International Medical Journal, Vol. 23., Iss. 4, 2017, P. 25−29.
PARTICIPATION OF POLYMORPHISM OF A1166C GENE OF TYPE 1 ANGIOTENSIN II RECEPTOR IN METABOLIC DISORDERS IN PATIENTS WITH ARTERIAL HYPERTENSION AND NON-ALCOHOLIC FATTY LIVER DISEASES
Kharkiv National Medical University, Ukraine
The urgency of investigation of the combination of arterial hypertension and non−alcoholic fatty liver disease is due to the high incidence of life−threatening complications caused by these diseases. Arterial hypertension and non−alcoholic fatty liver disease are comorbid diseases, which implies their interconnectedness and mutually complicating effect. Recently, much attention has been paid to the issues of the participation of gene polymorphisms in the development and progression of multifactorial diseases. Consideration of the specific version of the gene polymorphism in patients contributes to the maximum individualization of the diagnosis, which significantly increases its effectiveness, allows to prevent the development of complications and increase of the diseases severity. One of the gene polymorphisms involved in the development of arterial hypertension and disorders of carbohydrate and lipid metabolism is the polymorphism of A1166C gene of type 1 angiotensin II receptor (AGTR1). To study its participation in carbohydrate and lipid metabolism disorders in patients with arterial hypertension and nonalcoholic fatty liver disease, 55 patients, of them carriers of CC, A/C and A/A genotypes, were examined. Polymorphism of the angiotensin II type 1 receptor gene was performed using polymerase chain reaction. Serum glucose content was determined by the glucose oxidase method, insulin concentration − by immune enzyme method. The biochemical study included establishing the level of total cholesterol, high, low and very low density lipoproteins, triglycerides. Anthropometric indices of waist and hip size, height, body mass index were determined. Analysis of carbohydrate metabolism parameters, depending on AGTR1 gene genotypes in patients with hypertension and NAFLD shows that the carriers of C/C genotype have more pronounced disorders of carbohydrate metabolism in the form of hyperinsulinemia and decreased tissue sensitivity to insulin, whereas the patients with A/C and A/A genotypes are more resistant to gluco−metabolic disorders. The obtained data suggest that the allele C is a pathologic variant of AGTR1 gene (A1166C) polymorphism. The constitutional data of the examined patients did not differ. Evaluation of lipid metabolism in patients did not show differences between the levels of total cholesterol, high, low and very low density cholesterol, depending on genotypes of AGTR1 gene (A1166C). However, the generation of triglycerides was higher in the carriers of the C/C genotype, indicating the development of hypertriglyceridemia. Thus, comorbidity of arterial hypertension and non−alcoholic fatty liver disease in carriers of C/C genotype causes more distinct disorders of carbohydrate and lipid metabolism in the form of hyperinsulinemia, reduction of tissue sensitivity to insulin and hypertriglyceridemia while patients with genotypes A/C and A/A possess greater resistance to glucose−metabolic disorders.
Key words: polymorphism of A1166C gene of type 1 angiotensin II receptor, arterial hypertension, nonalcoholic fatty liver disease, metabolic disorders.