Parameters of endothelial function and insulin resistance in patients with metabolic syndrome before and after weight loss
https://doi.org/10.14341/omet2008118-22
Abstract
In clinical practice, physicians of different specialties often faced with the metabolic syndrome (MS) is a set of hormonal and metabolic disorders that share a common pathophysiological mechanism - insulin resistance (IR) [1, 5, 11]. MS is important for the clinician not only how widespread pathology, but primarily as a life-threatening condition. Of course, this syndrome plays an important role in accelerating the development and progression of diseases associated with atherosclerosis, which, according to experts WHO, ranks first among the causes of mortality in industrialized countries [12, 16, 19]. This situation is particularly important for Russia due to the relatively high spread of the syndrome, component, according to several authors, about 20% of the population, and high rates of death from coronary heart disease and stroke in the Russian population [2, 4, 5]. It is known that the risk of coronary heart disease (CHD), stroke, and total coronary mortality increases with the number of components of metabolic syndrome [14, 15, 20]. The study J.H. Park et al., Which included 478 patients with ischemic stroke, MS was diagnosed in 53.4% of patients (criteria NCEP ATP III), the thickness of the complex value of the index "intima-media" of the carotid arteries was increased in direct proportion to an increase in the number of available components of MS [20] . Link between R & D and cardiovascular disease, apparently, is endothelial dysfunction, which is the study at various metabolic diseases received much attention [9, 10, 22]. Endothelial dysfunction, which is typical for many patients with MS, is a marker of metabolic and vascular disorders [15, 22]. In the initial period of development of the atherosclerotic process, even when there are no obvious clinical manifestations and visible morphological changes of blood vessels, the main role is played by endothelial dysfunction [9, 21]. Endothelial dysfunction is also discussed as one of the reasons for the rapid development, progression of atherosclerosis and its complications in patients with MS [11,18]. For example, recent studies have shown that tears plaques leading to myocardial infarction, do not always occur in the zone of maximum stenosis of the coronary arteries [13]. Rather, they tend to occur in places restrictions of small - less than 50% by angiography. The study of endothelial function in patients with MS is at the initial stages of the study [8, 15, 18]. In addition, of particular interest is the study of the effect of weight loss on the state of the endothelium in the syndrome of insulin resistance.
About the Authors
A MkrtumyanMoscow State University of Medicine and Dentistry named after A.I.Evdokimov
E Biryukova
Moscow State University of Medicine and Dentistry named after A.I.Evdokimov
N Markina
Moscow State University of Medicine and Dentistry named after A.I.Evdokimov
M Garbuzova
Moscow State University of Medicine and Dentistry named after A.I.Evdokimov
References
1. Бутрова С.А. Метаболический синдром: патогенез, клиника, диагностика, подходы к лечению. // РМЖ 2001. - Т.2. - №9. - С.56-60.
2. Карпов Р.С. Современные проблемы атеросклероза: взгляд клинициста. // Бюллетень сибирской медицины 2003. - №3. - С.13-29.
3. Манухина E.Б., Дауни X.Ф., Маллет Р.Т., Малышев И.Ю. Защитные и повреждающие эффекты периодической гипоксии: роль оксида азота. // Вестник Российской АМН. - 2007. - №2. - С.25-33.
4. Никитин Ю.П., Казека Г.Р., Симонова Г.И. Распространенность компонентов метаболического синдрома Х в неорганизованной городской популяции (эпидемиологичское исследование). // Кардиология. - 2001. - Т.1. - №9. - С.37-40.
5. Чазова И.Е., Мычка В.Б. Метаболический синдром // Consilium medicum. - 2002. - Т.4. - №11. - С. 587-92.
6. Cersosimo E., DeFronzo R.A. Insulin resistance and endothelial dysfunction: the road map to cardiovascular diseases. // Diabetes Metab Res Rev 2006; 22 (6): 423-36.
7. Chan J.C.N., Cheung J.C.K., Stehouwer C.D.A., et al. The central roles of obesity-associated dyslipidemia, endothelial activation and cytokines in the Metabolic Syndrome - an analysis by structural equation modeling. // Int J Obes Relat Metab Disord. 2002; 26: 994-1008.
8. Dallaire P., Marette A. Obesity-linked insulin resistanse: is nitric oxide the missing link? //Canadian J of diabetes 2004; 28(1):59-66.
9. De Caterina R. Endothelial dysfunctions: common denominators in vascular disease.// Curr Opin Lipidol. 2000; 11:9-23.
10. Engeli S., Janke J., Gorzelniak K. et al. et al. Regulation of the nitric oxide system in human adipose tissue. // J Lipid Research 2004; 45: 1640-8.
11. Frustaci A. , Kajstura J., Chimenti C. et al. Myocardial cell death in human diabetes // Circ Res 2000; 87: 1123 - 32.
12. Gami A.S., Witt B.J., Howard D.E. et al. Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies // J Am Coll Cardiol. 2007; 49(4):403-14.
13. Hacket D., Davies G., Maseri A. Pre-existing coronary stenosis in patients with first myocardial infarction are not necessary severe. // Europ. Heart J. 1988;9: 1317-23.
14. Hong Y., Jin X., Mo J. Metabolic syndrome, its preeminent clusters, incident coronary heart disease and all-cause mortality - results of prospective analysis for the Atherosclerosis Risk in Communities study. // J Intern Med 2007;262 (1):113-23.
15. Irving R. J., Noon J.P., Watt G.C.M et al. Activation of the endothelin system in insulin resistance. // Q J Med 2001; 94:312-26.
16. Isomaa B., Almgren P., Tuomi T. et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. // Diabetes Care 2001; 24,683-9.
17. Juan C.C., Chuang T.Y., Chang C.L., Endothelin -1 regulates adiponectin gene expression and secretion in 3T3-L1 adipocytes via endothelin signaling pathways. // Endocrinology 2007; 148(4): 1835 - 42.
18. Noronha B.T., Li J.-M., Wheatcroft S. B. et al. Inducible Nitric Oxide Synthase Has Divergent Effects on Vascular and Metabolic Function in Obesity. // Diabetes 2005; 54 (4): 1082-9.
19. Park J.H., Kwon H.M., Roh J.K. Metabolic syndrome is more associated with intracranial atherosclerosis than extracranial atherosclerosis // Eur J Neurol. 2007; 14 (4): 379-86.
20. Piatti P.M., Monti L.D., Galli l. Et al. Relationship betweem endotelin-1 concentration and metabolic alteration typical of the insulin resistance syndrom. // Metabolism. 2000, 49: 748-52.
21. Van der Vliet A., Smith D., O’Neill C.A. et al. Interactions of peroxynitrite with human plasma and its constituents: oxidative damage and antioxidant depletion. // Biochem J. 1994; 303: 295-301.
22. Widlansky M.E., Gokce N., Keaney J.F. et al. The clinical implications of endothelial dysfunction. // J Am Coll Cardiol 2003;42:1149-60.
Review
For citations:
, , , Parameters of endothelial function and insulin resistance in patients with metabolic syndrome before and after weight loss. Obesity and metabolism. 2008;5(1):18-22. (In Russ.) https://doi.org/10.14341/omet2008118-22
Views:
369
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
