scholarly journals PLASMA CONCENTRATION OF ENDOTHELIN-1 IN PATIENTS WITH HYPERTENSION ASSOCIATED WITH OBESITY, DEPENDING ON THE LYS198ASN POLYMORPHISM OF THE ENDOTHELIN-1 GENE

2021 ◽  
Vol 9 (1) ◽  
pp. 87-94
Author(s):  
Yu.O. Smiianova

Endothelial dysfunction is considered one of the main mechanisms for the further development of arterial hypertension (AH) and its complications, and endothelin-1 (ЕТ-1) plays one of the key roles in this process. Endothelium is drawn into the pathological process at the earliest stages of AH development. ЕТ-1 is currently considered as a marker and predictor of the stage and consequences of AH, chronic heart failure (CHF), coronary heart disease (CHD), in particularly, acute myocardial infarction (MI), heart rhythm disorders, pulmonary hypertension, atherosclerotic vascular injury, target vascular disorders. One factor that may influence the level of ЕТ-1 is the endothelin-1 gene Lys198Asn polymorphism, which is considered by many researchers as a possible genetic marker of AH. However, the effect of this polymorphism on the level of plasma ЕТ-1 level in patients with AH of varying severity in Ukraine is understudied. The basis of this work were the materials of a complete examination of 160 patients with a verified diagnosis of AH I, stage II of 1, 2, 3 degrees (main group) and 110 apparently healthy persons (control group). Patients of the main group were divided into three subgroups: 1st group ­– 75 patients with normal body weight; 2nd group – 48 overweight patients; 3rd group – 37 patients with alimentary obesity. In obese patients, the waist circumference in women was around 103 (96–115) cm, and in men – 108 (105–116) cm, which indicates an abdominal type of obesity in these patients. As a result of the study, it was found that the level of ЕТ-1 is higher in patients with AH who suffer with overweight and obesity as compared with patients with AH and normal body weight. Also, the peptide level depends on the genotype of patients and is higher in AH patients with the genotype Asn198Asn and Lys198Asn as compared to carriers of the genotype Lys198Lys.

2015 ◽  
Vol 6 (1) ◽  
pp. 71-75
Author(s):  
Elena Anatol’yevna Yalfimova ◽  
Galiya Fettyakhovna Kutusheva

Obesity is a serious medical, social and economic issue in modern society. Relevance it is determined primarily by the high prevalence of obesity. Objective: identify medical and social factors influencing the development of obesity in adolescent girls with menstrual cycle. Materials and methods: questionnaires, analysis of medical records, clinical, laboratory and instrumental examination 167 girls from 14 to 18 years with obesity I degree (28,7 %), obesity degree II (58,1 %), obesity III degree (13.2 %) and their parents, and 211 girls with normal body weight and their parents. Results: artificial feeding from birth had 23,2% of the young women of the main group, in the control group the rate was 7.4 %. The regularity of meals keep 12.5 % of adolescents in primary and 27.1 % of adolescents in the control groups. The prevalence of high-calorie foods noted 21.1 % of girls are obese and only 4.9 % of normal body weight. The average age at onset of menarche in girls with obesity was 10 years and 9 months, which is 11 months earlier than in the con-control group girls. Girls with overweight significantly more often in 80.6 % of identified disorders of lipid compared with a group of girls with normal body weight, in 13.9 % of cases respectively. In the main group was observed hormonal changes, talking about changing the gonadotropic function of the pituitary gland, disorders of the cyclical release of gonadotropins, the absence of physiological “ovulatory peak”, a chaotic secretion of FSH and LH, the violation of physiological ratio of FSH/LH. When conducting USDG in the first group identified dyscirculatory violations arterial bed, in the form of the asymmetry of the flow and signs of venous degenii in the form of increased speed of blood flow in the jugular veins, monophasic flow in the veins, the blood flow in the vertebral veins in a horizontal position. Conclusions: the menstrual cycle occurs under the action of complex factors, such as physical illness, unbalanced diet, chronic stress, bad habits, poor physical living conditions. A survey of adolescent girls who turned over the menstrual cycle and with obesity should be integrated and include in addition to the laboratory, instrumentaltion survey joint management of such patients related-governmental experts.


