Some hormonal systems in males with arterial hypertension and metabolic syndrome
Abstract
Aim. To study carbohydrate, hormonal, and lipid parameters in patients with mild to moderate arterial hypertension (AH) and metabolic syndrome (MS) components. Material and methods. In total, 265 males (mean age 53.4±4.2 years) with mild to moderate AH and MS components were examined. Comparison group included 27 males with excess body mass (BM) without AH and carbohydrate metabolism disturbances, control group – 20 healthy males with normal BM. All participants underwent office blood pressure (BP) measurement, anthropometry, glucose tolerance test; lipid profile, levels of fasting and postglucose load insulin, leptin, thyroid hormones, cortisol, thyrotropic (TTH) and adrenocorticotropic hormone (ACTH) were measured. Results. Basal hyperinsulinemia was observed in 59% patients with isolated AH, and 52% of normotensive males with excess BM. In 93% of normotensive males with excess BM, hyperleptinemia was registered; insulin resistance (IR) was observed only in 52%. In AH and MS men, subclinical hypothyrosis (76%), increased levels of insulin, leptin, ACTH and cortisol were observed more often than in men with isolated AH or healthy participants. In obese individuals, there was a positive correlation of leptin level with BM, TTH, ACTH, cortisol, insulin, and triglycerides. Conclusion. In patients with AH and MS, increased cortisol, ACTH, insulin, and leptin production was linked to obesity severity, and was associated with subclinical hypothyrosis. In its turn, chronic increase in cortisol and insulin levels could facilitate IR and fat tissue percentage increase.
About the Authors
A. N. BritovRussian Federation
A. M. Inarokova
Russian Federation
M. A. Umetov
Russian Federation
References
1. Акмаев И.Г., Сергеев В.Г. Нейроиммуноэндокринология жировой ткани. Успехи физиолог наук 2002; 33(2): 3-16.
2. Благосклонная Я.В., Шляхто Е.В., Красильникова Е.И. Метаболический сердечно-сосудистый синдром. РМЖ 2001; 9(2): 67-71.
3. Бутрова С.А. Метаболический синдром: патогенез, клиника, диагностика, подходы к лечению. РМЖ 2001; 9(2): 56-60.
4. Левченко И.А., Фадеев В.В. Субклинический гипотиреоз. Пробл эндокрин 2002; 48(2): 13-22.
5. Профилактика, диагностика и лечение первичной артериальной гипертонии в Российской Федерации. Первый доклад экспертов научного общества по изучению артериальной гипертонии Всероссийского общества кардиологов и межведомственного совета по сердечно-сосудистым заболеваниям (ДАГ-1). РМЖ 2000; 8: 318-46.
6. Терещенко И.В. Лептин и его роль в организме. Пробл эндокрин 2001; 47(4): 40-6.
7. Терещенко И.В., Цепелев В.В., Иванова Э.С. О субклиническом гипотиреозе у больных ишемической болезнью сердца. Кардиология 1993; 11: 45-7.
8. Bornstein SR, Uhlmann K, Haidan A, et al. Evidence for a novel peripheral action of leptin as a metabolic signal to the adrenal gland: Leptin inhibits cortisol release directly. Diabetes 1997; 46: 1235-8.
9. Danese MD, Laderson PW, Meinert CL, Powe NR. Clinical review 115: effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab 2000; 85: 2993-3001.
10. Haffher SM. Obesity and metabolic syndrome: the San Antonio Heart Study. Br J Nutr 2000; 83(1): 67-70.
11. Hennes M, Dua A, Kisselbah A. Effects of free fatty acid and glucose on splanchnic insulin dynamics. Diabetes 1997; 46: 57- 62.
12. Fernandez-Real J, Richard W, Casamitjana R. Lower Cortisol level after oral glucose in subjects with insulin resistance and abdominal obesity. Clin Endocrinol 1997; 47: 583-8.
13. Ford ES, Giles WH, Dietz WH. Prevalence of the Metabolic syndrome among US adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002; 287(3): 356-9.
14. Mariotti S, Franceschi C, Cosarizza A, Pincyera A. The aging thyroid. Endocr rev 1995; 16(6): 686-715.
15. Pralong FP, Roduit R, Waeber G, et al. Leptin inhibits directly glucocorticoid secretion by normal human and rat adrenal gland. Endocrinology 1998; 139: 4264-8. 16. Schwartz MW, Peskind E, Raskind M, et al. Cerebrospinal fluid leptin levels: relationship to plasm a levels and to adiposity in humans. Nat Med 1996; 2(5): 589-93.
Review
For citations:
Britov A.N., Inarokova A.M., Umetov M.A. Some hormonal systems in males with arterial hypertension and metabolic syndrome. Cardiovascular Therapy and Prevention. 2006;5(3):61-67. (In Russ.)