Structural, functional and endothelial peculiarities of diabetic nephropathy in patients with arterial hypertension

Abstract

The aim of our one-stage observational study was the detail analysis of structural, functional, endothelial peculiarities of diabetic nephropathy in patients with coexistent arterial hypertension. Methods. Our study involved 96people with arterial hypertension and type 2 diabetes mellitus (I group), 25 patients with arterial hypertension (II group), 15 practically healthy persons (III group) treated and obtained in Sumy City Clinical Hospital №1. Cardiovascular complications were determined in all patients from I and II groups. The average age of the patients was 62.31 ± 0.2 years. The level of glycosylated hemoglobin (HbAlc) was determined by the biochemical method, albuminuria by immunoassay. The level of endothelin-1 (ET-1) in serum was studied using ELISA. Results. It was found that the level of ET-1 was significantly higher in patients with diabetes compared with only hypertensive patients. In the patients with urine albumin excretion rate category A2 the level of endothelin-1 was significantly higher compared with the category A1 patients and less compared with category A3 patients (11.42 ± 49 vs 25 ± 0.57pg/ml, p = 0.0329 and 11.42 ± 0.49 vs 2.25 ± 1.04pg/ml, p <0.0001, respectively. So, the level of ET-1 increased in proportion to albuminuria. In patients with the albuminuria category A2, the endothelin-1 level was higher than in subjects with the A1 category and lower than in patients with the A3 category. In addition, we identified a moderate direct correlation between the blood level of ET-1 in the patients with diabetes and blood glucose level (r = 0.29;p = 0.004). Conclusion. Finally, it is the confirmation of greater endothelial function disorders for arterial hypertension and type 2 diabetes mellitus. In conclusion, endothelial dysfunction promotes diabetic nephropathy progression.

Keywords

• diabetic nephropathy, arterial hypertension, type 2 diabetes mellitus, albuminuria, endothelin-1, glycated hemoglobin, glicemia, glomerular filtration rate.