NEUROHUMORAL PROFILES AND INSULIN RESISTANCE IN PATIENTS WITH ARTERIAL HYPERTENSION
Keywords:arterial hypertension, insulin resistance, neurohumoral profiles
Research objective: Studying indices of carbohydrate metabolism, activity of renin-angiotensin-aldosterone system (RAAS), adrenal glucocorticoid function thyroid and calcium-regulating hormones and their possible relationships in patients with hypertension (AH) with insulin resistance (IR) depending on the state of autonomic tone.
A comprehensive study of hormonal profile and vegetative tonus radioimmune method in 68 patients was held: with arterial hypertension stage II, 1-2 degrees, male (mean age – 53.7 ± 3.4 years), with a body mass index up to 30 kg / m² and verified insulin resistance, of which in 37 patients sympathetic tonus dominated (group I), and in 31 patients – parasympathetic tonus dominated (group II). Insulin resistance was verified by the value of the Caro index, which did not exceed 0.33. Variation pulsometry was performed to assess the state of the autonomic nervous system.
It is established that patients with hypertension with IR and sympathicotonia had increased level of catabolic hormones: thyroid-stimulating hormone, thyroxine, triiodothyronine, cortisol, calcitonin, aldosteron, whereas those with parasympathicotonia had increased level of anabolic hormones: insulin, parathyroid hormone, progesterone. There is a strong relation between thyroid and calcium-regulating hormones, insulin in the regulation of carbohydrate metabolism, mediated by the adenylate cyclase system, the content of intracellular Ca²⁺ and Mg²⁺. The effect of calcium-regulating hormones on the development of IR in patients with hypertension depends on autonomic tone. The mechanisms of interaction of insulin and renin-angiotensin-aldosterone system in hypertension with IR depend on the concentration of hormones, glucocorticoid function of the adrenal glands, and activity of the vegetative nervous system. Conclusion: in hypertension with a predominance of sympathetic tonus, probably receptor and postreceptor mechanisms of IR dominate, whereas in hypertension with a predominance of parasympathetic tone those at the level of target cells dominate.
Ormazabal V, Nair S, Elfeky O, et al. Cardiovascular Diabetol 2018;17(1): 122-136. https://doi.org/10.1186/s12933-018-0762-4.
Zhou D, Xi B, Zhao M, et al. Sci Rep 2018;8(1): 9418. https://doi.org/10.1038/s41598-018-27377-2.
Pashentseva AV, Verbovoy AF, Sharonova LA. Obes Metabol 2017;14(2): 9-17. https://doi.org/10.14341/omet201729-17.
Sokolova LA, Ievskaia EV, Vavilova TV, e t a l. Arterial Hypertens 2017; 23(4): 294-302. https://doi.org/10.18705/1607-419X-2017-23-4-294-302.
Statsenko ME, Derevyanchenko MV. Rus J Cardiol 2020;25(4): 27-34. https://doi.org/10.15829/1560-4071-2020-3752.
Zhou M, Schulman I, Zeng Q. Vasc Med 2012;17(5): 330-341. https://doi.org/10.1177/1358863X12450094.
Gutiйrrez-Rodelo C, Roura-Guiberna A, Olivares-Reyes JA. Gac Med Mex 2017;153(2): 214-228.
Balu D, Ouyang J, Parakhia RA, et al. Front Endocrinol (Lausanne) 2020;25: 11-33. https://doi.org/10.3389/fendo.2020.00033.
Mancusi С, Izzo R, Giuseppe di Gioia G, e t a l. High Blood Press Cardiovasc Prev 2020;27(6): 515-526. https://doi.org/10.1007/s40292-020-00408-8.
Williams B, Mancia G, Spiering W, et al. Eur Heart J 2018;39(33): 3021-3104. https://doi.org/10.1093/eurheartj/ehy339.
Gao P, Hu Y, Wang J, et al. Med Sci Monit 2020;11(26): e924334. https://doi.org/10.12659/MSM.924334.
Kurt Hшjlund. Dan Med J 2014;61(7): B4890.
Osegbe I, Okpara H, Azinge E. Ann African Med 2016; 15(1): 14. https://doi.org/10.4103/1596-3519.158524.
Forrester SJ, Booz GW, Sigmund CD, et al. Physiol Rev 2018;98(3): 1627-1738. https://doi.org/10.1152/physrev.00038.
Korchynski V. Ukr J Cardiol 2014;6: 60-65.
Baevsky RM. et al. Analysis of heart rate variability using various electrocardiographic systems: method. Recommendations, Moskva, 2002: 53 p.
Zhang S, Wei M, Yue M, et al. Endocrine 2018;62(3): 588-601. https://doi.org/10.1007/s12020-018-1700-7.
Moisa S. J Biomed Sci Engineering 2017;10(7): 343-354. https://doi.org/10.4236/jbise.2017.107026.