Mìžnarodnij Endokrinologìčnij Žurnal (Oct 2020)
Hormonal and hemodynamic changes in middle-aged urban residents with obesity depending on blood pressure
Abstract
Background. The relevance of the study is due to the significant spread of overweight of varying severity among the population and a significant risk of developing comorbid pathological conditions, including arterial hypertension (AH). Today, the question of hormonal-metabolic-hemodynamic differences in representatives of the Ukrainian population with obesity and AH and with obesity without AH remains unclear. Solving this issue can help optimize the algorithm of preventive measures for the development of hypertension among the Ukrainian population. Aim: to detail the features of hemodynamics, fluid compartments of the body, functioning of the renin-aldosterone system, secretion of leptin, insulin in middle-aged people with different body weights and blood pressure, taking into account the severity of chronic nonspecific inflammation. Materials and methods. We examined 273 middle-aged (56.41 ± 6.93 years) residents of Kharkiv (males/females = 56/217) who had not been treated for obesity and AH. Body mass index was calculated, waist circumference, blood pressure were measured. Body composition (fat, relative fat, lean, active cell mass) was evaluated using bioimpedance analysis; serum levels of insulin, leptin, renin, aldosterone and clusterin — by means of immunoassay. The HOMA was calculated. Results. Obese patients, regardless of the presence or absence of AH, have a probable increase in the absolute hydration of the body with a simultaneous increase in cardiac output and stroke volume compared to both healthy individuals and non-obese patients with AH. These changes are associated with a significant increase in blood renin and aldosterone levels in obese individuals. The development of obesity in patients with AH is accompanied by an increase in their circulating blood volume, total peripheral vascular resistance and mean blood pressure, the severity of insulin resistance and chronic nonspecific inflammation, increased levels of insulin-, leptin-, renin- and aldosteronemia. The levels of circulating renin and aldosterone in the serum of middle-aged persons are probably directly related to the degree of insulin-, leptin-, clusterinemia and the HOMA. Conclusions. An approximate assessment of the levels of reninemia and aldosteronemia in middle-aged urban residents of Ukraine during screening examinations can be carried out by measuring the integral body rheography to determine the parameters of the stroke index and stroke volume. The corresponding regression equations for their estimation are defined in this study.
Keywords
