Features of Сlinical-metabolic Disorders and Structural-functional Changes of Heart in Patients with Essential Hypertension with Abdominal Obesity and Heart Hypertrophy

Objective: to investigate the relationship between adiponectin level and metabolic syndrome (MS) after weight loss in patients with abdominal obesity (AO). Method: A 3-year randomized lifestyle intervention trial performed in 153 patients with AO, age 43,2±0,8 yrs, BMI 32,1±1,9 kg/m 2 . 74 patients keep hypocaloric diet (gr.1), 79 patients keep diet and performed aerobic exercise (gr.2). Adiponectin concentration, body mass (BM), waist circumference (WC), body fat (BF), BMI, the levels of BP, glucose, insulin, HOMA-IR, TC, HDL-C, LDL-C, TG, CRP were measured before and after a 3-years outpatient intervention program. Results. 100% patients with AO had some metabolic disorders and 38% had MS before the treatment. The adiponectin levels and others parameters didn’t differ between the groups before intervention (p>0,05). In 3 years 53 (71,6%) and 58 (73,4%) patients from 1 and 2 groups reduced weight. The rate of improving BM, BMI, BF, WC, HDL-C, TG and insulin was grater in patients gr.2 (p<0,05). The favorable dynamics of MS (MS didn’t appeared at the end of study or didn’t registered in patients who had it before) didn’t differ between the groups 1 and 2 (81,1% and 91,4%, p>0,05). The increasing of adiponectin level occurred more often in patients gr.2, than gr.1 (93,1% and 58,5%, p=0,001, respectively). Adiponectin level increased only in patients gr.2 (18,0±1,1mcg/ml and 23,8±1,3 mcg/ml, p= [[Unable to Display Character: р]]=0,0001), didn’t changed in gr.1 (p>0,05). It was established that in patients with combination of weight loss and increasing of adiponectin level favorable dynamics of MS occurred more often than in patients who lost weight without increasing of adiponectin level (91,7% and 69,2%, p=0,0001). In patients with favorable dynamics of MS increasing of adiponectin level had met more often, than in patients with unfavorable dynamics of MS (MS continued or appeared) (88,6% and 11,4%, p=0,0001). Increasing of adiponectin level associated with positive dynamics of the MS - OR=9,1 (4,0-20,6). Conclusion. Combination of weight loss and increasing of adiponectin level associated with favorable dynamics of the metabolic syndrome.

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Microalbuminuria as a Marker of Preclinical Diastolic Dysfunction in Newly Diagnosed and Never-Treated Essential Hypertension

Journal of Institute of Medicine ◽

10.3126/jiom.v35i1.8890 ◽

2013 ◽

Vol 35 (1) ◽

pp. 3-8

Author(s):

RM Gajurel ◽

A Sayami

Keyword(s):

Essential Hypertension ◽

Diastolic Dysfunction ◽

Myocardial Dysfunction ◽

Public Health Problem ◽

Left Ventricular Diastolic Dysfunction ◽

Left Ventricular ◽

Newly Diagnosed ◽

Spot Urine ◽

Functional Changes ◽

Ventricular Diastolic Dysfunction

Introduction: Hypertension (HTN) is a global public health problem with one fourth adults worldwide estimated to have high blood pressure (BP)1 The incidence of hypertension continues to increase in all developed and developing societies as the population grows older and more obese. The Framingham Study and other epidemiological surgeys have clearly defined HTN as an important cause of morbidity and mortality. The aim of this study was to determine the spot urine Microalbuminuria as a marker of preclinical cardiac structural and functional changes in the form of left ventricular diastolic dysfunction in newly diagnosed and never treated essential hypertensive subjects. Methods: A cross sectional study was used for those patients who were attended outpatient clinic of MCVTC with diagnosis of newly diagnosed and never treated hypertension over a period of October 2011 to November 2012. Results: A total of 130 essential hypertensive patients underwent for spot urine for microalbuminuria estimation and Echocardiography for evaluation of left ventricular diastolic function. Among 56 (43.1%) urine samples showed negative test [(Microalbuminuria -); ( UACR 30 mg/Gm)] and those 74 (56.9%) samples revealed positive test [(Microalbuminuria+); (UACR 30 to 300 mg/Gm)]. Patients with microalbuminuria positive was found to have more left ventricular diastolic dysfunction than those who were negative for Microalbuminuria. Conclusion: Microalbuminuria was found to have early preclinical marker of myocardial dysfunction in the form of left ventricular diastolic dysfunction in new and never treated essential hypertension. DOI: http://dx.doi.org/10.2126/joim.v35i1.8890 Journal of Institute of Medicine, April, 2013; 35:3-8

