Associations of METS-IR insulin resistance index with components of cardiometabolic risk in patients with hypertension

Abstract

Objective — to accurate some possible associations of insulin resistance (IR) index METS‑IR with blood pressure (BP) level, parameters of visceral obesity (VO), values of lipid, carbohydrate and uric exchange in persons with essential hypertension (EH) who were the representatives of nonorganized population of Kharkov’s region.
 Materials and methods. The retrospective study included some data about 165 patients (pts) — 74 (44.8 %) females and 91 (55.1 %) males aged to 20 — 65 years old (an average age is 56.42 ± 1.18 years old) with EH of I — II stages who had been examined and undergone treatment in the clinics of the L. T. Mala National Therapy Institute of NAMS of Ukraine (Kharkiv). Uncomplicated EH in pts included in the study was combined with the components of cardiometabolic risk (CMR) such as excessive body mass (EBM), VO, intolerance to glucose, hyperuricemia, nonalcoholic fatty liver disease and dyslipoproteinemia). The persons with type 2 diabetes mellitus were excluded from the study. Among anthropometric measures derived from the history cases there was body mass index (BMI) and based on it some parameters of VO such as body fat percentage (BFP), total fat mass (TFM) and fat mass index (FMI). The data about pts’ BP as well as data about serum glucose and uric acid (UA) levels had been also taken from the history cases. For analysis of lipid exchange state the characteristics of pts’ lipid profile measured by enzyme method on analyser such as total cholesterol (TC), high‑density lipoprotein cholesterol (HDL‑C), triglycerides (TG), very‑low density lipoprotein cholesterol (VLDL‑C), low‑density lipoprotein cholesterol (LDL‑C), coefficient of atherogenity (CA) and non‑high‑density lipoprotein cholesterol (non‑HDL‑C) as a difference between TC and HDL‑C were derived from the history cases. The values of lipid ratios reflected a functional state of lipid transport systems such as direct cholesterol transport system, reverse cholesterol transport system and system of lipoprotein lipolysis which were closely associated with IR had been calculated additionally.
 Results. It was established that in persons with EH combined with EBM and VO included in the study the secondary lipid abnormalities increased CMR more significantly than glycemia and uricemia and it was confirmed by correlations of METS‑IR index with lipid exchange values and lipid ratios characterized the state of direct cholesterol transport system, reverse cholesterol transport system and system of lipoprotein lipolysis. The pts with EH and VO compared with persons who had EBM are shown to have more significant pathological deviations in the system of lipoprotein lipolysis of TG‑containing VLDL promoted a reduction in HDL synthesis and reverse cholesterol transport disorder and combined with elevation of METS‑IR index.
 As a whole independently on IR there were no significant correlations of METS‑IR index with BP level, serum glucose and parameters of VO such as BMI, BFP, TFM and FMI in pts with EBM and VO included in the study. There was a weak association between METS‑IR index and serum concentration of UA (r = 0.337; p = 0.004 in pts with EBM and r = 0.301; p = 0.004 in pts with VO). But in the case of IR presence in persons with EBM some associations of METS‑IR index with age (r = 0.391; p = 0.029), BFP (r = 0.544; p = 0.002), TFM (r = 0.436; p = 0.014), FMI (r = 0.513; p = 0.003) and serum UA level (r = 0.443; p = 0.013) were found.
 Conclusions. METS‑IR index for CMR evaluation and confirmation of IR presence is concluded to be worth calculated in persons without type 2 diabetes mellitus and BMI > 25 kg/m2 who had hypertriglyceridemia and/or low HDL‑C independently on glycemia level.