ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet2016354-59ometendo-8021Research ArticleНаучные исследованияOriginal studiesСвязь уровня инсулиноподобного фактора роста 1 с патологическим ремоделированием миокарда у лиц с избыточной массой телаRelationship of IGF-1 and cardiac remodeling in overweight patientsШпагинаОльга ВикторовнаShpaginaOlga

аспирант

shpagina_olga@mail.ruБондаренкоИрина ЗиятовнаBondarenkoIrina

д.м.н.

iz_bondarenko@mail.ruКуклинаМария ДмитриевнаKuklinaMaria

к.м.н.

m_kuklina@mail.ruМанченкоОксана ВикторовнаManchenkoOksana

к.м.н.

xana03@mail.ruКолесниковаГалина СергеевнаKolesnikovaGalina

д.б.н.

kkk@mail.ruГончаровНиколай ПетровичGoncharovNikolai

д.м.н.

ng@mail.ruФГБУ «Эндокринологический научный центр» Минздрава России, МоскваРоссияEndocrinology Research CentreRussian FederationФГБУ Эндокринологический научный центрРоссияEndocrinology Research CentreRussian Federation2016090920161335459Copyright © Шпагина О.В., Бондаренко И.З., Куклина М.Д., Манченко О.В., Колесникова Г.С., Гончаров Н.П., 20162016Шпагина О.В., Бондаренко И.З., Куклина М.Д., Манченко О.В., Колесникова Г.С., Гончаров Н.П.Shpagina O., Bondarenko I., Kuklina M., Manchenko O., Kolesnikova G., Goncharov N.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/8021Цель

Цель. Определить роль инсулиноподобного фактора роста 1 (ИФР-1) в развитии ремоделирования миокарда у лиц с избыточным весом и ожирением 1 степени.

Материалы и методы

Материалы и методы. В исследование было включено 75 мужчин (средний возраст 55,3±6,3 лет) с избыточной массой тела или ожирением 1 степени (ИМТ 28,6±3,6), без сахарного диабета. В группу 1 вошли 46 человек с нормальной или избыточной массой тела. В группу 2 включено 27 мужчин с ожирением 1 степени (ИМТ=30–34,9 кг/м2). ИБС подтверждалась коронарографией или с помощью тредмил-теста. Всем участникам исследования проводился глюкозотолерантный тест (НТГ), оценивались показатели ЭхоКГ, общего холестерина (ХС), ХСЛНП, ХСЛВП, триглицеридов (ТГ), ИФР-1.

Результаты

Результаты. Пациенты обеих групп были сопоставимы по возрасту и достоверно не различались по среднему уровню АД, количеству больных ИБС, а также наличию НТГ. Группы различались по количеству больных с АГ и длительности ее течения. Средний уровень ИФР-1 в группах 1 и 2 не отличался (210,1 и 216,6 нг/мл, p>0,05). Однако, во второй группе чаще наблюдалось превышение референсных значений ИФР-1 – у 50% человек по сравнению с 1 группой – у 25,5% (р=0,039). При нормальном уровне ИФР-1 частота концентрического ремоделирования составила 38%, при повышенном уровне – 52%, эксцентрическая гипертрофия при нормальном уровне не наблюдалась, при повышенном уровне составила 16%, частота концентрической гипертрофии уменьшалась по мере увеличения ИФР-1 с 30,7% до 4%.

Выводы

Выводы. 1. ИФР-1 является важным участником развития ремоделирования миокарда у больных ИБС и с избыточной массой тела. 2. Уровень ИФР-1 может быть полезным индивидуальным индикатором в оценке прогноза ХСН у пациентов с ожирением. 3. ИФР-1 может рассматриваться как маркер повышенного риска развития АГ и связанного с ней ремоделирования миокарда.

Objectives

Objectives: To investigate the role of IGF-1 in the development of cardiac remodeling in patients with overweight and mild obesity.

Materials and Methods

Materials and Methods: The study included 75 men (mean age 55.3 ± 6.3 years), which are overweight or have mild obesity (body mass index (BMI) 28.6 ± 3.6) without diabetes. Group 1 included 46 patients with normal weight and overweight (BMI 26.5 ± 3.6). Group 2 included 27 patients with obesity (mean BMI 32.4 ± 3.5). Coronary artery disease was confirmed by treadmill test and coronarography. All participants were evaluated by impaired glucose tolerance test (IGT), cholesterol, triglycerides (TG), IGF-1 and LPHD, and LPLD levels, geometry of the heart chambers by echocardiography.

Results

Results: Patients in both groups did not differ by age, blood pressure, percent of CAD and impaired glucose tolerance. IGF-1 levels were not significantly different among the study groups (210.1 and 216.6 ng/ml, p>0.05). High circulating IGF-1 levels were frequently observed in Group 2 (in 50% and 25% patients, respectively; р=0.039). The concentric remodeling for patients with normal IGF-1 seen in 38% of patients compared to 52% in patients with high level of IGF-1. The eccentric hypertrophy for patients with normal IGF-1 was not observed compared to 16% in patients with high level of IGF-1. The concentric hypertrophy for patients with normal IGF-1 was 30.7% compared to 4% in patients with high level of IGF-1.

Conclusions

Conclusions: IGF-1 has a significant effect on cardiac remodeling in patients with coronary artery disease and obesity. IGF-1 may be an important marker of prognosis of chronic heart failure in patients with obesity and an indicator of hypertension and associated cardiac remodeling.

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