2021 ◽  
Vol 23 (6) ◽  
pp. 766-771
Author(s):  
T. O. Kulynych ◽  
O. O. Lisova ◽  
O. V. Shershnova ◽  
A. V. Hrytsai

Pneumonia presents a considerable challenge in patients with cardiovascular disease due to an increase in the incidence, difficulties of diagnosis and treatment, high mortality. Aim: to study the characteristics of cardiac arrhythmias and heart rhythm autonomic regulation in patients with chronic coronary syndrome (CCS) and community-acquired pneumonia (CAP), and to define their relationship with the clinical features of the disease. Materials and methods. A monocenter cross-sectional study analyzed 90 patients with CCS in parallel groups. The main group included 60 CCS patients with CAP; the control group consisted of 30 patients without concomitant CAP. A complex clinical examination of patients was performed on 1–3 days of hospital stay in accordance with the National Recommendations. Holter ECG monitoring was performed using a CARDIOSENS K device (XAI-MEDICA, Ukraine). Results. Based on the results of 24-hour ECG monitoring, heart rhythm disorders, increased duration of myocardial ischemia and ST-segment depression depth with an increase in the total duration of tachycardia episodes within 24 hours were more common in the main group patients. The severity of CAP on the PSI/PORT scale was correlated with the 24-hour mean heart rate (r = +0.31, P < 0.05), the number of ventricular extrasystoles – with respiratory rate (r = +0.29, P < 0.05), supraventricular extrasystoles – with the duration of ST-segment depression (r = +0.57, P < 0.05). In patients with CCS and CAP, there was a decrease in the total heart rate variability (HRV), mainly in the passive period, combined with an increase in the LF/HF ratio and stress index (SI), which was directly correlated with the severity of CAP and intoxication syndrome. Conclusions. Patients with CCS and CAP are characterized by the increased 24-hour heart rate, duration of ST-segment depression, frequency of supraventricular and ventricular arrhythmias on 24-hour Holter monitoring, paroxysms of atrial fibrillation with the decreased total HRV combined with significantly increased activity of the sympathetic autonomic nervous system.


2021 ◽  
pp. 18-28
Author(s):  
Andrey V. Ivanov ◽  
Alexey A. Malov ◽  
Vadim A. Kichigin ◽  
Vasily A. Ivanov ◽  
Larisa V. Tarasova

Despite a decrease in the incidence of pulmonary tuberculosis in the Russian Federation in recent years, among the newly diagnosed patients there remains a significant proportion of patients with bacterial excretion and destructive pulmonary tuberculosis. In patients with destructive pulmonary tuberculosis, surgical treatment is often the only possible method for saving lives. We studied the results of extrapleural posterosuperior thoracoplasty in 42 patients with destructive pulmonary tuberculosis. The comparison group consisted of 30 patients who received medicamentous therapy. The mortality rate for 3 years of follow-up in the conservative treatment group was 36.7%, in the surgical treatment group it was 23.8%, p = 0.237. Among patients with more than 2 years of disease experience, mortality was 45% in the main group, 88% in the comparison group, p = 0.070. In the absence of drug resistance, mortality in the main group was 4%, that in the comparison group – 14.2%, p = 0.283. Mortality in individuals with normal body weight was lower in the group of patients who underwent thoracoplasty than in the comparison group: 17.6% vs. 33.3% (p = 0.202). Among those who did not achieve sputum negative reaction, mortality was lower, and passing to the 3rd group of dispensary care was more common in the surgical treatment group – 41.7% vs. 71.4% (p = 0.077) and 33.3% vs. 21.4% (p = 0.426). Among patients with drug resistance or low body weight or unachieved sputum negative reaction, mortality rates were comparable in both groups. Thus, thoracoplasty, in comparison with conservative therapy, makes it possible to improve treatment results in patients regardless of the length of the disease in groups with Mycobacterium tuberculosis sensitive process, with normal body weight, with preservation of elimination of bacilli. The effectiveness of thoracoplasty decreases in patients with an increase in the disease duration.