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Essential hypertension, metabolic disorders, and insulin resistance

American Heart Journal ◽

10.1016/0002-8703(91)90433-i ◽

1991 ◽

Vol 121 (4) ◽

pp. 1274-1282 ◽

Cited By ~ 82

Author(s):

Eleuterio Ferrannini ◽

Andrea Natali

Keyword(s):

Insulin Resistance ◽

Essential Hypertension ◽

Metabolic Disorders

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Diabetic Fetopathy As an Outcome of Manifest Diabetes Mellitus First Detected During Pregnancy

Effective Pharmacotherapy ◽

10.33978/2307-3586-2020-16-26-44-49 ◽

2020 ◽

Vol 16 (26) ◽

pp. 44-49

Author(s):

M.I. Sviridova ◽

◽

N.M. Startsevа ◽

N.P. Romm ◽

O.A. Ulyanova ◽

...

Keyword(s):

Diabetes Mellitus ◽

Neurological Disorders ◽

Metabolic Disorders ◽

Clinical Case ◽

Morphological Changes ◽

Heart Hypertrophy ◽

Endocrine Diseases ◽

High Risk Factors ◽

Different Types ◽

Left And Right

The article presents a clinical case of diabetic fetopathy in a newborn from a mother with diabetes mellitus, which manifested itself not only by phenotypic disorders, but also by morphological changes in the heart – hypertrophy of the left and right ventricles with obstruction of the outflow parts of the heart, the development of respiratory, heart failure, and neurological disorders. Disorder of carbohydrate metabolism in a patient with high risk factors for metabolic disorders, which was not detected in time, and the refusal of the necessary treatment led to the need to treat the newborn in the intensive care unit. The frequency of occurrence of diabetic fetopathy in different types of diabetes mellitus was shown on the basis of data from the Center for Endocrine Diseases of Pregnant Women on the basis of GKB No. 29

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

Medical Council ◽

10.21518/2079-701x-2019-6-170-175 ◽

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.

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Intervertebral disc homeostasis at normal conditions and during pathology

Kazan medical journal ◽

10.17816/kmj2315 ◽

2012 ◽

Vol 93 (2) ◽

pp. 304-307

Author(s):

A E Kobyzev

Keyword(s):

Intervertebral Disc ◽

Metabolic Disorders ◽

Spinal Column ◽

Intervertebral Discs ◽

Metabolic Processes ◽

Functional Changes ◽

Normal Metabolism ◽

Capillary Zone ◽

Vertebral Bodies ◽

Complex Structural

Intervertebral discs are rather complex structural units of the spine. It is believed that a disturbance of the factors of their homeostasis immediately leads to changes in the bone tissue of the vertebral bodies and, consequently, to pathological changes at the level of the vertebral-motor segment. It follows that the maintenance of normal metabolism within the discs is one of the key directions in the prevention of many clinically important lesions involving the entire vertebral complex. The causes of metabolic processes disorders in the intervertebral disc can be divided into several levels: chronic diseases that directly affect the blood supply to the spinal column as a whole; diseases that affect the permeability of the capillary zone of the subchondral zone of the vertebral bodies; disturbances in the delivery of nutrients into the disc through its matrix, which serves an important selective barrier. However, regardless of the level of the causes of metabolic disorders, all of which eventually lead to anatomical and functional changes in the intervertebral discs and to their subsequent incapacity to provide the daily life cycle of the vertebral complex, consisting of periods of stress and relaxation. Thus, based on the known literature data we can conclude that: the intervertebral discs to date, remain poorly understood elements, however even from a narrow range of studies on this subject it is evident that their functionality is largely dependent on the properties of the disc matrix and the interstitial nature of metabolic processes.

