Interrelation of cardiovascular risk factors with high albuminury among patients with arterial hypertension living in Mountain Shoriya


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Abstract

Aim: to evaluate the association of a complex of cardiovascular risk factors and genetic markers with the development of high albuminuria among patients with arterial hypertension in the population of Mountain Shoriya, taking into account ethnicity. Materials and methods. A clinical epidemiological study of a compactly residing population in remote areas of Mountain Shoria was carried out. 1409 people were examined [901 people - representatives of the indigenous nationality (Shorians), 508 people - representatives of non-indigenous nationality (90% of them are Caucasians)]. Hypertension was diagnosed according to the National Guidelines of the Russian Society of Cardiology/the Russian Medical Society on Arterial Hypertension (2010). All patients underwent clinical, laboratory and instrumental investigation. To study the state of the kidneys, the concentration (the presence of elevated levels) of albumin (albuminuria) in the morning portion of urine by an immunoturbidimetric method was analyzed. Polymorphisms of genes ACE (I/D, rs4340), АGT (c.803T>C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A>G, Ser49Gly, rs1801252), ADRA2B (I/D, rs28365031), MTHFR (c.677С>Т, Ala222Val, rs1801133) and NOS3 (VNTR, 4b/4a) were tested using PCR. Results. In the group of shors with arterial hypertension, high albuminuria was associated with polymorphisms of the ACE genes (OR=2.05), ADRA2B (OR=6.00), elevated triglyceride level (OR=2.86), decreased index of cholesterol of high density lipoproteins (OR=5.57) and increased index of low density lipoproteins (OR=2.49); in the new population - with polymorphisms of the AGTR1 genes (OR=8.66), ADRA2B (OR=6.53), MTHFR (OR=7.16), obesity (OR=2.72), and abdominal obesity (OR=3.14). Conclusion. The primary predictors determining the development of high albuminuria among patients with arterial hypertension in both ethnic groups were genetic ones. In addition to them, non-genetic risk factors also contributed to the development of this organ damage to the kidneys: age and lipid metabolism disorders in representatives of indigenous nationality; age and abdominal obesity in the examined patients non-indigenous nationality.

About the authors

T A Mulerova

Research Institute for Complex Issues of Cardiovascular Diseases; Novokuznetsk State Institute for Further Training of Physicians - Branch Campus of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

Email: mulerova-77@mail.ru
к.м.н., с.н.с. лаб. эпидемиологии ССЗ ФГБНУ НИИ КПССЗ; доцент каф. кардиологии НГИУВ - филиала ФГБОУ ДПО РМАНПО Минздрава России; ORCID: 0000-0002-0657-4668

E S Filimonov

Novokuznetsk State Institute for Further Training of Physicians - Branch Campus of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

спирант каф. терапии НГИУВ - филиала ФГБОУ ДПО РМАНПО Минздрава России; ORCID: 0000-0002-2204-1407

S A Maksimov

Research Institute for Complex Issues of Cardiovascular Diseases

д.м.н., в.н.с. лаб. эпидемиологии ССЗ ФГБНУ НИИ КПССЗ; ORCID: 0000-0003-0545-2586

V N Maksimov

Research Institute of Internal and Preventive Medicine - Branch of the Federal Research Center Institute of Cytology and Genetics of Siberian Branch of the Russian Academy of Sciences (IIPM - Branch of IC&G SB RAS)

д.м.н., зав. лаб. молекулярно-генетических исследований терапевтических заболеваний НИИТПМ - филиала ИЦиГ СО РАН; ORCID: 0000-0002-7165-4496

M I Voevoda

Research Institute of Internal and Preventive Medicine - Branch of the Federal Research Center Institute of Cytology and Genetics of Siberian Branch of the Russian Academy of Sciences (IIPM - Branch of IC&G SB RAS)

д.м.н., проф., акад. РАН, директор НИИТПМ - филиала ИЦиГ СО РАН; ORCID: 0000-0001-9425-413Х

M Yu Ogarkov

Research Institute for Complex Issues of Cardiovascular Diseases; Novokuznetsk State Institute for Further Training of Physicians - Branch Campus of the Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation

д.м.н., проф., зав. каф. кардиологии НГИУВ - филиала ФГБОУ ДПО РМАНПО Минздрава России; зав. лаб. эпидемиологии ССЗ ФГБНУ НИИ КПССЗ; ORCID: 0000-0002-7252-4845

