to hypertriglyceridemia. The latter had the lowest diagnostic level (18,8%).Summary. The rate of metabolic syndrome and its main criterions in Lviv children did not differ from the universal rate. The most informative and spread metabolic syndrome criterions in descending order were: abdominal obesity → arterial hypertension→ hyperinsulinemia → insulin resistance →hyperglycemia→low concentrarion of high-densitycholesterol→high concentration of triglycerides in blood. It is rational to monitor metabolic syndrome in Ukraine, whichreflects a real spread of metabolic disorders in order to prevent and correction them.

scholarly journals Metabolic syndrome in older women

2019 ◽  
Vol 68 (3) ◽  
pp. 81-88
Author(s):  
Maria A. Shalina
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Older Women ◽  
Metabolic Disorders ◽  
Preventive Measures ◽  
Social Importance

This paper presents the current literature data on the pathogenesis of metabolic disorders in menopause. The association of metabolic syndrome with a high risk of coronary heart disease, hypertension, diabetes, and insulin resistance is of great medical and social importance. It emphasizes the need for early diagnosis of metabolic syndrome in older women and optimization of therapeutic and preventive measures. The article highlights the role of pathogenetic, multi-component therapy, including menopausal hormone one, in the treatment of metabolic disorders in menopause.

scholarly journals Metabolic syndrome: new aspects of old problem

2007 ◽  
Vol 13 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Y. A. Vasyuk ◽  
I. A. Sadulaeva ◽  
E. N. Yuschuk ◽  
E. A. Nesterova ◽  
M. V. Chirkov ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Endothelial Dysfunction ◽  
Left Ventricular Hypertrophy ◽  
Arterial Hypertension ◽  
Physical Training ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Target Organs ◽  
Structure And Functions

Metabolic syndrome includes obesity, dyslipidemia, arterial hypertension, hyperglycemia or insulin resistance, microalbuminuria, hyperuricemia. Till nowadays there are no clear data of its classification. According to numerous researches metabolic syndrome also includes endothelial dysfunction, left ventricular hypertrophy, renal dysfunction, rheological blood pathology. So that, patients with metabolic syndrome demand more carefull monitoring with necessary study of metabolism, also during physical training, and more complete examination of target-organs, their structure and functions.

scholarly journals Impaired endothelial functional state in patients with peptic ulcer and duodenal ulcer combined with metabolic syndrome

2013 ◽  
Vol 17 (1 (65)) ◽  
pp. 163-168
Author(s):  
O. I. Fediv ◽  
I. O. Sitsinska
Keyword(s):  
Metabolic Syndrome ◽  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Endothelial Dysfunction ◽  
Functional State ◽  
Vascular Wall ◽  
Endothelial Factors

The principal information, dealing with the role of an endothelial dysfunction in case of peptic ulcer of the stomach and duodenum in the procces of origination and development of metabolic syndrome is generalized in a review paper.The findings, pertaining to the effect of endothelial factors on the development of remodeling the vascular wall in case of gastric and duodenal uncer and metabolic syndrome are submitted.

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