Введение

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/2079-701X-2022-16-17-80-91

medsovet-7114

Research Article

КОМОРБИДНЫЙ ПАЦИЕНТ

COMORBID PATIENT

Ассоциация между адипокинами и ремоделированием сердца у пациентов с ожирением на доклинических стадиях сердечной недостаточности

Association between adipokines and cardiac remodeling in obese patients in preclinical heart failure

https://orcid.org/0000-0003-0613-829X

Лясникова

Е. А.

Lyasnikova

E. A.

к.м.н., старший научный сотрудник научно-исследовательской лаборатории высокотехнологичных методов лечения сердечной недостаточности научно-исследовательского отдела сердечной недостаточности Института сердца и сосудов, доцент кафедры факультетской терапии с клиникой Института медицинского образования,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Cand. Sci. (Med.), Senior Researcher of the Research Laboratory of High-Tech Methods for the Treatment of Heart Failure of the Research Department of Heart Failure of the Institute of Heart and Vessels, Associate Professor of the Department of Faculty Therapy with the Clinic of the Institute of Medical Education,

2, Akkuratov St., St Petersburg, 197341

https://orcid.org/0000-0002-2695-4924

Матвеев

Г. А.

Matveev

G. A.

младший научный сотрудник научно-исследовательской лаборатории предиабета и других метаболических нарушений научно-исследовательского отдела генетических рисков и персонифицированной профилактики научного центра мирового уровня «Центр персонализированной медицины»,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Junior Researcher, Research Laboratory of Prediabetes and Other Metabolic Disorders, Research Department of Genetic Risks and Personalized Prevention, World-Class Scientific Center “Center for Personalized Medicine”,

2, Akkuratov St., St Petersburg, 197341

matveev_ga@almazovcentre.ru

https://orcid.org/0000-0003-4376-3721

Голикова

Т. И.

Golikova

T. I.

младший научный сотрудник научно-исследовательской лаборатории предиабета и других метаболических рисков научно-исследовательского отдела генетических рисков и персонифицированной профилактики научного центра мирового уровня «Центр персонализированной медицины»,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Junior Researcher, Research Laboratory of Prediabetes and Other Metabolic Risks, Research Department of Genetic Risks and Personalized Prevention, World-Class Research Center “Center for Personalized Medicine”,

2, Akkuratov St., St Petersburg, 197341

https://orcid.org/0000-0002-8624-5046

Деревицкий

И. В.

Derevitskii

I. V.

инженер Национального центра когнитивных разработок,

197101, Санкт-Петербург, Кронверкский проспект, д. 49

Engineer of the National Center for Cognitive Research,

49, Kronverksky Ave., St Petersburg, 197101

https://orcid.org/0000-0002-7674-5258

Федоров

А. В.

Fedorov

A. V.

к.б.н., заведующий научно-исследовательской лабораторией молекулярно-клеточных механизмов атеросклероза,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Cand. Sci. (Biol.), Head of the Research Laboratory of Molecular Cellular Mechanisms of Atherosclerosis,

2, Akkuratov St., St Petersburg, 197341

https://orcid.org/0000-0002-2115-8873

Васильева

Е. Ю.

Vasilyeva

E. Yu.

к.м.н., заведующий Центральной клинико-диагностической лабораторией, врач клинической лабораторной диагностики,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Cand. Sci. (Med.), Head of the Central Clinical Diagnostic Laboratory, Doctor of Clinical Laboratory Diagnostics,

2, Akkuratov St., St Petersburg, 197341

https://orcid.org/0000-0002-0559-697X

Бабенко

А. Ю.

Babenko

A. Yu.

д.м.н., руководитель научно-исследовательского отдела генетических рисков и персонифицированной профилактики, заведующий научно-исследовательской лабораторией предиабета и метаболических нарушений научного центра мирового уровня «Центр персонализированной медицины», заведующий научно-исследовательской лабораторией диабетологии, профессор кафедры внутренних болезней Института медицинского образования,

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Dr. Sci. (Med.), Head of the Research Department of Genetic Risks and Personalized Prevention, Head of the Research Laboratory of Prediabetes and Metabolic Disorders of the World-Class Research Center “Center for Personalized Medicine”, Head of the Research Laboratory of Diabetology, Professor of the Department of Internal Diseases of the Institute of Medical Education,

2, Akkuratov St., St Petersburg, 197341

alina_babenko@mail.ru

Национальный медицинский исследовательский центр имени В.А. АлмазоваРоссияAlmazov National Medical Research CentreRussian Federation

Национальный исследовательский университет ИТМОРоссияITMO UniversityRussian Federation

2022

12102022

0178091

2022

Лясникова Е.А., Матвеев Г.А., Голикова Т.И., Деревицкий И.В., Федоров А.В., Васильева Е.Ю., Бабенко А.Ю.