2019 ◽  
Vol 43 (4) ◽  
pp. 47-53
Author(s):  
S.D. Khimich ◽  
O. M. Chemerys

Abstract Introduction. It’s known that the issue of polytrauma is one of the most urgent problems of surgery, and among injured patients a special approach is required for patients with overweight and obesity of varying degrees. Purpose of the study. To study prognostic features of traumatic disease course and to improve the results of diagnostics and surgical treatment of patients with polytrauma suffer obesity. Materials and methods. Clinical material was made up of 106 patients with combined body trauma, which were divided into three groups according to body mass index. Results. The results of the research showed a significant difference in the course of traumatic disease in patients with normal body weight and obesity. In particular, in the process of diagnostics of blunt chest and abdominal trauma the frequency of application of interventional methods of diagnostics was directly proportional to the increase of body mass index. The course of traumatic disease in the obese patients had a number of characteristic features that formed the basis for the development of diagnostics and differential program of treatment. Conclusions. The results of the research showed that the course of traumatic disease in combined injury obese patients is directly proportional to the body mass index and has certain features that differentiate them from patients with normal body weight. Keywords: polytrauma, obesity, traumatic disease, diagnostics, treatment.


2018 ◽  
Vol 20 (6) ◽  
pp. 913-920
Author(s):  
M. V. Antonyuk ◽  
T. A. Gvozdenko ◽  
T. P. Novgorodtseva ◽  
T. I. Vitkina ◽  
B. I. Geltser ◽  
...  

Combination of bronchial asthma (BA) and obesity is a difficult-to-control phenotype. Studies of inflammatory process with respect to severity of the disease are important for understanding the potential influence of obesity on the BA clinical course. The objective of this study was to determine cytokine profile in patients with mild BA combined with obesity. The study involved fifty-three patients with partially controlled mild BA. The patients were recruited as volunteers and signed an informed consent. The first observation group consisted of 27 asthma patients with normal body weight, the second observation group consisted of 26 patients with BA combined with obesity. A control group included 25 healthy volunteers. All the patients underwent clinical and laboratory examination in accordance with clinical standards for BA and obesity. The levels of TNFα, IL-2, IL-4, IL-6, IL-10 were evaluated in blood serum by means of flow cytometry. The ratios of proand anti-inflammatory cytokines (TNFα/IL-4, TNFα/IL-10, IL-6/IL-4, IL-6/IL-10) were calculated. Asthma patients with obesity (the 2nd group) had elevated levels of IL-2 over control group and group 1, by 38% and 44% respectively(p < 0.05). The concentration of proinflammatory cytokines TNFα and IL-6 was significanty increased in the both patient groups. Mean TNFα level was increased 2.5 times (p < 0.05), and IL-6 levels were increased by 30% (p < 0.05) in the 1st group as compared to the controls. TNFα and IL-6 concentrations showed a 3-fold increase over control values (p < 0.05) in the 2nd group. The level of antiinflammatory cytokine IL-4 was increased in patients with BA, independently of body mass. It should be noted that the concentration of this cytokine in obese patients was higher by 29% than in patients with normal body weight. IL-10 levels in patients from the 2nd group were reduced more than 2 times than in the 1st group. The patients of the 1st group showed a decrease in the IL-6/IL-10 index, in comparison with control parameters, thus indicative of an imbalance due to the elevation of the anti-inflammatory IL-10 cytokine. Among BA patients with obesity (group 2) the TNFα/IL-10 and IL-6/IL-10 indexes were higher than those of the control group (2.3- and 5.5-fold, respectively) and the group 1 (2.6- and 2.5-fold, respectively). Dynamics of these indexes confirms the systemic nature of inflammation and a predominance of non-atopic  inflammation in asthma patients with obesity. Thus, features of the cytokine profile in BA with obesity consist of a significant increase in pro-inflammatory IL-2, IL-6, TNFα cytokines, and a relative decrease in anti-inflammatory IL- 10 cytokine. The development of BA with obesity, even in mild-severity BA, is accompanied by development of a cytokine disbalance, which is typical for a mixed-type inflammation, with a prevalence of neutrophil inflammation. 