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The Association Between Parity and Metabolically Unhealthy Normal-Weight in Chinese Postmenopausal Women

10.21203/rs.3.rs-91685/v1 ◽

2020 ◽

Author(s):

Mengte Shi ◽

Xinhe Zhou ◽

Chao Zheng ◽

Youjin Pan

Keyword(s):

Postmenopausal Women ◽

Abdominal Obesity ◽

Metabolic Disorders ◽

Smoking Status ◽

Density Lipoprotein ◽

Normal Weight ◽

Age At Menarche ◽

Patients With Diabetes ◽

Drinking Status ◽

Chinese Postmenopausal Women

Abstract BackgroundStudies analyzing the association between parity and metabolically unhealthy normal-weight (MUHNW) individuals in postmenopausal women remain limited, this study aimed to explore the association between parity and MUHNW among Chinese postmenopausal women.MethodsIn total, 776 normal-weight undiagnosed type 2 diabetes postmenopausal women who visited the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University for a routine health check-up between 1 January 2017 and 31 December 2019 were included in the study. All individuals had fully completed information records encompassing standardized electronic medical records, physical examinations, and biochemical measurements. The association between parity and MUHNW was analyzed using multivariate logistic regression.ResultsCompared to women with a parity of one, the odds ratios (OR) [95% confidence interval (CI)] of the parity 2, 3, and ≥4 groups were observed to be 1.40 (0.89, 2.20), 2.00 (1.16, 3.44) and 1.87 (0.96, 3.62), respectively, with P for trend < 0.05 after adjusting for potential confounding factors. Women with a higher parity (≥3) had an increased OR of abdominal obesity, while the OR (95% CI) of the parity 3 group was 2.54 (1.46, 4.40) and that of the parity 4 group was 4.25 (2.11, 8.56), the P for trend < 0.001 after adjusting for age, body mass index (BMI), education level, first-degree relatives of patients with diabetes, smoking status, alcohol drinking status, physical activity, pregnancy losses, age at menarche, and duration of reproductive years. No significant differences were detected for other metabolic disorders including high levels of triglycerides (TG), blood pressure, fasting plasma glucose (FPG), and decreased high-density lipoprotein cholesterol (HDL-C) in different parity groups.ConclusionHigher parity was associated with a higher risk of MUHNW in Chinese postmenopausal women. Accordingly, it may be plausible that parity serves as a risk factor for metabolic disorders irrespective of BMI, and abdominal obesity may play an important role in metabolic disorders.

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Embryonic cardiospecific knockout of α-E-catenin gene leads to alteration of energy metabolism in adult heart

Bulletin of Taras Shevchenko National University of Kyiv Series Problems of Physiological Functions Regulation ◽

10.17721/2616_6410.2017.23.65-69 ◽

2017 ◽

Vol 23 (2) ◽

pp. 65-69

Author(s):

V. Balatskyy ◽

L. Macewicz ◽

O. Piven

Keyword(s):

Lipid Metabolism ◽

Energy Metabolism ◽

Transgenic Mice ◽

Lipid Droplets ◽

Metabolic Disorders ◽

Conditional Knockout ◽

Heart Hypertrophy ◽

Oil Red O Staining ◽

Oil Red O

Previously we have shown that the α-E-catenin knockout in the embryonic heart leads to hypertrophy in adult and activation of canonical Wntsignaling. Heart hypertrophy is also accompanied by metabolic disorders, but role of the α-E-catenin in these processes is not known. Aim of our work is to study the effect of α-E-catenin deletion on the lipid metabolism in the heart. Methods. In our experiment we have used α-Е-catenin conditional knockout and αMHC-Cre transgenic mice. We have utilized histological (Oil Red O staining) and molecular biological (Western blot) methods. Results. α-Е-catenin deletion leads to accumulation of lipid droplets in myocardium, and to violation of expression and phosphorylation of key regulators of lipid metabolism (Ampk, Pparα, Acc, Hsl). Conclusions. Ous results suggest that α-Е-catenin deletion leads to inhibition of lipid metabolism in the heart.