References

  1. Зелвеян П.А., Дгерян Л.Г. Микроальбуминурия как ранний показатель поражения почек у больных с артериальной гипертензией. Клиническая медицина. 2014;5:11-7.
  2. Кобалава Ж.Д., Виллевальде С.В., Боровкова Н.Ю., Шутова А.М., Ничик Т.Е., Сафуанова Г.Ш. Распространенность маркеров хронической болезни почек у пациентов с артериальной гипертонией: результаты эпидемиологического исследования ХРОНОГРАФ. Кардиология. 2017;10: 39-44. https://doi.org/10.180 87/cardio.2017.10.10041
  3. Нефрология. Клинические рекомендации / Под ред. Е.М. Шилова, А.В. Смирнова, Н.Л. Козловской. - М.: ГЭОТАР-Медиа, 2016. - 816 с.
  4. Viazzi F, Leoncini G, Conti N, Tomolillo C, Giachero G, Vercelli M, Deferrari G, Pontremoli R. Microalbuminuria is a predictor of chronic renal insufficiency in patients without diabetes and with Hypertension: The MAGIC Study. Clin J Am Soc Nephrol. 2010;5(6):1099-106. https://doi.org/10.2215/ cjn.07271009
  5. Шафранская К.С., Зыков М.В., Быкова И.С., Кашталап В.В., Кузьмина О.К., Иванов С.В., Сумин А.Н., Барбараш О.Л. Влияние почечной дисфункции на ранние и отдаленные результаты коронарного шунтирования. Комплексные проблемы сердечно - сосудистых заболеваний. 2017;1:27-36. http://dx.doi.org/10.17802/2306-1278-2017-1-27-36
  6. Parchwani D.N, Palandurkar K.M, Hema Chandan Kumar D, Patel D.J. Genetic predisposition to diabetic nephropathy: evidence for a role of ACE (I/D) gene polymorphism in type 2 diabetic population from kutch region. Indian J Clin Biochem. 2015;30(1):43-54. http://doi.org/10.1007/s12291-013-0402-4
  7. Dell'Omo G, Penno G, Pucci L, Lucchesi D, Del Prato S, Pedrinelli R. Lack of association between TGF-beta-1 genotypes and microalbuminuria in essential hypertensive men. Nephrol Dial Transplant. 2009;24(6):1864-69. http://doi. org/ 10.1093/ndt/gfn754
  8. Ilic V, Ilic M, Soldatovic I, Popovic S, Magic Z. Association of renin - angiotensin system genes polymorphism with progression of diabetic nephropathy in patients with type 1 diabetes mellitus. Vojnosanit Pregl. 2014; 71(7):627-33. https://doi.org/10.2298/vsp1407627i
  9. Fabris B, Bortoletto M, Candido R, Barbone F, Cattin M.R, Calci M, Scanferla F, Tizzoni L, Giacca M, Carretta R. Genetic polymorphisms of the renin - angiotensin - aldosterone system and renal insufficiency in essential hypertension. J Hypertens. 2005;23(2):309-16. https://doi.org/10.1097/00004872-200502000-00013
  10. Ukinc K, Ersoz H.O, Karahan C, Erem C, Eminagaoglu S, Hacihasanoglu A.B, Yilmaz M, Kocak M. Methyltetrahydrofolate reductase C677T gene mutation and hyperhomocysteinemia as a novel risk factor for diabetic nephropathy. Endocrine. 2009;36(2):255-61. https://doi.org/10.1007/s12020-009-9218-7
  11. Snapir A, Scheinin M, Groop L.C, Orho-Melander M. The insertion/deletion variation in the α2B-adrenoceptor does not seem to modify the risk for acute myocardial infarction, but may modify the risk for hypertension in sibpairs from families with type 2 diabetes. Cardiovasc Diabetol. 2003;2:15. https:// doi.org/10.1186/1475-2840-2-15
  12. Lima J.J, Feng H, Duckworth L, Wang J, Sylvester J.E, Kissoon N, Garg H. Association analyses of adrenergic receptor polymorphisms with obesity and metabolic alterations. Metabolism. 2007;56(6):757-65. https://doi.org/10.1016/ j.metabol.2007.01.007
  13. Salimi S, Firoozrai M, Nourmohammadi I, Shabani M, Mohebbi A. Endothelial nitric oxide synthase gene intron4 VNTR polymorphism in patients with coronary artery disease in Iran. Indian J Med Res. 2006;124(6):683-88.
  14. Барбараш О.Л., Воевода М.И., Артамонова Г.В., Мулерова Т.А., Воропаева Е.Н., Максимов В.Н., Огарков М.Ю. Генетические детерминанты артериальной гипертензии в двух национальных когортах Горной Шории. Терапевтический архив. 2017;89(9):68-77. http://doi. org/10.17116/terarkh201789968-77
  15. Верткин А.Л., Хавасова Н.И., Смирнова Н.П. Микроальбуминурия, ее клиническое значение и возможности определения. Поликлиника. 2011; 5(2):44-7.
  16. Tangjatuporn W, Nimitpornsuko P, Chindamporn P, Srisuwarn P, Ulit K, Sanpantarat K, Tonglua C, Jongstapongpun P, Koopitukkajorn T, Pornrattanakavee P, Chokteerasawad P, Homhol W, Kengpanich S, Baisopon S, Salyakhamthorn N, Ruangkanchanasetr P, Uerojanaungkul P, Chantrarat T, Areekul W, Panichkul S, Rangsin R, Suthijumroon A, Hatthachote P. Associated factors of blood pressure control and complications of hypertension in hypertensive rural Thai populations of Baan Nayao, Chachoengsao Province. J Med Assoc Thai. 2012;95(5):48-57.
