PP.28.20

Abstract

Objective: The peroxisome proliferator-activated receptor gamma-2 (PPAR-γ2) plays a major role in lipid metabolism regulation and modulates activity of renin-angiotensin-system linking biological effects of both. While abdominal obesity (AO) remains a major risk factor of essential arterial hypertension (EAH), the aim of the study is to evaluate the role of PPAR-γ2 gene's Pro12Ala polymorphism and I/D polymorphism of angiotensin-converting enzyme (ACE) gene (rs1801282 and rs4646994, respectively), as risk factors of EAH in overweight/AO patinets. Design and method: One hundred and ten patients (56.4% women, 43.6% men; mean age 53.3 ± 6.05 years) with EAH I-III stages participated in the study. EAH I in 22.7% cases, EAH II in 45.45%, EAH III in 31.8%; overweight persons – 38.2%, AO – 53.6%. Control group included 50 healthy individuals. Alleles of polymorphic loci were studied by PCR. Results: DD-genotype of ACE gene was registered in 39.1% EAH patients and associated with a higher frequency of concomitant coronary artery disease, cerebrovascular disease, left ventricle hypertrophy (LVH) in women, higher levels of systolic blood pressure (SBP) and obliterating arterial disease of lower limb arteries (OADLLA). PPAR-γ2 gene's ProPro-genotype was found in 63.6% cases, similarly (p > 0.05) to control (60.0%). Pro-allele dominated in EAH patients (79.5% vs. 20.4% Ala-allele carriers), associated with significantly higher frequency of diabetes mellitus type 2, AO, LVH, OADLLA, higher SBP, diastolic BP and waist circumferences in men. In patients with EAH I I-allele of ACE gene dominates by 3.8 and 3.23 times and ProPro-genotype of PPAR-γ2 gene by 4.67 and 14 times. Among patients with EAH III were only D-allele (ACE) and Pro-allele (PPAR-γ2) carriers. II-genotype prevails over DD-genotype in normal body weight or AO 1st degree EAH patients by 2 and 4 times, respectively. In overweight or AO 2nd degree patients the ProPro-genotype dominated 12–17 times. Conclusions: DD-genotype or D-allele of ACE gene and Pro-allele of PPAR-γ2 gene are the risk factors for heavier course of EAH (II and III stages), OR = 2.33–4.45, p < = 0.014–0.013; overweight, OR = 4.10–4.45, p < 0.001; abdominal obesity, OR = 4.45, p < 0.001; with the lowest probability of moderate EAH, OR = 0.22, p = 0.007.