Role of adipocytokines in the integrated assessment of nutritional status of patients with a combination of hypertension and chronic obstructive pulmonary disease

• Gerasimenko O.N.
• Sukhaterina N.A.
• Shpagin I.S.

Abstract

The aim of the study was to identify early markers of diagnosis and efficacy of treatment of patients with arterial hypertension (AH) in combination with chronic obstructive pulmonary disease (COPD) basing on the study of adipocytokine and nutritional status. A comprehensive clinical and functional examination of 187 patients has been carried out, including 27 patients without AH and COPD that formed the control group, 53 patients with hypertension, 51 patients with COPD and 56 patients with hypertension combined with COPD. Examination of all patients included general clinical methods, evaluation of the indicators of respiratory function, daily monitoring of blood pressure. The level of adipokines in the blood was determined by ELISA; cytokine status indicators in blood serum - by electrochemiluminescent method; indicators of lipid, carbohydrate and protein metabolism - on the analyzer; evaluation of body composition by bioimpedance method. In the group of persons suffering from AH in combination with COPD, a significant prevalence of patients with a hemodynamic variant of non-dippers (48.2%) was found, a decrease in the indicators of external respiration function was revealed (the volume of forced expiration in the first second was statistically significantly 1.5 fold lower than the index of patients from the control group, the Tiffno index was 1.3 fold lower, p<0.05). When anthropometric study in the comorbid group of hypertension and COPD determined a significant increase in waist circumference index and waist circumference/ hips circumference (p<0.05), increase in body fat mass, decrease of body lean and active cellular mass in comparison with the control group, the content of extracellular fluid was significantly higher than rates in the control group. A decrease in the value of the phase angle was also noted. The signs of protein deficiency, atherogenic dyslipidemia, insulin resistance were revealed. In patients with comorbid flow, the highest adipokine (increase in the concentration of leptin and resistin on the background of a decrease in the level of adiponectin and leptin-binding receptor) and cytokine (increase in the concentration of mediators of inflammation) activities of adipose tissue were revealed.

Keywords:arterial hypertension, chronic obstructive pulmonary disease, adipocytokines, nutritional status, diagnostic markers

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