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Bobronnikova Biomarker of metabolic disorders and cardiovascular remodeling

with AH and type 2 DM [Gal-3, CRP (r = 0.52, P < DM. [26] This process is largely a result of activation of
0.01), and HOMA-IR (r = 0.62, P < 0.01)]. the sympathetic-adrenal system, a powerful stimulus
for renin and angiotensin II excretion with a consequent
In patients with concomitant AH and type 2 DM there increase of aldosterone production and development of
was a positive correlation between Gal-3 and the IMT the hyperkinetic, hyper-renin variant of hypertension. [27]
CCA (r = 0.44, P < 0.001). It is should be noted that Powerful hypertrophic and proliferative processes in
in patients with isolated AH and in patients of groups the myocardium are triggered accompanied by volume
2 and 3 having LVH, Gal-3 levels were significantly overload of the heart, which leads to LVH in patients
higher than in patients without LVH (P < 0.05). with AH and type 2 DM. The most important proliferative
and hypertrophic factors involved in the processes of
DISCUSSION myocardial hypertrophy include a number of cytokines
and other growth factors. [25]
The study found patients from group 3 to have the
highest insulin and C-peptide values, suggesting It has been observed that Gal-3 levels are positively
that the progression of IR under hyperinsulinemia is correlated with insulin resistance indices (CRP, НОМА)
associated with the presence of type 2 diabetes. in all groups of patients. These data confirm that Gal-
3 is involved in the formation of insulin resistance. In
Identified correlations between insulin and LVH and this study, higher levels of Gal-3 are associated with
IMT CCA in patients from groups 2 and 3, suggest that the development of type 2 DM. The obtained results
hyperinsulinemia is an important component for the substantiate the study of Seferovic et al., [28] which
development and progression of AH and contributes describes elevated levels of Gal-3 in patients with
to the development of myocardial hypertrophy and type 2 DM that were strongly correlated with HbA1c
smooth muscle elements of peripheral vessels. levels. Yilmaz et al. [29] showed that Gal-3 may be
an independent predictor of type 2 DM in general.
Further observation is necessary in patients from Recent clinical studies have shown that high levels
groups 2 and 3 with identified atherosclerotic plaques of Gal-3 correlate with gender, age, and the risk of
of stenosis grade exceeding 10%. It should be noted cardiovascular pathology development. [30] On the other
that current results are concordant with the Insulin hand, the study of Ohkura et al. [31] found that low levels
Resistance Atherosclerosis Study, which revealed a of serum Gal-3 are associated with insulin resistance
clear direct dependence between the degree of insulin in patients with type 2 DM, but it should be noted that
resistance and the carotid artery wall thickness both in a small sample of patients were examined with no
individuals without diabetes, and in patients with type 2 comorbid pathology and a BMI within the normal range.
DM. With each unit of insulin resistance, IMT increased
by 30 μm. [22] Similar conclusions were obtained in an Gal-3 values were positively correlated with LVH
analysis of the results of 11 studies, involving 1578 and increased indices of IMT CCA. These data are
patients with type 2 DM, including 132 patients with consistent with available literature showing that Gal-3
pre-diabetes who developed IMT CCA index during the increases its activity under the influence of such factors
treatment. [23] It was found that un-treated patients with as increased levels of angiotensin II and pressure
type 2 DM had an average content of HbA1c = 7.86%, overload of the myocardial wall. References contain
and an increase in IMT CCA by 0.034 mm per year. [24] some data identifying a correlation of GAL-3 and the
This reveals significant dependence between HbA1c total number of atherosclerosis plaques in coronary
levels and the rate of IMT CCA increase. [24] arteries. [32] It can be assumed that Gal-3 levels may
be a marker for the major pathogenetic mechanisms of
Patients of group 2 with concomitant AH presented with development and progression of atherosclerosis, which
structural-functional and intraventricular hemodynamic can help the early detection of atherosclerosis before
changes, changes that were most apparent in group 3. its clinical manifestations. Also, increasing serum Gal-
3 levels may help to identify early heart failure with
As to the mechanisms of LVH in AH patients with type preserved LV ejection fraction, which often occurs in
2 DM, we should mention a complex of metabolic patients with hypertension, diabetes, and obesity. [33]
disorders which are typical for type 2 DM. [25] Those
disorders primary include insulin resistance and The above results indicate that elevated levels of Gal-
hyperinsulinemia. Indeed, insulin resistance and 3 in the blood plasma can be a predictor of type 2
hyperinsulinemia are triggers that induce a series of DM, and factor in the development of structural and
hormonal, neurohumoral and metabolic events that are functional changes in the myocardium. Nevertheless,
the basis of early LVH in concomitant AH and type 2 these findings require further study on a large sample
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