ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12923ometendo-12923Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESРастворимый эндоглин — потенциальный маркер эндотелиальной дисфункции у пациентов с первичным гиперпаратиреозом: пилотное исследованиеSoluble endoglin as a perspective marker of endothelial dysfunction in patients with primary hyperparathyroidism: a pilot studyhttps://orcid.org/0000-0001-6581-4521ГорбачеваА. М.GorbachevaA. M.

Горбачева Анна Максимовна.

117036, Москва, ул. Дмитрия Ульянова, д. 11

Anna M. Gorbacheva - MD.

11, Dm. Ul’yanova street, 117036 Moscow

ann.gorbachewa@yandex.ruhttps://orcid.org/0000-0001-5952-5846БибикЕ. Е.BibikE. E.

Бибик Екатерина Евгеньевна.

Москва

Ekaterina E. Bibik - MD.

Moscow

bibikaterina@mail.ruhttps://orcid.org/0000-0002-8916-7346ДобреваЕ. А.DobrevaE. A.

Добрева Екатерина Александровна - кандидат медицинских наук.

Москва

Ekaterina A. Dobreva - MD, PhD.

Moscow

dobrevae@mail.ruhttps://orcid.org/0000-0001-6935-3187ЕлфимоваА. Р.ElfimovaA. R.

Елфимова Алина Ринатовна.

Москва

Alina R. Elfimova - MD.

Moscow

9803005@mail.ruhttps://orcid.org/0000-0001-6667-062XЕремкинаА. К.EremkinaA. K.

Еремкина Анна Константиновна – кандидат медицинских наук.

Москва

Anna K. Eremkina - MD, PhD.

Moscow

eremkina.anna@endocrincentr.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваН. Г.MokryshevaN. G.

Мокрышева Наталья Георгиевна – доктор медицинских наук, профессор.

Москва

Natalia G. Mokrysheva - MD, PhD, Professor.

Moscow

parathyroid.enc@gmail.comНМИЦ эндокринологии Минздрава РоссииРоссияEndocrinology Research CentreRussian Federation202226012023194358368Copyright © Горбачева А.М., Бибик Е.Е., Добрева Е.А., Елфимова А.Р., Еремкина А.К., Мокрышева Н.Г., 20232023Горбачева А.М., Бибик Е.Е., Добрева Е.А., Елфимова А.Р., Еремкина А.К., Мокрышева Н.Г.Gorbacheva A.M., Bibik E.E., Dobreva E.A., Elfimova A.R., Eremkina A.K., Mokrysheva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12923Обоснование

Обоснование. Первичный гиперпаратиреоз  (ПГПТ) ассоциирован с высокой частотой сердечно-сосудистых  заболеваний, в том числе обусловленных дисфункцией эндотелия. Оценка эндотелиальной дисфункции у пациентов с ПГПТ позволит выявить предрасположенность  к развитию кардиоваскулярной  патологии и определить оптимальную тактику ведения при этой патологии.

Цель

Цель. Оценить концентрацию растворимого эндоглина и фотоплетизмографические показатели как потенциальные маркеры эндотелиальной  дисфункции в сочетании  с параметрами пуринового,  липидного  и углеводного  обмена у пациентов с ПГПТ.

Материалы и методы

Материалы и методы. Проведено  одноцентровое  одномоментное исследование  50 пациентов  с верифицированным ПГПТ, не имевших подтвержденной сердечно-сосудистой  и иной сопутствующей  соматической  патологии, и 21 условно здорового добровольца, сопоставимых по полу и возрасту. Всем участникам проводился биохимический анализ крови (кальций общий, ионизированный, альбумин, липидограмма, мочевина, мочевая кислота, глюкоза, креатинин), оценивались концентрации  паратиреоидного  гормона (ПТГ), 25(ОН)D и эндоглина. Кроме того, выполнялись эхокардиография,  ультразвуковое  дуплексное сканирование брахиоцефальных  артерий и артерий нижних конечностей, а также фотоплетизмография.

Результаты

Результаты. Группы ожидаемо различались по показателям минерального обмена, характерным для ПГПТ; по параметрам жирового, пуринового  и углеводного  обмена отличий выявлено не было. Сывороточные  концентрации эндоглина были ниже в исследуемой группе (р=0,002). В объединенной группе обнаружены отрицательные корреляции между концентрацией альбумин-скорректированного кальция и ПТГ с эндоглином (r1=-0,370; p1=0,003 и r2=-0,475; p2<0,001 соответственно) и положительная корреляция между концентрацией эндоглина и фосфора (r=0,363; p=0,003). Описанные факты сопровождались изменениями фотоплетизмографических показателей, характеризующих  увеличение жесткости сосудистой стенки.

Заключение

Заключение. Сывороточная  концентрация  растворимого  эндоглина ниже у пациентов с ПГПТ, чем у здоровых добровольцев. Уровень эндоглина отрицательно коррелирует  с сывороточными концентрациями кальция и ПТГ и положительно — с концентрацией фосфора сыворотки крови. Дальнейшие исследования позволят установить патогенетический механизм выявленных взаимосвязей и оценить роль эндоглина в качестве потенциального  предиктора сердечно-сосудистой  патологии при ПГПТ.

BACKGROUND

BACKGROUND: Primary hyperparathyroidism  (PHPT), one of the most common endocrine pathologies, is associated with a higher incidence of cardiovascular diseases, in particular, those caused by endothelial dysfunction. Evaluation of endothelial dysfunction in patients with PHPT will predict the development of cardiovascular pathology and determine the optimal tactics for PHPT management.

AIM

AIM: To evaluate the concentration  of soluble endoglin  and photoplethysmographic parameters as potential markers of endothelial dysfunction in patients with PHPT.

MATERIALS AND METHODS

MATERIALS AND METHODS:  A single-center interventional single-stage study was carried out. 2 groups were formed. The first group included 50 patients with verified PHPT who did not have cardiovascular or other concomitant somatic pathologies in anamnesis. The comparison group included 21 healthy volunteers comparable in sex and age. All participants underwent a biochemical blood test (total calcium, ionized, albumin, lipidogram, urea, uricacid, glucose, creatinine, alkaline phosphatase), parathyroid hormone, 25 (OH) D and endoglin concentrations were evaluated. In addition, echocardiography, ultrasound of the brachiocephalic arteries and arteries of the lower extremities, as well as photoplethysmography were performed.

RESULTS

RESULTS: The groups differed in mineral parameters associated with PHPT; no differences were found in parameters of lipid, uric acid and carbohydrate metabolism. Serum levels of endoglin  were lower in PHPT patients (p=0.002). We found a negative correlation between the concentration of albumin-corrected calcium and PTH with endoglin (r1=-0.370, p1=0.003 and r2=-0.475, p2<0.001, respectively) and a positive correlation between the concentration of endoglin  and phosphorus (r=0.363, p=0.003). These associations s were accompanied by changes in photoplethysmographic parameters that indicate an increase in the vascular wall stiffness.

CONCLUSION

CONCLUSION: The serum level of soluble endoglin  is lower in patients with PHPT than in healthy volunteers, negatively correlates with calcium and PTH concentrations and positively with serum phosphorus concentrations. Further studies will make it possible to establish the pathogenetic mechanism of the identified relationships and evaluate the role of endoglin as a potential predictor of cardiovascular pathology in PHPT population.

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The authors declare that there are no conflicts of interest present.