HORMONAL DISORDERS AND COMPONENTS OF METABOLIC SYNDROME IN PATIENTS AFTER MYOCARDIAL INFARCTION
DOI:
https://doi.org/10.14739/2310-1237.2014.1.25156Keywords:
myocardial infarction, metabolic syndrome, insulin, C-peptide, leptin, Hydrocortisone, Thyreotropin, ThyroxineAbstract
Introduction. Hormonal disorders can be considered as one of the pathogenic factors of myocardial infarction in patients with metabolic syndrome. The level of insulin, leptin, C-peptide, cortisol, thyroid status metabolism in patients with myocardial infarction and metabolic syndrome in accordance to its components have been studied insufficiently.
Objective: to explore the features of hormonal disorders and their statistico-correlational interrelations with the components of metabolic syndrome in patients after acute myocardial infarction.
Materials and methods. The study involved 153 patients with Q-myocardial infarction in age from 40 to 85 years (mean age 62,5±0,90 years) in the acute stage of the disease: 122 - with metabolic syndrome and 31 - without metabolic syndrome. The control group consisted of 22 healthy individuals with normal carbohydrate metabolism, compared by age and sex. Depending on the components of metabolic syndrome patients of the basic group were divided in following manners: Group 1 - 36 patients with type 2 diabetes, obesity, hypertension and dislipoproteinemia (full metabolic syndrome), group 2 - 34 patients with obesity, hypertension, dislipoproteinemia and normal indicators of fasting glucose (in the absence of diabetes); Group 3 - 52 patients with type 2 diabetes, hypertension, and dislipoproteinemia and normal body weight (without obesity).
Results. Statistically significant increasing of leptin, insulin, cortisol, C-peptide, TSH levels and decreasing of free T4 level in patients with Q-myocardial infarction with metabolic syndrome were revealed compared with the control group and patients with Q-myocardial infarction without metabolic syndrome. Distinct hormonal changes were inherent in patients with all components of the metabolic syndrome (obesity, diabetes, dyslipidemia, hypertension). Patients with incomplete MS and obesity (group 2) and diabetes (group 3) generally have a similar hormonal profile, except for the lower levels of insulin and leptin. The obtained correlational and statistical relationships of cortisol, TSH, leptin and insulin levels with components of metabolic syndrome indicate a pathogenetic relationship of identified violations.
Conclusions:
- Hyperleptinemia combined with hyperinsulinemia, hypercortisolemia, increased levels of thyroid stimulating hormone and C-peptide are inherent to patients with Q-myocardial infarction with metabolic syndrome.
- Condition of hormonal profile in the acute period of myocardial infarction associated with the metabolic syndrome is directly dependent on the number of its components, and the most significant changes are observed in patients with a complete metabolic syndrome.
The results of correlation and regression analysis proved presence of the relationships between hyperleptinemia and fasting glucose, glycosylated hemoglobin, insulin levels, thyroid stimulating hormone, index HOMA, which indicates modulating role of chronic hyperglycemia, insulin resistance and hormonal disorders in the expression and realization of the biological actions of leptin in patients with Q-myocardial infarction with metabolic syndrome
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