Adipocytokines, Oxidized LDL Aid in Metabolic Balance in Hypertensive Patients.

Mohamed Makrelouf, MD

Preliminary results from a recent investigation from Algeria suggested an “important metabolic role” for adipocytokines and oxidized low-density lipoprotein (LDL) in hypertensive patients.

The study was presented this week at the 19th Annual World Congress Insulin Resistance Diabetes & Cardiovascular Disease Meeting.

Investigators led by Mohamed Makrelouf, MD, Biochemistry and genetic Laboratory ,University hospital of BAB EL OUED/ University of Algiers, noted that oxidative stress, obesity and metabolic syndrome had all been implicated in the physiopathology of hypertension in previous studies.

Additionally, the regulating tissue of lipid metabolism, visceral adipose tissue, was cited as playing a major endocrine role in the selections of adipoctyokines, while also controlling insulin sensitivity.

In the present study, Otmane and colleagues aimed to determine if oxidized LDL and antioxidant vitamin levels in hypertensive patients, while also correlating to the studied metabolic parameters of insulin resistance and metabolic syndrome.

The Methods

The prospective study enrolled a total of 245 Algerian patients with hypertension, including 118 women and 42 men.

A fasting metabolic assessment was then conducted for each participant, which included glycemia and renal status and a complete lipid profile assessment including total cholesterol, triglycerides, HDLc, LDLc, CRPus, and insulinemia.

Insulin resistance was then estimated by the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), which was paired with anthropometric measurements including weight, body mass index, and waist circumference.

Leptin, adiponectin, and oxidized LDL were determined by an enzyme-linked immunosorbent assay (ELISA), while antioxidant vitamins (A/E) were measured by the High-Performance Liquid Chromatography (HPLC).

The Findings

Investigators recorded that hypertensive women predominated their study (88.42%), compared to men (20.58%).

Regarding age, 42.85% of participants in the 50-59 years age group were hypertensive, followed by hypertensive participants over the age of 60 years (30.35%).

Arterial hypertension was diagnosed in less than 5 years for 40.81% of all patients included in the study, followed by 24.5% of patients who had been diagnosed for 10 years or more. A majority (88%) were followed and treated for their hypertension.

The investigators found that the most prescribed hypertensive in most patients was angiotensin II receptor antagonists (ARAII, 48.83%), followed by diuretics (33.02%) and calcium channel blockers (25.11%)/

The prevalence of metabolic syndrome was 47,35%, with the team observing that 45% of patients were sedentary, while 47% were overweight and 36.25% of them were obese.

The prevalence of insulin resistance evaluated by the HOMA index was 45%.

Additionally a statistically significant difference (p = 0.046), with a mean low concentration for the MS + group 6.92 (3.18) ng/ml, was recorded for adiponectin, whereas the mean concentration was higher 8.74( 5.02) ng / m for arterial hypertension without MS.

For oxidized LDL, 4.58 (3.74) μg/ml MS + and 2.16 (1.41) μg / ml were found for the group without MS, with p<10-5.

“The preliminary results suggest that there is an important metabolic role of adipocytokines and oxLDL, (as) they interact directly with the insulin signal transmission pathways,” the team wrote. “Their measurement with the antioxidant vitamins allows to complete the metabolic balance especially in hypertensive patients with metabolic syndrome.”

“Interaction between Metabolic Syndrome, Insulin Resistance and Oxidative Stress in Hyptertensive Patients,” was published online by WCIRDC.