O.Yu. Kulyk, O.I. Mitchenko, V.Yu. Romanov, L.V. Yakushko. Leptin resistance and cardiovascular risk in patients with essential hypertension and metabolic syndrome.

The aim – to study the relationship between leptin resistance and cardiovascular risk in patients with essential hypertension (EH) and metabolic syndrome (MS).

Material and methods. 160 patients (pts) with EH and MS have been surveyed, in 84 of them soluble leptin receptors were determined. Four groups have been formed: 1st – pts with MS without carbohydrate disorders, 2nd – pts with MS and insulin resistance (IR) without DM and IGT, 3rd – pts with MS and impaired glucose tolerance (IGT, 4th – pts with MS and diabetes mellitus (DM). In each group the analysis for men and women was carried out separately. The following methods were used: body mass index (BMI), waist circumference (WC), blood pressure monitoring, echocardiography, fasting levels of sOB-R, leptin, glucose, insulin.

Results. Among women, correlations between free leptin index and BMI (r=0.61, Р<0.05) and WC (r=0.60, P=0.05) were found. Relationships between free leptin index and total cholesterol (r=0.49, Р<0.05), triglycerides (r=0.37, Р<0.05), glucose (r=0.48, Р<0.05), systolic blood pressure (r=0.46, Р<0.05) and diastolic blood pressure (r=0.39, Р<0.05) were established, respectively. A similar trend was observed in male groups. In order to assess cardiovascular risk, all patients underwent additional stratification of cardiovascular risk using scales SСOREBMI, PROCAM, Framingham, DRS. Conclusions. Leptin resistance is associated with increased detection of cardiovascular risk factors in patients with EH and MS. Relation of free leptin index to factors of cardiovascular risk such as WC, BMI, cholesterol, triglycerides, glucose and blood pressure levels in male and female groups was found. In patients with EH, diabetes and MS high risk of complications by IRIS-II scale was associated with more sings of leptin resistance. Free leptin index was 5.45±1.09 in women and 4.5±1.6 in men, respectively, and may be used to optimize early detection of complications in patients with diabetes.

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