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Pathogenetic mechanisms of development of myocardial pathology in patients with malignant tumors: the current state of the problem

Kardiologiia ◽

10.18087/cardio.2020.2.n985 ◽

2020 ◽

Vol 60 (2) ◽

pp. 142-154

Author(s):

A. G. Obrezan ◽

N. V. Shcherbakova

Keyword(s):

Metabolic Disorders ◽

Malignant Tumors ◽

Current Data ◽

Related Factors ◽

Functional Changes ◽

Pathogenetic Mechanisms ◽

Current State ◽

Neoplastic Process ◽

Mechanisms Of Development ◽

Myocardial Pathology

The myocardium, which has a high metabolic activity, responds to metabolic disorders and energy imbalance induced by a growing malignant tumor. In addition, the tumor itself can produce substances that directly affect metabolic processes and the life cycle of cells not involved in the neoplastic process, including cardiomyocytes. This review summarized and systematized current data on individual aspects of detrimental effects of oncogenes and tumor-related factors on the heart muscle and morpho-functional changes in the cardiovascular system of oncology patients. Also, the authors described in detail development of these pathogenetic mechanisms.

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Endoplasmic reticulum stress inhibition blunts the development of essential hypertension in the spontaneously hypertensive rat

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00523.2018 ◽

2019 ◽

Vol 316 (5) ◽

pp. H1214-H1223 ◽

Cited By ~ 6

Author(s):

Safaa Naiel ◽

Rachel E. Carlisle ◽

Chao Lu ◽

Victor Tat ◽

Jeffrey G. Dickhout

Keyword(s):

Blood Pressure ◽

Endoplasmic Reticulum ◽

Essential Hypertension ◽

Er Stress ◽

Spontaneously Hypertensive Rat ◽

Resistance Arteries ◽

Spontaneously Hypertensive ◽

Functional Changes ◽

Hypertensive Rat ◽

Hypertension Development

Essential hypertension is the leading cause of premature death worldwide. However, hypertension’s cause remains uncertain. endoplasmic reticulum (ER) stress has recently been associated with hypertension, but it is unclear whether ER stress causes hypertension. To clarify this question, we examined if ER stress occurs in blood vessels before the development of hypertension and if ER stress inhibition would prevent hypertension development. We used the spontaneously hypertensive rat (SHR) as a model of human essential hypertension and the Wistar-Kyoto (WKY) rat as its normotensive control. Resistance arteries collected from young rats determined that ER stress was present in SHR vessels before the onset of hypertension. To assess the effect of ER stress inhibition on hypertension development, another subset of rats were treated with 4-phenylbutyric acid (4-PBA; 1 g·kg−1·day−1) for 8 wk from 5 wk of age. Blood pressure was measured via radiotelemetry and compared with untreated SHR and WKY rats. Mesenteric resistance arteries were collected and assessed for structural and functional changes associated with hypertension. Systolic and diastolic blood pressures were significantly lower in the 4-PBA-treated SHR groups than in untreated SHRs. Additionally, 4-PBA significantly decreased the media-to-lumen ratio and ER stress marker expression, improved vasodilatory response, and reduced contractile responses in resistance arteries from SHRs. Overall, ER stress inhibition blunted the development of hypertension in the SHR. These data add evidence to the hypothesis that a component of hypertension in the SHR is caused by ER stress. NEW & NOTEWORTHY In this study, 4-phenylbutyric acid’s (4-PBA’s) molecular chaperone capability was used to inhibit endoplasmic reticulum (ER) stress in the small arteries of young spontaneously hypertensive rats (SHRs) and reduce their hypertension. These effects are likely mediated through 4-PBA's effects to reduce resistant artery contractility and increase nitric oxide-mediated endothelial vasodilation through a process preventing endothelial dysfunction. Overall, ER stress inhibition blunted the development of hypertension in this young SHR model. This suggests that a component of the increase in blood pressure found in SHRs is due to ER stress. However, it is important to note that inhibition of ER stress was not able to fully restore the blood pressure to normal, suggesting that a component of hypertension may not be due to ER stress. This study points to the inhibition of ER stress as an important new physiological pathway to lower blood pressure, where other known approaches may not achieve blood pressure-lowering targets.

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