Аннотации:
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.
