The relationship of hypertriglyceridemia and left ventricular remodeling types in patients with chronic kidney disease

Aim. To assess the relationship between hypertriglyceridemia (THG) and left ventricular remodeling types in patients with chronic kidney disease(CKD). Materials and methods. A total of 152 patients with CKD from stages 1 to 3 were examined, 98 of them with CKD without THG (subgroup 1) and 54 with CKD and THG. All patients were assessed for the parameters of anthropometry, hemodynamics, lipid spectrum, uric acid, calcium, C-reactive protein (CRP), and serum cystatin C measurement with calculation of glomerular filtration rate. The parameters of vascular stiffness (augmentation index and stiffness) and echocardiography are analyzed. Results and discussion. In the 2nd subgroup (CKD + THG), the number of patients suffering from type 2 diabetes, a stable form of coronary heart disease, gout, and their combination with hypertension, as well as cerebrovacular disorders and hyperuricemia was significantly higher compared with patients with CKD without GTG (p<0.05). Persons with chronic obstructive pulmonary disease, chronic pyelonephritis were significantly more common in the 1st group (p<0.05). In the 2nd group, the BMI (30.1±5.4 kg/m2 vs. 28.1±5.8 kg/m2; p=0.049), the thickness of the posterior wall of the left ventricle (LV) (0.95±0,18 cm vs. 0.89±0.16 cm; p=0.040), the number of patients with a concentric type of remodeling (12.9% vs. 2.0%; p<0.05) and LV hypertrophy (51.8% vs. 26,5%; p=0.005), as well as with a high content of CRP in serum was significantly higher compared with the 1st group. In addition, the concentration of total cholesterol (5.61 [4.82; 6.57] mmol/l vs. 4.77 [4.08; 5.35] mmol/l; p=0.001), low - density lipoprotein cholesterol (cholesterol LDL) (3.49 [3.00; 4.52] mmol/l vs. 3.13 [2.67; 3.86] mmol/l; p=0.031) and uric acid (0.439±0.150 mmol/l vs. 0.376±0.109 mmol/l; p=0.005) serum was significantly higher than similar indicators of the 1st group. In patients with CKD and without THG, the following parameters influenced the magnitude of glomerular filtration rate (GFR): augmentation index (R²=37%; p=0.024), indexed left ventricular myocardial mass (LVMI) (R²=37%; p=0.005), concentrations of uric acid (R²=37%; p=0.009) and serum LDL cholesterol (R²=37%; p=0.002). In the subgroup of patients with CKD without THG, the systolic level (R²=12%; p=0.046) and diastolic blood pressure (BP) (R²=12%; p=0.045), uric acid concentration (R²=12%; p=0.005) and serum LDL (R²=12%; p=0.006). Then whereas the factors affecting the index of LVMI in patients of the 1st subgroup were the augmentation index (R²=19; p=0.045) and the GFR value (R²=19; p=0.038). In the 2nd subgroup, the factors affecting LVMI is the systolic (R²=28; p=0.016) and diastolic blood pressure (R²=28; p=0.023), augmentation index (R²=28; p=0.041), uric acid content (R²=28; p=0.020), LDL cholesterol (R²=28; p=0.032), triglycerides (R²=28; p=0.017) and the level of GFR (R²=28; p=0.007). Conclusion. In CKD with THG, the concentric type of remodeling and left ventricular hypertrophy are significantly more common. In patients with CKD and THG, the frequency of hyperuricemia and an increase in serum CRP was significantly higher. In CKD and THG, the factors affecting the glomerular filtration rate are the values of augmentation index, uric acid concentration, low serum lipoprotein cholesterol and indexed left ventricular myocardial mass. In patients with CKD and THG, the level of systolic and diastolic blood pressure, augmentation index, uric acid concentration and low - density lipoprotein cholesterle had the greatest influence on the value of the indexed mass of the left ventricular myocardium.

hypertriglyceridemia, left ventricular remodeling, chronic kidney disease