Effect of the body weight index on the intensity of metabolic disorders in essential hypertension patients associated with ischemic heart disease and type 2 diabetes mellitus

Abstract

Objective of the work is to study peculiarities of metabolic disorders in patients with essential hypertension stage I (EH stage I) associated with ischemic heart disease (IHD) and type 2 diabetes mellitus (DM 2) depending on the body mass index (BMI).Material and methods. 45 patients with EH stage II associated with IHD, 52 patients with EH stage II associated with IHD and DM 2, 26 practically healthy individuals representative by the age and sex were included into the investigation. The indices of carbohydrate and lipid metabolism, oxidative homeostasis, the content of nitrogen monoxide (NO) final metabolites in the blood depending on BMI were investigated.Results. In patients with EH stage II associated with IHD and excessive body weight compared with the control a reliable increase of immunoreactive insulin (IRI) concentration and HOMA-IR index were determined. In case of obesity I a reliable increase of glucose concentration in plasma, IRI, HOMA-IR index, decreased concentration of high density lipoprotein (HDL) cholesterol and increased content of low density lipoprotein (LDL) cholesterol, increased concentration of Malone aldehyde (MA) in erythrocytes were determined compared with the control and patients with normal body weight. A direct interrelation of a moderate density between IRI content and body weight, reverse direct correlation of a moderate density between HDL cholesterol and body weight were determined. In patients with EH stage II associated with IHD and DB 2 and obesity I a reliable increase of total cholesterol concentration (42,54%), triacylglyceroles (42,5%), LDL cholesterol (14,5%), MA of erythrocytes (16,14%), decreased content of HDL cholesterol (18,0%), reduced glutathione (17,75%), normalization of catalase activity in comparison with the patients with normal body weight were found. A direct correlation was found between moderate density and IRI level and body weight, total cholesterol, HDL cholesterol, MA, catalase; between body weight and total cholesterol.Conclusions. In patients with EH stage II associated with IHD dependence of certain indices of metabolism and body mass index was determined. In the blood of patients with obesity I compared with those having excessive body weight, a reliable (p<0,05) increase of IRI concentration and HOMA-IR index, LDL cholesterol, decreased concentration of HDL cholesterol, increased content of MA in erythrocytes were found. More pronounced effect of increased body weight on metabolism was found in patients with EH stage II associated with IHD and DM 2.