COMPARATIVE CHARACTERISTICS OF SOME LIPID METABOLISM AND ENDOTHELIAL FUNCTION INDICES IN THE PATIENTS WITH COMPENSATED CHRONIC COR PULMONALE OF BRONCHO-PULMONARY GENESIS AND IN CONDITIONS OF ITS COMORBIDITY WITH HYPERTENSIVE DISEASE
About the author:
Petrov Ye. Ye., Burmak Yu. G., Treumova S. I., Ivanytska T. A.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The indices of lipid metabolism and endothelial function in 64 patients with chronic obstructive pulmonary disease (COPD) and compensated chronic cor pulmonale (CCP) (female – 22, male – 42, mean age – 54,8± 2,5) have been studied and analyzed. The patients were subdivided into two groups: the comparative group which comprised 32 patients and the main group consisted of 32 patients with сomorbid hypertensive disease (HD) of the II stage, of the 2 degree of arterial hypertension. The patients of the both groups were of the same sex, age and duration of disease’s course. The treatment of the both CCP of broncho-pulmonary genesis and HD was given in accordance with the requirements of the protocol. The obtained research results in the patients of the main and comparative groups were compared in groups and also with the indices of practically healthy individuals (n = 15) of the same sex and age. It has been established that the patients with compensated CCP of broncho-pulmonary genesis had the increase of triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, the decrease of high-density lipoprotein (HDL) cholesterol, LDL/HDL cholesterol ratio in comparison with the practically healthy individuals, but these changes weren’t significant and showed only a tendency. At the same time, the changes of lipid metabolism indices in the patients with compensated CCP and comorbid HD were more significant – the cholesterol content was 5,8±0,6 mmol/l, LDL cholesterol – 4,8±0,5 mmol/l. They exceeded the indices among healthy individuals in 1,4 times (р˃0,05) and 1,5 times (р<0,05), accordingly; and in comparison with the comparative group they were increased in 1,2 times (р˃0,05) and 1,3 times (р<0,05), accordingly. Moreover, the patients of the main group had a significant decrease of the HDL cholesterol content (1,4±0,02 mmol/l) – in 1,3 times in comparison with healthy individuals and downward tendency in comparison with the comparative group (1,6±0,04 mmol/l). Unlike patients with compensated CCP of broncho-pulmonary genesis, whose atherogenic index (2,2±0,2) tended to be higher in comparison with practically healthy individuals (1,7±0,3), LDL/HDL cholesterol ratio among the patients of the main group (3,4±0,1) was 2 times as high as among practically healthy individuals and 1,5 times as high as among the patients of the comparative group (р<0,001). It reflects the proatherogenic direction of lipid metabolism’s changes quantitatively and qualitatively. A significant decrease of NOx both in the patients of the comparative group (26,5±1,2 mmol/l) and the patients with comorbidity (16,2±1,3 mmol/l) (р<0,001) in comparison with practically healthy individuals (36,3±0,8 mmol/l) has been established in the further research of the total content of the stable metabolites of nitrogen oxide (NOx) in blood serum. Besides, the content of NOx among the patients of the main group was 1,6 times as low as among the patients of the comparative group (р<0,001). The direction of endothelin-1 (ET-1) changes was opposite. Its maximal point was observed in the patients with the compensated CCP of broncho-pulmonary genesis with comorbid HD (5,2±0,1 pmol/l). It was 1,3 times (р<0,001) as high as the same index among the patients of the comparative group(4,0±0,4 pmol/l) and 1,6 times as high as (р<0,001) one among the practically healthy individuals (3,2±0,5 pmol/l). The established changes of endothelial function indices (the decrease of NOx content and the increase ЕТ-1) in the patients with compensated CCP of broncho-pulmonary genesis reflect a disorder of regulatory endothelial function and testify about their maximal significance in the patients with comorbid course of CCP and HD. Conclusions. 1. The origin of lipid metabolism changes in the patients with compensated CCP of broncho-pulmonary genesis reflects generally their proatherogenic tendency, and maximal significance of these changes is typical of the patients with comorbid HD. 2. The diagnosed changes of lipid metabolism in the patients with compensated CCP of broncho-pulmonary genesis are combined with significant disorders of regulatory endothelial function, besides maximal significance of endothelial dysfunction manifestations is observed in the patients with comorbid HD. 3. The origin and direction of the changes of lipid metabolism and endothelial function in the patients with compensated CCP of broncho-pulmonary genesis should be considered as markers of unfavorable development of the vascular sclerosis and the increased risk of the vascular complications.
chronic cor pulmonale, hypertensive disease, comorbidity, lipid metabolism, endothelial function
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 179-182 pages, index UDK 616.12-008.331.1-009.72:612.397