Lyasnikova E.A., Matveev G.A., Golikova T.I., Derevitskii I.V., Fedorov A.V., Vasilyeva E.Y., Babenko A.Y.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/7114

Введение

Введение. Ассоциация между гипертрофией левого желудочка (ГЛЖ) при ожирении и сопутствующих метаболических рисках с уровнем адипокинов на различных стадиях сердечной недостаточности (СН) в настоящее время обсуждается.

Цель – изучить взаимосвязь уровней циркулирующих адипокинов с ГЛЖ у пациентов с ожирением на доклинических стадиях СН. Материалы и методы. Исследованы 74 пациента с ожирением: 43% без маркеров ГЛЖ (стадия A СН) – группа 1, 57% с ГЛЖ (стадия B СН) – группа 2. Проведена трансторакальная эхокардиография, оценка N-концевого предшественника мозгового натрийуретического пептида (Nt-proBNP), стимулирующего фактора роста, экспрессируемого геном 2, растворимая форма (sST2), уровней лептина и адипонектина, расчет индекса инсулинорезистентности HOMA-IR. Применен статистический метод согласованных пар – matched pairs analysis.

Результаты

Результаты. Установлены отрицательные корреляции маркеров ГЛЖ с уровнем лептина в группе 1 (стадия А СН) и с уровнем адипонектина в группе 2 (стадия В СН) (все p < 0,05). Наблюдались положительные корреляции между соотношением sST2/ адипонектин и HOMA-IR с параметрами ГЛЖ в группе 2 (стадия В СН) (все p >< 0,05). Заключение. Направленность ассоциаций между циркулирующим уровнем адипокинов и ГЛЖ различается в зависимости от доклинической стадии СН. Полученные данные могут отражать взаимосвязь между ремоделированием сердца в ответ на молекулярные механизмы воспаления и инсулинорезистентность с ожирением на определенной стадии сердечнососудистого континуума. Ключевые слова: лептин, адипонектин, инсулинорезистентность, HOMA-IR, воспаление, sST2, гипертрофия левого желудочка>˂ 0,05). Наблюдались положительные корреляции между соотношением sST2/ адипонектин и HOMA-IR с параметрами ГЛЖ в группе 2 (стадия В СН) (все p ˂ 0,05).

Заключение

Заключение. Направленность ассоциаций между циркулирующим уровнем адипокинов и ГЛЖ различается в зависимости от доклинической стадии СН. Полученные данные могут отражать взаимосвязь между ремоделированием сердца в ответ на молекулярные механизмы воспаления и инсулинорезистентность с ожирением на определенной стадии сердечнососудистого континуума.

Introduction

Introduction. Association of left ventricular hypertrophy (LVH) in obesity and accompanying metabolic risks with adipokines levels at the different stage of heart failure (HF) is still debatable.

The aim of study was to investigate the relationship of circulating adipokines levels with LVH in obese patients at preclinical stage of HF.

Materials and methods

Materials and methods. The study included 74 obese patients: 43% had no markers of LVH (stage A HF, group 1); 57% had LVH (stage B HF, group 2). Transthoracic echocardiography, laboratory assessment of N-terminal fragment of the brain natriuretic peptide, soluble suppression of tumorigenesis-2 (sST2), circulating leptin and adiponectin levels, homeostasis model assessment of insulin resistance (IR) (HOMA-IR) were done. Matched-pairs analysis was applied.

Results

Results. Negative correlations of LVH with leptin levels in group 1 (stage A HF) and with adiponectin levels in group 2 (stage B HF) were detected (all p < 0.05). Positive correlations of the sST2 / adiponectin ratio and HOMA-IR with the parameters of LVH were detected in group 2 (all p >< 0.05). Conclusion. The direction of the associations between circulating adipokines and LVH varies with the preclinical stage of HF. The data obtained may reflect a relationship between heart remodeling in response to molecular mechanisms of inflammation and IR in obese patients at the certain stage of cardiovascular continuum. Keywords: leptin, adiponectin, insulin resistance, HOMA-IR, inflammation, sST2, left ventricular hypertrophy>˂ 0.05). Positive correlations of the sST2 / adiponectin ratio and HOMA-IR with the parameters of LVH were detected in group 2 (all p ˂ 0.05).

Conclusion

Conclusion. The direction of the associations between circulating adipokines and LVH varies with the preclinical stage of HF. The data obtained may reflect a relationship between heart remodeling in response to molecular mechanisms of inflammation and IR in obese patients at the certain stage of cardiovascular continuum.

лептинадипонектининсулинорезистентностьHOMA-IRвоспалениеsST2гипертрофия левого желудочка

leptinadiponectininsulin resistanceHOMA-IRinflammationsST2left ventricular hypertrophy

Исследование выполнено при финансовой поддержке Министерства науки и высшего образования Российской Федерации (соглашение №075-15-2022-301 от 20.04.2022).

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