Особливості дисліпідемії у осіб із різною масою тіла

Abstract

Aim. To describe specific features of lipid metabolism in population of Kharkiv in relation to the body mass and composition; to study changes in its parameters associated with the topography of adipose tissue accumulation, presence and significance of insulin resistance; markers of metabolic disorders, local inflammation of adipose tissue, systemic low-intensity inflammation, and leptinemia level. Material and Methods. 250 residents of Kharkiv were examined (mean age 65.48±11.86 years). Body mass index, waist circumference and hip circumference were measured in the examined individuals; adipose, relative adipose and active body cell mass were determined by bioimpedance technique; circulatory fractalkine, clusterin, vaspin, omentin, leptin and insulin were identified by enzyme immunoassay technique; contents of free fatty acids, total cholesterol, high density lipoproteins cholesterol, triglycerides were determined by biochemical method; НОМА insulin resistance index, low and very low density lipoproteins cholesterol and atherogenicity coefficient were calculated by conventional formulas. Results and Discussion. Deepening of metabolic disorders upon increase of the body mass was proved, firstly, due to the adipose tissue accumulation, which is confirmed by the evidence of correlations between lipid metabolism parameters and body mass index, and relative contents of adipose tissue. It was revealed that such pro-atherogenic parameters as levels of total cholesterol, triglycerides, low density lipoproteins cholesterol, and atherogenicity coefficient correlate positively and significantly (p<0.001) with the markers of the development of inflammation and metabolic disorders - blood fractalkine (r=0,194; r=0,350; r=0,239; r=0,406), clusterin (r=0,189; r=0,389; r=0,222; r=0,401), vaspin (r=0,217; r=0,381; r=0,263; r=0,433) levels, and show negative correlation - with omentin level (r=- 0,258; r=- 0,409; r=-0,301; r=-0,478). Level of high density lipoproteins cholesterol demonstrated the opposite type of correlations with the mentioned parameters (r=-0,455; r=-0,448; r=-0,485; r=0,510), (p<0.001, p<0.001, p<0.001, p<0.001). Leptin levels in the overweight patients were higher compared to those examined with normal body mass (р<0.001). Elevation of this parameter value in relation to the individuals with excessive body mass (р<0.001) was registered in obese patients. The mutual influence between lipid homeostasis and insulin resistance was confirmed by statistical difference at the level of p<0.001 of the main parameters of lipid metabolism in the groups of insulin resistant patients and individuals with normal tissue insulin sensitivity. Conclusion. The degree of dyslipidemia in the individuals within various classes of excessive body weight is stipulated by close correlation between the body mass index, body composition specific features, topography of adipose tissue deposition, evidence of local inflammation of adipose tissue and systemic low-intensity inflammation in the body, and carbohydrate metabolism.