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, T. V. Ashcheulova

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.


Keywords


arterial hypertension; prediabetes; type 2 diabetes mellitus; genetic polymorphisms of the renin-angiotensin system; cytokines

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