Al-Trawneh O. Pathogenetic and prognostic role of omentin, vsfatin, zinc-?2-glycoprotein, glipikan-4 in cardiovascular regimen in patients with hypertension and type 2 diabetes.

In the study of structural and functional changes in the myocardium, it was revealed that the left ventricular myocardial mass index (LVMI) was significantly higher in patients with combined course of hypertension and type 2 diabetes mellitus than in patients without type 2 diabetes mellitus. Patients with hypertension and type 2 diabetes mellitus were characterized by the development of adversed myocardial remodeling associated with concentric and eccentric hypertrophies. The thickness of the intima media complex of the common carotid artery (IMС СCA) was significantly higher in patients with hypertension and type 2 diabetes mellitus than in patients with hypertension without type 2 diabetes mellitus and were extremaly elevated in patients with comorbidity. In patients with hypertension and type 2 diabetes mellitus the levels of omentin, zinc-?2-glycoprotein (Zn?2G) and glypican-4 in serum were significantly lower than in hypertensives without type 2 diabetes mellitus and healthy volunteers, while levels of visfatin, TNF-? and C-reactive protein (СRP) were significantly increased. It was found that patients with the allele in the genotype of the polymorphic marker 2350 A/G of the ACE G gene are characterized by significant higher levels of blood pressure, LVMI, IMС СCA, and lowered level of the HDL cholesterol. There are more pronounced manifestations of the violation of carbohydrate metabolism and adipocytokine imbalance in comparison with patients with AA genotype. Antihypertensive therapy consisted of a combination of angiotensin-converting enzyme (lisinopril) and beta-blocker (carvedilol), the dose of the drugs was titrated until the desired therapeutic effect was achieved. Thus, there was no significant difference between the efficacy of treatment of the patients with hypertension and type 2 diabetes mellitus, depending on the variant of the ACE gene of the polymorphic marker 2350 A/G.