medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-23-357-365medsovet-7317Research ArticleПРАКТИКАPRACTICEОсобенности формирования менопаузального метаболического синдрома при артериальной гипертензииFeatures of the formation of menopausal metabolic syndrome in arterial hypertensionhttps://orcid.org/0000-0002-6762-5238РуяткинаЛ. А.RuyatkinaL. A.

Руяткина Людмила Александровна - доктор медицинских наук, профессор.

630091, Новосибирск, Красный проспект, д. 52

Lyudmila A. Ruyatkina - Dr. Sci. (Med.), Professor, Novosibirsk State Medical University.

52, Krasny Ave., Novosibirsk, 630091

larut@list.ruhttps://orcid.org/0000-0003-3431-5943РуяткинД. С.RuyatkinD. S.

Руяткин Дмитрий Сергеевич – кандидат медицинских наук, доцент.

630091, Новосибирск, Красный проспект, д. 52

Dmitriy S. Ruyatkin - Cand. Sci. (Med.), Associate Professor, Novosibirsk State Medical University.

52, Krasny Ave., Novosibirsk, 630091

dr79@mail.ruhttps://orcid.org/0000-0001-9270-9188ЩербаковаЛ. В.ShcherbakovaL. V.

Щербакова Лилия Валерьевна - старший научный сотрудник.

630089, Новосибирск, ул. Бориса Богаткова, д. 175/1; 

Liliya V. Shcherbakova - Senior Researcher, Research Institute of Therapy and Preventive Medicine.

175/1, Boris Bogatkov St., Novosibirsk, 630089

9584792@mail.ruНовосибирский государственный медицинский университетРоссияNovosibirsk State Medical UniversityRussian FederationНаучно-исследовательский институт терапии и профилактической медициныРоссияResearch Institute of Therapy and Preventive MedicineRussian Federation202219012023023357365Copyright © Руяткина Л.А., Руяткин Д.С., Щербакова Л.В., 20232023Руяткина Л.А., Руяткин Д.С., Щербакова Л.В.Ruyatkina L.A., Ruyatkin D.S., Shcherbakova L.V.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/7317Введение

Введение. Концепция стадирования кардиометаболических заболеваний (КМЗ) при кластеризации компонентов метаболического синдрома (МС) тесно связана с инсулинорезистентностью (ИР), зависимой от статуса половых гормонов и возраста. Предполагается, что формирование менопаузального МС стартует в перименопаузе вследствие изменения функционального состояния оси «гипофиз – яичники». Однако механизмы, объясняющие половые различия ИР, особенно в период менопаузального перехода, не установлены.

Цель

Цель. Оценить взаимосвязи маркеров МС в когорте женщин 35–59 лет без нарушений углеводного обмена с различным функциональным состоянием яичников в зависимости от наличия артериальной гипертензии (АГ) и влияния возрастассоциированных факторов.

Материалы и методы

Материалы и методы. У 88 нормогликемических женщин 35–59 лет с различным функциональным состоянием оси «гипофиз – яичники» и разделенных на 2 группы в зависимости от наличия АГ определены: ИМТ, окружность талии (ОТ), уровни артериального давления (АД), триглицеридов (ТГ), ХС-ЛПВП, ФСГ и эстрадиола, гликемии натощак (ГН), индекс TyG. С помощью SPSS (версия 13) оценивали ME (25–75%), межгрупповые различия по критерию Манна – Уитни, проводили корреляционный анализ по Спирмену и частичный для нивелирования влияния возраста.

Результаты

Результаты. Наибольший спектр значимых ассоциаций, независимых от возраста и в тандеме с ним, выявлен только в группе пациенток с АГ: у ОТ и ГН, усиливающихся при уровнях ФСГ > 25 мЕд/л; у липидных параметров между собой и с ГН; TyG с уровнями ФСГ и эстрадиола, а также TyG со всеми параметрами c акцентом на ОТ и ХС-ЛПВП.

Выводы

Выводы. В процессе формирования менопаузального МС при АГ значимые взаимосвязи традиционных маркеров КМЗ с индексом TyG, отражающим наличие ИР через взаимосвязи углеводного и липидного обменов, находятся под частичным влиянием уровней ФСГ и эстрадиола в тандеме с возраст-ассоциированными показателями: длительностью АГ и постменопаузы.

Introduction

Introduction. The concept of staging of cardiometabolic diseases (CMD) in the clustering of metabolic syndrome (MS) components is closely related to insulin resistance (IR), which depends on the status of sex hormones and age. It is assumed that the formation of menopausal MS starts in perimenopause due to changes in the functional state of the pituitary-ovarian axis. However, mechanisms explaining sex differences in IR, especially during the menopausal transition, have not been established.

Aim

Aim. To evaluate the relationship of MS markers in a cohort of women aged 35–59 years without carbohydrate metabolism disorders with different functional state of the ovaries, depending on the presence of arterial hypertension (AH) and the influence of age-associated factors.

Materials and methods

Materials and methods. In 88 normoglycemic women aged 35–59 years with different functional state of the pituitary-ovarian axis and divided into 2 groups depending on the presence of hypertension, the following were determined: BMI, waist circumference (WC), levels of blood pressure (BP), triglycerides (TG), HDL cholesterol, FSH and estradiol, fasting glucose (FG), TyG index. SPSS (version 13) assessed ME (25–75%); intergroup differences according to the Mann-Whitney test; Correlation analysis according to Spearman and partial correlation were performed to level the effect of age.

Results

Results. The largest range of significant associations, independent of age and in tandem with it, was found only in the group of patients with hypertension: in OT and FG, which increase at FSH levels > 25 mU/l; lipid parameters among themselves and with FG; TyG with FSH and estradiol levels, and TyG with all parameters focusing on OT and HDL cholesterol.

Conclusions

Conclusions. In the process of the formation of menopausal MS in AH, significant relationships of traditional CMD markers with the TyG index, which reflects the presence of IR through the relationship of carbohydrate and lipid metabolism, are partially influenced by FSH and estradiol levels in tandem with age-associated indicators: the duration of AH and postmenopause.

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