Pathogenetic connection of lipid profile changes with left ventricle hypertrophic models depending on genes polymorphism' ace (I/D), eNOS (T894G) in patients with essential hypertension

Abstract

Purpose. To establish the dependence of lipid profile changes in patients with essential arterial hypertension (EAH) on the type of left ventricular hypertrophy (LVH) and gene polymorphism of angiotensin-converting enzyme (ACE, I/D) and endothelial nitric oxide synthase (eNOS, T894G). Design/approach. In a prospective study 120 patients with EAH I-III severity stages: 12,5% (15) persons with EAH I, 60,0% (72) with EAH II, 27,5% (33) with EAH III; 48,3% (58) women and 51,7% (62) men, mean age 52,91±9,24, the disease duration from 2 to 28 years; the control group - 20 healthy individuals were involved. Ventricular mass (LVM) was evaluated by Echo-KG. Plasma lipids were studied by spectrophotometer, analyzed according to the recommendations of the ESC, ESH (2009). Genes' allele polymorphic areas of ACE (I/D), eNOS (T894G) were set by PCR analysis. Findings. High-risk groups of lipid profile changes in patients with EAH is a carriers of DD-genotype of ACE gene by increasing of low density cholesterol level and atherogenic index by 1,3 times (p<0,05). Genetic risk of dyslipidemia in EAH patients with unfavorable eccentric and concentric LVH and ACE and eNOS genes mutations (ID/TT, ID/ TG, DD/TG haplotypes) increases by 2,57-3,86 time (OR=2,57-3,86). Combination of Wild I-allele of ACE gene and G-allele of eNOS gene (II/GG, II/TG haplotypes) is protective against development of hypercholesterolemia in patients with unfavorable patterns of LVH (OR=0,12-0,94) and makes the chances of dyslipidemia risk the lowest in the population of EAH patients (p=0,05). Research limitations/implications. The study is limited by the peculiarities of laboratory and diagnostic tests. Originality/value. The original research without a prototype provides pathogenetic data for early detection and prevention of metabolic disorders in the presence/absence of LVH in patients with EAH.