Differences in aging rates based on different methods of calculation in patients with arterial hypertension and subclinical hypothyroidism

Abstract

Objective — to evaluate two distinct methods for determining biological age (BA) and aging rates among patients with arterial hypertension (AH) in combination with subclinical hypothyroidism (SH) that can be applicable to practical medical settings.
 Materials and methods. The study involved 150 patients (women 54.7%, n=82) with an average age of 47.1 [39.7;54.0] years, who were divided into three groups reciprocal by age and sex: the main group included 70 patients with AH in combined with SH, the comparison group consisted of 50 subjects with isolated AH, and control group of 30 healthy volunteers. All subjects were assessed for objective data, anthropometric status, standard clinical‑biochemical indicators, insulin, HOMA IR, C‑reactive protein (CRP), tumor necrosis factor‑alpha (TNF‑α), thyroid‑stimulating hormone (TSH), free thyroxine (T4), and sirtuin 1 (SIRT1). Additionally, the pro‑oxidant‑antioxidant balance was evaluated by assessing total hydroperoxides (THP) levels and total antioxidant activity (TAA). The assessment of BA and aging rates (ΔBA) were chosen as the main markers of premature aging and were performed with two different methods: by M. Levin et al. (ΔBA1), by authors’ own method (ΔBA2). Depending on ΔBA, patients from all three groups were divided into subgroups with normal/slowed aging rates (ΔBA ≤0) and accelerated aging rates (ΔBA >0).
 Results. According to ΔBA1 (p=0.004), 4 subjects with accelerated aging rates reveled in the controls, while in the main group the rate was 2.2 times higher than in the comparison group (40.0% versus 18%). According to ΔBA2 (p=0.0001), more people had an increased aging rates both in the main group and in the comparison group (57.1% versus 38.0%). Patients with AH and accelerated aging rates according to ΔBA1 had significant differences in the levels of SIRT1 (p=0.012), aspartate aminotransferase (AST) (p=0.012), alanine aminotransferase (ALT) (p=0.005), uric acid (p=0.011), and diastolic blood pressure (DBP) (p=0.001), and according to ΔBA2, higher levels of insulin (p=0.019), HOMA IR (p=0.013), triglycerides (TG) (p=0.011), very low‑density lipoprotein cholesterol (VLDL‑C) (p=0.020), DBP (p=0.032), and lower levels of total protein (p=0.048), compared to patients with AH and normal/slower aging rates. In the group of patients with AH combined with SH, differences in the levels of THP (p=0.023), uric acid (p=0.044), and body mass index (BMI) (p=0.046) were found among patients with different aging rates according to ΔBA1, and according to the results of the ΔBA2 assessment — in the levels of glucose (p=0.045) and uric acid (p=0.026). Among the studied patients in the AH group and in the group with a combined course of AH and SH, there were 52 patients whose aging rates (accelerated and normal/slowed) did not coincide in the assessment according to ΔBA1 and ΔBA2 : 11 patients had accelerated aging rates only according to ΔBA1, and 23 patients — only according to ΔBA2. Among the aforementioned 52 patients, 50% had elevated levels of ALT, 32.7% — AST, 3.8 — alkaline phosphatase (ALP), 90.2% — HOMA IR, 80.8% — total cholesterol (TC), 28.8% — triglycerides (TG), 26.9% had decreased levels of high‑density lipoprotein cholesterol (HDL‑C), 82.7% had elevated levels of LDL‑C, 15.4% — creatinine, 46.2% had decreased eGFR, 15.4% had elevated levels of CRP, 3.8% — TNF‑α, and 50.0% had uncontrolled levels of systolic and diastolic BP.
 Conclusions. Assessment of BA should be mandatory for patients with AH and SH to enable early detection and prevention of premature aging. As an indicator of accelerated aging rates, the combined use of ΔBA assessment based on clinical and biochemical indicators according to the method of M. Levin et al. (2018), as well on our own developed method based on the assessment of anthropometric indicators, TSH levels and the content of THP can be effective. Primary determination of BA can be conducted during regular (e.g., annual) preventive screening of patients. In case of detection of cardiometabolic disorders, repeat determination of BA can be performed after some time following their correction.