Goptsij O. Leptinemia, insulin resistance and tumor necrosis factor-? in hypertensive patients with obesity.

Dissertation is devoted to optimization of diagnostics of metabolic abnormalities and determination of their pathogenic role in formation of clinical course of the arterial hypertension associated with obesity on the base of complex assessment of anthropometric parameters in relation to leptin, insulin, lipids and TNF-? serum levels. It was defined that in patients with arterial hypertension with excessive body mass leptin serum levels was statistically higher as compared with hypertensive patients with normal body mass and healthy persons. Leptin serum blood levels elevation in patients with arterial hypertension corresponds to obesity degree. Patients with arterial hypertension with abdominal type of fat tissue distribution characterized by statistically higher leptin levels as compared with hypertensive patients without abdominal obesity. Carbohydrates and lipid metabolism abnormalities in patients with arterial hypertension with overweight and obesity were detected, that was more pronounced in patients with abdominal type of fat tissue distribution. It was found statistically significant elevation of proinflammatory cytokine TNF-? in patients with arterial hypertension and excessive body mass as compared with hypertensive patients with normal body mass and control group. Statistically significant increasing of this cytokine in blood serum was evaluated correspondingly to obesity degree: maximal means were determined in patients with 2 degree obesity, in patients with arterial hypertension and 3 degree obesity level of this cytokine was decreased. TNF-? levels that was detected in patients with abdominal obesity was higher than in patients without abdominal obesity. TNF-? and leptin levels, carbohydrates and lipid metabolism parameters significantly elevated in hypertensive patients with insulin resistance presence as compared with patients without insulin resistance. Relationships between TNF-? and HOMA index, leptin levels, insulin levels; between leptin levels and HOMA index, insulin levels were evaluated. Adipokines production abnormalities, carbohydrates homeostasis changes, immune-inflammation and obesity presence in complex are influence on arterial hypertension clinical course