Age-related features of lipid and carbohydrate metabolism and hemostasis in young patients with different components of the metabolic syndrome

Abstract

Objective. To study the features of the lipid and carbohydrate metabolism, hemostasis and the level of adipokines in young patients with abdominal obesity (AO) and arterial hypertension (HTN) in different age subgroups (younger and older than 35 years). Design and methods. The study included both males and females aged 20 to 45 years (group 1 — control, group 2 — patients with isolated AO, group 3 — patients with metabolic syndrome (MS), group 4 — patients with HTN). Patients of each group were divided into 2 subgroups: patients aged 20 to 35 years and patients aged 36 to 45 years. Laboratory parameters of carbohydrate and lipid metabolism, hemostasis and levels of leptin and adiponectin were assessed. Results. Lipid and carbohydrate metabolism parameters differed between young patients with AO and the control group. Levels of leptin and D-dimer were increased compared to the group 1. Dyslipidemia was found in patients with MS 20–45 years old, and it was characterized by increased total cholesterol, low-density lipoprotein cholesterol and triglyceride levels and decreased high-density lipoprotein cholesterol compared to the control group. Insulin and HOMAIR value were higher than in group 1. Leptin level was higher in patients with MS compared to controls, and the adiponectin level was reduced. The hemostasis in group 3 was characterized by increased concentration of fibrinogen, decreased plasminogen activity, increased concentration of soluble fibrin monomer complex, D‑dimer, plasminogen activator inhibitor type 1, as well as the activation of anticoagulant systems. HTN patients showed changes in lipid and carbohydrate metabolism compared to the control group as following: increased total cholesterol, low density lipoprotein cholesterol and glucose. The level of D‑dimer was higher compared to the group 1. Conclusions. Serum leptin level was higher in young patients with AO compared to patients without MS. Patients with MS aged 20–35 years showed insulin resistance. The levels of total cholesterol, low density lipoprotein cholesterol, triglycerides and leptin were comparable in young patients older the 35 with HTN and with MS. Young patients with isolated AO and isolated HTN demonstrated the activation of coagulation and fibrinolytic systems, and patients with MS showed the activation of coagulation, fibrinolytic and anticoagulant systems. Patients aged 36–45 years with MS have increased concentration of fibrinogen and decreased plasminogen activity compared to patients younger than 35 years.