2021 ◽  
Vol 12 ◽  
Author(s):  
Agata Grzyb ◽  
Małgorzata Domagalska-Szopa ◽  
Andrzej Siwiec ◽  
Ilona Kwiecień-Czerwieniec ◽  
Andrzej Szopa

Background: One of the objective methods of assessing the level of cardiopulmonary capacity in overweight and obese children and adolescents is cardiopulmonary exercise testing (CPET).Aims: The purpose of present study is an evaluation of aerobic capacity in high body mass index (BMI) children and adolescents by comparing them with a normal weight control group by CPET.Methods and Procedures: The subjects were recruited from participants of the Program of Treatment for Overweight and Obese Children organized by a local pediatric rehabilitation center in Poland. Based on BMI for age and gender, two validation groups were selected: (1) a group of overweight children (n = 49) and (2) a group of obese children (n = 48). The study included also 53 normal weight participants as a reference group (REF). The study consisted of two parts: anthropometric measurements and CPET. The Godfrey protocol for CPET was applied.Outcomes and Results: In this study, obese children and adolescents showed similar absolute VO2peak values in liters per minute (1.64 L/min) compared to overweight children (1.48 L/min), but significantly higher than children with normal body weight (1.39 L/min). The obese children and adolescents presented lower VO2peak in relation to body weight (25.44 ml/kg/min) compared to their peers with normal body weight (36.5 ml/kg/min), and overweight children (29.18 ml/kg/min).Conclusion and Implications: The main finding of our study was recognition of significant differences between cardiopulmonary capacity parameters in obese children in comparison not only to normal weight peers, but to overweight, too.


2019 ◽  
Vol 6 (1) ◽  
pp. 51-57 ◽  
Author(s):  
O. A. Gerasimchik ◽  
Ya. V. Girsh

Background. The steady growth of obesity in the children’s age group determines the need for integrated modern approaches to diagnosis and therapy.Objective. To determine the body composition of adolescents with different body mass for the quantitative analysis of the internal environment of the organism using the method bioimpendancemetria.Design and methods. To determine the composition of the body, 121 adolescents aged 10–17 years were examined, the average age was 13.9 years (± 2.1). Evaluation of anthropometric data and determination of BMI at the 1st stage of the study allowed to identify 3 groups of patients: group 1 — adolescents with normal body weight, 40 people (33 %), group 2 — overweight, 48 people (40 %) and group 3 — obese, 33 adolescents (27 %). At stage 2nd, the analysis of the body structure using computer impedance, which allows to determine the composition of the body in a percentage.Results. When assessing the structure of the body, in group with normal body weight, the content of adipose tissue corresponds to the normal value. In adolescents overweight and obesity in 100 % of cases there was an increased content of fat mass. In the group of adolescents with normal body weight, the percentage deviation of AKM is 16–17 %, in the group with excess body weight 12–40 %. Insufficient as well as excessive percentage of AKM causes hunger. The higher AKM in full adolescents, the more difficult the process of weight loss. During the evaluation of the main metabolism it was found that in the group of obese patients the indicators exceeded those in the groups with normal and overweight.Conclusion. The use of bioimpedance analysis allows to create an optimal set of sequential effects aimed at correcting the fat mass, water composition and muscle mass of the patient, which determines a more directed and effective weight loss and the possibility of dynamic control.


2019 ◽  
Vol 15 (1-2) ◽  
pp. 69-73
Author(s):  
O.M. Misiura ◽  
M.V. Khaitovych

Relevance. Recent changes in lifestyle and diet have led to a significant increase of overweight and obesity among children and adolescents. According to the results of our previous studies, it was found that among adolescents with overweight/obesity, essential hypertension is 1,5-7,5 times more common than among peers. It is known that children and adolescents with obesity are inherent in emotional instability and impulsivity. Objective of this work was to study the personality characteristics of adolescents with essential hypertension and overweight/obesity. Materials and methods. In the Kiev Children's Clinical Hospital No. 6, a comprehensive clinical and psychological study of 67 adolescents (18 girls, 49 boys) aged 12-17 years (average of 14,40±1,63 years) was carried out, who were hospitalized for essential hypertension. Overweight was found in 7 girls and 21 boys, obesity - in 2 girls and 8 boys. The remaining patients (9 girls and 20 boys) had normal body weight (comparative group). We evaluated the level of anxiety, alexithymia, depression, the type of attitude to the disease, and also determined the personality characteristics of the patients. Results. Adolescents with essential hypertension and overweight/obesity on average differed significantly higher pulse daily blood pressure (61,98±8,13 mmHg versus 57,02±6,70; P<0,005), lower values of anxiety scales (5,11±4,77 points versus 9,62±7,72 points; P<0,01), hypochondria (5,70±5,20 points versus 9,00±5,20 points; P<0,05), neurasthenia (7,19±7,49 points versus 11,14±7,90 points; P<0,05) and egocentrism (5,70±4,44 points versus 8,57±5,08 points; P<0,05) related to TOBOL test. According to the personality test R.-B. Kettell in adolescents with overweight/obesity was on average higher level Q2 scale (6,72±2,14 points versus 4,91±2,63 points; P<0,05). Conclusion. Adolescents with essential hypertension and overweight, obesity, in contrast to patients with normal body weight, are less neurotic by the disease, but they are characterized by non-conformity.


