PARTICULARITY OF CLINIC COURSE OF ARTERIAL HYPERTENSION ON THE VBACKGROUND OF OBESITY AND NONALCOHOLIC FATTY LIVER DISEASE DEPENDING ON THE GENDER FEATURES
DOI:
https://doi.org/10.11603/2415-8798.2017.2.7823Keywords:
hypertension, obesity, nonalcoholic steatohepatitis, interleukin-6, leptin, 13C-methacetin breathe test.Abstract
In Ukraine, the structure of the share of total mortality for cardiovascular disease (CVD) accounts for 62.5–63.4 %. In particular, at least 75–80 % of deaths from cardiovascular disease are associated with atherosclerotic blood vessels, namely: hypertension (HT), myocardial infarction and stroke.
The aim of the study – to make a comparative evaluation of anthropometric, instrumental and laboratory indicators in patients with arterial hypertension combined with obesity and non-alcoholic steatohepatitis, depending on gender features.
Materials and Methods. 110 patients were divided into groups on the basis of gender. There were 42 men (38.2 %), 68 women – (61.8 %). Patients underwent anthropometric and series of instrumental and laboratory studies.
Results and Discussion. Comparing the anthropometric indices, it was revealed that men were significantly dominated by height, weight and waist circumference. However, according to the average BMI value, there is no reliable difference between men and women – respectively, 32.94±0.54 kg/m2 in men versus 34.32±0.41 kg/m2 – in women. According to echocardiography, left ventricular and left atrial hypertrophy was the same in men and women, this correlates with the growth of body mass index equally in both sexes. The average levels of total cholesterol, high-density lipoproteins, medium-density lipoproteins and triglycerides, as well as the level of total bilirubin among men and women, did not differ significantly. Certain differences in hepatic transaminase activity were noted. The average value of ALT in men was 1.97± 0.82 mmol/(hour×l), in women – 0.64±0.05 mmol/(hour×l). The level of AST was also higher in men (1.74±0.81 mmol/(hour×l) vs. 0.53±0.02 mmol/(hour×l) – in women, indicating that it was in men who frequently developed steatohepatitis. In women, the average leptin concentration was 45.63±9.06 ng/ml and was higher than in men (35.94±8.12 ng/ml). The levels of interleukin-6 among women and men did not differ significantly and amounted to 8.46±1.02 pg/ml and 7.98±0.86 pg/ml, respectively. According to the results of the 13C-methacetin breath test, the metabolic rate among women and men was not significantly different.
Conclusions. In patients with arterial hypertension combined with obesity and non-alcoholic steatohepatitis, there were no gender differences in anthropometric examinations, ultrasound examination of the heart and liver, and also in the lipidogram. A significant increase in the mean levels of hepatic transaminases in men was diagnosed, which indicated the frequent occurrence of steatohepatitis in them. In women we noted a significant increase in the level of leptin.
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