Role of Genetic Polymorphisms of the Renin-Angiotensin System and Immune Inflammation in the Development of Glycometabolic Disorders in Patients with Arterial Hypertension

  • M. V. Kulikova Kharkiv National Medical University, Kharkiv
  • T. V. Ashcheulova Kharkiv National Medical University, Kharkiv
Keywords: arterial hypertension, prediabetes, type 2 diabetes mellitus, genetic polymorphisms of the renin-angiotensin system, cytokines

Abstract

129 patients with arterial hypertension (AH) were examined. They were divided into three groups depending on the presence or absence of concomitant glycometabolic disorders including pre-diabetes, type 2 diabetes mellitus (T2DM) and the control group (10 individuals). The distribution of genotype frequencies of the renin-angiotensin system (RAS) genes was characterized by a significant prevalence of the TT genotype of the AGT M235T polymorphism in patients with AH, pre-diabetes and T2DM. When comparing the levels of inflammatory markers in the control group and patients with AH depending on the presence of pre-diabetes and T2DM an activation of pro-inflammatory immune response was detected, as evidenced by a significant increase in interleukin-18 (IL-18) plasma levels in patients with AH of 3 groups. There was observed a production of anti-inflammatory cytokines IL-10 in patients with AH and those with AH secondary to prediabetes compared to patients of the control group, which may be regarded as a protective reaction. Informative pronating markers influencing the development and forecasting glycometabolic disorders including pre-diabetes and T2DM in patients with AH were seven indicators - body mass index (BMI), heart rate (HR), serum IL - 10 levels, glucose levels after exercise tolerance test, HbA1c levels and genetic signs of C allele of AGTR1 gene A1166S polymorphism and T allele of the AGT M235T polymorphism.

References

Kovalenko VM, Kornatskyi VM. Dynamics of the health status of the people of Ukraine and regional characteristics: analytical and statistical manual. Kyiv.2012;211.

Kovalenko VN, Talayeva TV, Bratus VV. Cardiovascular diseases and the renin-angiotensin system. Kyiv. 2013;231.

Leoncini G, Ratto E, Viazzi F. Metabolic syndrome is associated with early signs of organ damage in nondiabetic, hypertensive patients. J. Int. Med. 2005;257:454-460.

Securi C, Cam FS, Ercan E. Renin-angiotensin system gene polymorphisms and premature coronary heart disease. JRAAS. 2005;6:38-42.

Parving HH, de Zeeuw D, Cooper ME. ACE gene polymorphism and losartan treatment in type 2 diabetic patients with nephropathy. J. Am. Soc. Nephrol. 2008;19:771-779.

Zintzaras E, Raman G, Kitsios G. Angiotensin-converting enzyme insertion/deletion gene polymorphic variant asa marker of coronary artery disease: a meta-analysis. Arch. Intern. Med. 2008;168:1077-1089.

Mancia G, Laurent S, Agabiti – Rosei E. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J. Hypertension. 2009;27:2121-2158.

World Health Organization. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO. IDF Consultation. Geneva, World Health Org. 2006.

ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. The Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD). European Heart Journal. 2013;34:3035-3087.

Sethi AA, Nordestgaard BG, Gronholt ML, et al. Angiotensinogen single nucleotide polymorphisms, elevated blood pressure, and risk of cardiovascular disease. Hypertension. 2003;6:102-111.

Van Rijn MJ, Bos MJ, Isaacs A, et al. Polymorphisms of the rennin – angiotensin system are assotiated with blood pressure, atherosclerosis and cerebral white matter pathology. J. Neurol. Neurosurg. Psychiatry. 2007;78:1083-1087.

Published
2015-12-31
Issue
Vol. 21 No. 2 (2015)
Section
Original Research

Copyright (c) 2015 M. V. Kulikova, T. V. Ashcheulova

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Authors who publish with this journal agree to the following terms:
  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).