2014 ◽  
Vol 60 (1) ◽  
pp. 24-31 ◽  
Author(s):  
N N Volevodz ◽  
E A Bogova ◽  
M V Nemtsova ◽  
M A Ermakova ◽  
T O Chernova ◽  
...  

Aim. The nalysis of peculiar features of obesity and metabolic disorders in the children presenting with Prader-Willi syndrome (PWS). Results of clinical, hormonal, and metabolic studies are presented obtained by the observation of 45 children of the prepubertal age suffering from obesity despite the normal body weight. The control group was comprised of 47 children presenting with exogenous constitutional obesity. The percent content of fatty mass in the patients with PWS and obesity was higher than in those with exogenous constitutional obesity (p=0.01) despite a similar degree of obesity. In contrast, the percent content of lean mass in the patients of the former group was significantly smaller (p<0.01). The prevalence of insulin resistance among the children with PWS and obesity was 11.1% compared with 42.5% in those with exogenous constitutional obesity (p=0.013). The blood leptin level, occurrence of dyslipidemia. and percent content of fatty mass in the children with PWS in the absence of obesity were similar to those in the patients with exogenous constitutional obesity.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Anna Shalimova ◽  
Valentyna Psarova ◽  
Nataliia Kyrychenko ◽  
Maryna Kochuieva

Abstract The results of a number of studies have shown that in arterial hypertension (AH), G/T and T/T genotypes of the adiponectin gene (ADIPOQ) and Gly/Arg and Arg/Arg genotypes of the insulin receptor substrate 1 gene (IRS-1) are associated with a greater severity of metabolic disorders and hemodynamic parameters compared with G/G and Gly/Gly genotypes of these genes. The aim of the study: to evaluate the severity of cardiovascular remodeling and metabolic disorders in hypertensive obese patients in the simultaneous presence of two unfavorable genotypes of the ADIPOQ and IRS-1 genes. Methods: We examined 300 AH patients: 200 patients with AH and obesity, 50 patients with AH and normal body weight, 50 patients with AH and overweight, 40 patients with AH, obesity and type 2 diabetes mellitus (DM2), 30 healthy individuals. The polymorphisms of the ADIPOQ and IRS-1 was assessed by molecular genetic method. Results: It was found that in all groups of hypertensive patients, regardless of body weight and the presence of DM2, the simultaneous presence of two unfavorable genotypes of the ADIPOQ and IRS-1 genes occurred significantly more often than in healthy individuals: in 41% of AH patients with obesity, 30% of AH patients with normal weight, 40% of AH with overweight, 57.5% of AH with obesity and DM2 vs. 13.3% of healthy individuals. In hypertensive patients, in the presence of overweight and obesity, the frequency of combination of the two unfavorable genotypes of these genes was significantly higher than in AH patients with normal body weight. Conducting comparative evaluation of AH patients with obesity depending on the presence of two unfavorable genotypes or two protective genotypes of the ADIPOQ and IRS-1 genes showed that carriers of the combination of the G/T + T/T genotype of the ADIPOQ and the Gly/Arg + Arg/Arg genotype of the IRS-1 had a higher body mass index, more pronounced insulin resistance, cardiovascular remodeling, adipokine imbalance, impaired carbohydrate and lipid metabolism. Conclusions: In AH patients, the frequency of the simultaneous presence of two unfavorable polymorphisms of ADIPOQ and IRS-1 genes was higher than in healthy individuals. In AH patients with overweight and obesity, the frequency of combination of the two unfavorable genotypes of the ADIPOQ and IRS-1 genes was significantly higher than in normal body weight. The presence of a combination of two unfavorable genotypes of the ADIPOQ and IRS-1 genes in patients with AH and obesity was associated with a greater severity of cardiovascular remodeling and metabolic disorders compared with the combination of two protective genotypes of these genes.


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