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).
Material 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.
PATIENTS AND METHODS: Materials and methods: The study included 210 patients with high and very high cardiovascular risk. The first group consisted of 75 patients who studied at the School of Health 'Fundamentals of Healthy Lifestyle'. The second group consisted of 75 patients who were offered individual counseling. The control group consisted of 60 individuals. Patients in both groups were examined before and after the end of the course.
RESULTS: Results and conclusions: We conducted a general clinical examination, determined anthropometric parameters, blood pressure (BP), glucose, cholesterol and its fractions in the blood. It has been established that the group training of patients with high and very high cardiovascular risk in Schools of Health 'Fundamentals of Healthy Lifestyle' promotes better BP control, but does not significantly affect the lipid metabolism. Individual training for patients with high and very high cardiovascular risk leads to a significant reduction in BP levels, improved lipid metabolism, increased physical activity, and improved quality of life.