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Bilovol Arterial hypertension and type 2 diabetes progression

index (BMI). The severity of obesity was determined statistical methods.
following guidance from the International Diabetes
Federation (2015). Diagnoses of type 2 diabetes RESULTS
were made following general recommendations of the
European Association for the Study of Diabetes (2013) Analyses of trophologic parameters revealed specific
and the ESC (2013). [11] Inclusion criteria: fasting blood patterns in both groups. Patients with isolated AH
glucose ≤ 8.5 mmol/L, postprandial hyperglycemia ≤ (group 1) exhibited BMI measurements ranging
11 mmol/L, and HbA1c level ≤ 9%. Exclusion criteria: from 18.5 to 24.9 kg/m (4 patients). The majority of
2
pregnancy or lactation; self-reporting with insulin- patients with isolated AH and comorbid AH with T2DM
dependent diabetes, previous acute myocardial (group 2; 65.1% and 54.6%, respectively) had BMI
infarction or ischemic stroke; cardiovascular damage ≥ measurements ranging from 30 to 34.9 kg/m . Third-
2
II by New York Heart Association criteria; liver disease degree obesity (BMI > 40.0 kg/m ) was observed in 2
2
indicated by transaminase values more than 3 times patients with isolated hypertension and in 6 patients
greater than normal; chronic kidney disease with with comorbid AH and T2DM.
serum creatinine > 2 mg/dL; ongoing dialysis; human
immunodeficiency virus positive disease; history of Serum lipid spectra were altered with significantly higher
chronic alcohol abuse in the last 2 years; or history of frequency in patients with concomitant AH and T2DM
cancer, stroke, or organ transplantation. rather than AH alone (62.6% and 44.2%, respectively;
P < 0.05). Serum TG levels [Table 1] were 1.4 fold (Р =
Enzyme-Linked ImmunoSorbent Assay 0.0002) higher in group 2 patients (AH plus T2DM) than
Serum concentrations of omentin (BioVendor, Czech in group 1 patients (AH alone), and 1.5 fold higher than
Republic), adiponectin, tumor necrosis factor-alpha in the controls (Р = 0.0020). HDL-C levels in group 2
(TNF-α), C-reactive protein (CRP) - DRG Elisa, USA patients were significantly reduced compared to controls
and resistin (MBL International Corporation, USA) (53.2% and 21.0%, respectively; Р = 0.0020). Group 2
were determined with ELISA. Serum concentrations of patients with BMI measurements of 30 to 34.9 kg/m
2
interleukin (IL)-1, IL-4, and IL-6 were also determined had significantly lower levels of HDL-C compared
by Enzyme-Linked ImmunoSorbent Assay (ELISA, with control patients (P < 0.05). Progression of lipid
Protein Contour, St. Petersburg). All assays were disorders in patients with comorbid AH and T2DM
tested per the manufacturers’ guidelines. directly depended on BMI. Maximum TC and TG levels
were observed in patients with BMI measurements of
Lipid metabolism assays 35 to 40 kg/m (P = 0.242, P = 0.062, respectively),
2
Total cholesterol (TC) in plasma, high-density while HDL cholesterol serum concentrations were the
lipoprotein (HDL), and triglyceride (TG) levels were lowest in these patients (P = 0.042).
determined in all patients by enzymatic methodologies
on a Humalyser autoanalyzer (Human Company, Next, insulin resistance (IR) indices were analyzed in
Germany). Low-density lipoprotein (LDL) cholesterol the cohort. Patients in group 2 exhibited significantly
content was calculated using the Friedewald W. higher HOMA-IR index values, as well as insulin and
T. formula: LDL cholesterol (mmol/L) = TC - HDL C-peptide measurements, when compared to group 1
cholesterol - TG/2.22. Whole blood HbA1c levels and the controls (P < 0.0001, P = 0.0003, P = 0.0004,
were determined by Reagent Test-Systems (Ukraine). respectively) [Table 2]. These data indicated that
Fasting plasma glucose levels was determined using hyperinsulinemic IR progression was associated with
glucose oxidase methodology. Fasting serum insulin T2DM incidence. HOMA-IR indices in patients with AH
levels were determined by ELISA. Glucose tolerance alone were 2-fold higher than in controls (Р = 0.00001).
was measured using oral glucose tolerance tests. In patients with both AH and T2DM, HOMA-IR indices
Homeostatic model assessment for insulin resistance were 2.2-fold higher than in controls (Р = 0.00001).
(HOMA-IR) levels were calculated based on laboratory
insulin and fasting glucose levels. HOMA-IR = fasting Regression analyses of these data identified statistically
insulin × fasting glucose (mmol/L)/22.5. HOMA-IR significant relationships between HOMA-IR levels and:
levels > 2.77 were diagnosed as insulin resisted. glucose levels (r = 0.42, P = 0.06), C-peptide levels (r
= 0.64, P = 0.0001), BMI (r = 0.54, P = 0.0054) and
Statistical analysis cholesterol levels (r = 0.64, P = 0.056). These results
Statistical data analyses were performed using the supported the hypothesis that the development and
general-purpose data processing software package in progression of IR correlated with hyperinsulinemia
Statistica 8.0. Analyses of statistical significance were and dyslipidemia. These data also suggest that IR was
performed using Student’s t-tests and non-parametric associated with inflammation and the development of
24 Vessel Plus ¦ Volume 1 ¦ March 31, 2017