The Interconnection of Insulin Resistance Indices with Metabolic Factors of Cardiovascular Risk in Patients with Hypertension

Abstract

Background: Among the risk factors (RF) of cardiovascular diseases, insulin resistance (IR) occupies one of the main places. Objective: To identify possible association of insulin resistance (IR) indices with metabolic factors (MF) of cardiovascular risk (CVR) in patients (pts) with essential hypertension (EH). Materials and methods: The prospective study involved 255 patients with EH of I—III stages. Patients were divided into four groups by two IR indices (triglyceride-glucose index (TGGI) and atherogenic index of blood plasma (AIBP)): IR presence was considered at TGGI>4.82 and AIBP>0.21. The state of lipid transport system and system of lipoprotein lipolysis were additionally estimated by calculation of lipid ratios such as non-HDL- C/TC, TC/HDL-C and TG/HDL-C. The results: It has been established that in patients with atherogenic dyslipidemia, the association of IR indices (TGGI and AIBP) as MF of CVR was implemented via disturbances in the system of lipoprotein lipolysis of TG-containing lipoproteins and in the system of reverse cholesterol transport. The association of TGGI and AIBP with hyperglycemia and changes of uric acid (UA) levels was realized through such MF of CVR as glucose intolerance, type 2 diabetes mellitus and elevated UA levels (predominantly in women). In pts with EH and IR, the TGGI was mostly associated with such MF of CVR as increased body mass index (BMI) due to body fat accumulation, while AIBP was mostly associated with body fat lipolysis that was confirmed by the decreased correlation between BMI and parameters of visceral obesity. Conclusions: The most significant (in frequency) MF of CVR associated with IR in pts with EH were hyperglycemia, hypercholesterolemia, elevated levels of TG, low HDL-C, hyperuricemia, as well as BMI elevation due to body fat depositions and activation of their lipolysis confirmed by correlation analysis.