  17. Böhm M, Thoenes M, Danchin N, Bramlage P, La Puerta P, Volpe M. Association of cardiovascular risk factors with microalbuminuria in hypertensive individuals: the i-SEARCH global study. J Hypertens. 2007;25(11):2317-24. https://doi.org/10.1097/hjh.0b013e3282ef1c5f
  18. Нагайцева С.С., Швецов М.Ю., Шалягин Ю.Д., Пягай Н.Л., Иванова Е.С., Шилов Е.М. Факторы риска повышения альбуминурии как раннего маркера хронической болезни почек в разных возрастных группах. Нефрология. 2013;4:89-115.
  19. Авдеева М.В. Щеглова Л.В. Функциональные возможности центров здоровья в выявлении лиц с почечной патологией и риском развития сердечно - сосудистых заболеваний. Клиническая нефрология. 2011;3:57-60.
  20. Ene - Iordache B, Perico N, Bikbov B, Carminati S, Remuzzi A, Perna A, Islam N, Bravo R.F, Aleckovic-Halilovic M, Zou H, Zhang L, Gouda Z, Tchokhonelidze I, Abraham G, Mahdavi-Mazdeh M, Gallieni M, Codreanu I, Togtokh A, Sharma S.K, Koirala P, Uprety S, Ulasi I, Remuzzi G. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross - sectional study. Lancet Glob Health. 2016;4(5):307-19. https://doi.org/ 10.1016/S2214-109X(16)00071-1
  21. Крячкова А.А., Савельева С.А., Кутурина И.М. Роль нарушений липидного обмена в поражении почек при метаболическом синдроме, ассоциированном с ожирением. Терапевтический архив. 2011;83(8):54-8.
  22. Томилина Н.А. Хроническая болезнь почек. Избранные главы нефрологии. М.: ГЭОТАР-Медиа, 2017; 512 с.
  23. Pedrinelli R, Dell'Omo G, Penno G, Di Bello V, Pucci L, Fotino C, Lucchesi D, Del Prato S, Dal Fiume C, Barlassina C, Cusi D. Alpha - adducin and angiotensin - converting enzyme polymorphisms in hypertension: evidence for a joint influence on albuminuria. J Hypertens. 2006;24(5):931-37.
  24. Parchwani D.N, Palandurkar K.M, Hema Chandan Kumar D, Patel D.J. Genetic predisposition to diabetic nephropathy: evidence for a role of ACE (I/D) gene polymorphism in type 2 diabetic population from Kutch region. Indian J Clin Biochem. 2015;30(1):43-54. https://doi.org/10.1007/s12291-013-0402-4
  25. Cardoso R.L, Nogueira A.R, Salis L.H, Urményi T.P, Silva R, Moura-Neto R.S, Pereira B.B, Rondinelli E, Souza e Silva N.A. The association of ACE gene D/I polymorphism with cardiovascular risk factors in a population from Rio de Janeiro. Braz J Med Biol Res. 2008;41(6):512-18. https://doi.org/10.1590/s01 00-879x2008000600013
  26. Wyawahare M, Neelamegam R, Vilvanathan S, Soundravally R, Das A.K, Adithan C. Association of angiotensin - converting enzyme gene polymorphisms and nephropathy in diabetic patients at a tertiary care centre in South India. Clin Med Insights Endocrinol Diabetes. 2017;10:1179551417726779. https://doi. org/10.1177/1179551417726779
  27. Möllsten A, Vionnet N, Forsblom C, Parkkonen M, Tarnow L, Hadjadj S, Marre M, Parving H.H, Groop P.H. A polymorphism in the angiotensin II type 1 receptor gene has different effects on the risk of diabetic nephropathy in men and women. Mol Genet Metab. 2011;103(1):66-70. https://doi.org/10.1016/ j.ymgme.2011.01.004
  28. Кузнецова Т.Ю., Гаврилов Д.В., Самоходская Л.М., Постнов А.Ю., Бойцов С.А. Клинико - генетические факторы риска развития микроальбуминурии при артериальной гипертензии. Системные гипертензии. 2010;1:15-21.
  29. Елисеева М.Р., Срожидинова Н.З., Хамидуллаева Г.А., Абдуллаева Г.Ж. Генетические детерминанты ремоделирования сердечно - сосудистой системы при эссенциальной гипертонии у узбеков. Терапевтический архив. 2009;81(1):64-9.
  30. El-Baz R, Settin A, Ismaeel A, Khaleel A.A, Abbas T, Tolba W, Abd Allah W, Sobh M.A. MTHFR C677T, A1298C and ACE I/D polymorphisms as risk factors for diabetic nephropathy among type 2 diabetic patients. J Renin Angiotensin Aldosterone Syst. 2012;13(4):472-77. https://doi.org/10.1177/147 0320312444651
  31. Jafari Y, Rahimi Z, Vaisi-Raygani A, Rezaei M. Interaction of eNOS polymorphism with MTHFR variants increase the risk of diabetic nephropathy and its progression in type 2 diabetes mellitus patients. Mol Cell Biochem. 2011;353(1-2):23-34. https://doi.org/ 10.1007/s11010-011-0770-0

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