Page 70 - Read Online

Bobronnikova Biomarker of metabolic disorders and cardiovascular remodeling

(EASD, 2013). 0.05 was chosen; in case of multiple comparison a
Bonferroni correction was made.
Glycated hemoglobin (HbA1c) levels in whole blood were
measured using the test-system produced by Reagent RESULTS
(Ukraine). Homeostatic model assessment for insulin
resistance (HOMA-IR) was calculated by the formula: The results of trophological status analysis revealed
HOMA-IR = insulin (fasting insulin, mcU/mL) × fasting characteristic features in the examined groups. Patients
glucose (mmol/L) / 22.5. At HOMA-IR > 2.77 patients with a BMI of 18.5 to 24.9 kg/m (n = 5) were identified
2
were considered as having insulin resistance. [21] in the group with isolated AH. However third-degree
C-reactive protein (CRP) - DRG Elisa were determined obesity (BMI > 40.0 kg/m ) was observed in one patient
2
with Enzyme-Linked ImmunoSorbent Assay (ELISA). with AH, in three patients with AH and pre-diabetes,
and in 5 patients with concomitant AH and type 2 DM.
The concentrations of fasting blood glucose (FBG) The majority of patients with isolated and concomitant
levels was determined using glucose oxidase disease in groups 2 and 3 (64.2%, 54.3%, and 51.3%
methodology. Fasting serum insulin levels were respectively) had a BMI of 30 to 34.9 kg/m . In patients
2
determined by ELISA with DRG kit (USA). In order to with type 2 DM, those with a BMI of 30.0 to 34.9 kg/m
2
determine glucose tolerance, an oral glucose tolerance were predominately male (67.3%), while those with a
test was performed. BMI of 35.0 to 39.9 kg/m were predominately female
2
(74.5%).
Gal-3 levels in the serum were determined by ELISA
using the kit of Bender Med Systems (Austria). FBG levels were significantly higher in patients with
concomitant AH and type 2 DM compared with patients
Structural-functional cardiac parameters were in group 1, group 2 and the control group (P < 0.05).
determined by echocardiography using the diagnostic
system (Philips IU, USA) in B- and M-modes by standard Maximal values of HOMA-IR, insulin and C-peptide in
technique according to the general recommendations patients of group 3 compared to that of groups 1 and
of the American Society of Echocardiography (2015). 2 [Table 1], describes the progression of IR associated
The determination of the interventricular septal wall with the presence of type 2 diabetes. HOMA-IR
thickness, LV posterior wall, end-systolic dimension exceeded control values by 2.1-fold in the group
(ESD), end-diastolic dimension (EDD), LV ejection of patients with AH, 2.4-fold in patients with AH and
fraction; end-systolic volume (ESV), end-diastolic pre-diabetes, and by 2.7-fold higher in patients with
volume (EDV); and analysis of the LV diastolic function concomitant AH and type 2 DM.
were conducted during the registration of transtricuspid
diastolic flow in the pulsed-wave Doppler mode. LV In groups 2 and 3, there was a positive correlation
myocardial mass (LVMM) was calculated using the between insulin levels in the peripheral blood and LV
formula of Devereux R.B. (1986) and the index of hypertrophy (LVH) (r = 0.44, P < 0.01; and r = 0.42, P
LVMM (LVMMI) was determined as the ratio of LVMM < 0.01, respectively) and IMT CCA (r = 0.36, P < 0.05;
to body surface area as described by Brown D.W. and r = 0.38, P < 0.05, respectively).
(2000).
Examination of IMT CCA showed mean values
To assess the structural-functional state of the vessels in patients with AH (0.85 ± 0.05 mm, P < 0.05) in
we performed ultrasound scanning of common carotid comparison with groups 2 and 3, and control group. In
arteries with measurement of the intima-media patients with AH and pre-diabetes this index was 0.9
complex thickness of the common carotid artery (IMT ± 0.05 mm (P < 0.05). In patients with AH and type
CCA) using an ultrasound diagnostic system (Philips 2 diabetes IMT CCA was 0.95 ± 0.07 mm (P < 0.05).
IU, USA) with linear sensor at the frequency of at least IMT CCA indices in groups 2 and 3 displayed reverse
7 MHz in B-mode. correlation with HOMA-IR (r = 0.36, P < 0.001).

As soon as the distribution of indices were converted An increase of IMT CCA ≥ 0.9 mm was observed in
to the normal, statistical processing of obtained patients with AH in 46.8% of cases, 52.7% in patients
results was performed by parametric methods (with with AH and pre-diabetes, and 59.2% in patients with
evaluation of mean, its standard error or standard concomitant disease.
deviation; Student t-test for independent samples by
groups, Pearson correlation) using Statsoft Statistica Indices of IMT CCA were associated with age (P =
8.0 software package. The threshold of P-value of 0.032), BMI (P = 0.044), waist measurements (P =
Vessel Plus ¦ Volume 1 ¦ June 27, 2017 63