DIFFERENCES IN PHYLOGENETIC FACTORS OF ETIOLOGY AND PATHOGENESIS UNITY OF METABOLIC PANDEMIAS - CIVILIZATION DISEASES

Regulation of metabolism in vivo can be understood when considering the formation in phylogenesis of the function of humoral, hormonal mediators, vegetative regulators separately: a) at the cell level; b) in paracrinally regulated cell communities (PC), organs and systems and c) at the body level. Each of regulation levels was formed at different stages of phylogenesis; the completion of levels occurred, we suppose, when reaching “relative biological perfection”. Formation of organs and organ systems was finished also, in our opinion, at the level of this perfection. When three levels reached sequentially were analyzed in Homo sapiens , it was revealed with systemic approach that through “relative biological perfection” at the level of the body, “regular mismatch” of metabolism is observed. Phylogenetic mismatch of the regulation of metabolism at three levels of “relative biological perfection” are etiological factors of “metabolic pandemias” of each of “civilization diseases”. All “metabolic pandemias” including atherosclerosis, metabolic arterial hypertension, IR status, obesity, metabolic syndrome and nonalcoholic fatty liver disease are disorders of one, late in phylogenesis, biological function of locomotion. Etiological basis for metabolic (essential) arterial hypertension is a regular mismatch: a local compensation of disturbances of the biological response metabolism ↔ microcirculation in the distal arterial bed with endothelium-dependent vasodilatation and only systemic compensation at the level of the body in the proximal part. For millions of years, there coexist two functionally connected and phylogenetically separated pools of fatty cells: the earlier visceral fatty cells (VFC) and the later subcutaneous adipocytes. Insulin blocks TG hydrolysis and release of nonetherified fatty acids (NEFA) into the blood plasma only from adipocytes; hormone cannot block lipolysis in phylogenetically early VFC and inhibit the effect of phylogenetically early hormones on them. Increase in blood plasma NEFA in the course of biological response of stress in vivo does not accompany proportional growth in albumin concentration. The function of phylogenetically early resident macrophages and monocytes ↔ macrophages, differentiated in intima of arteries in situ and ex tempore , is not identical. Biological response of fatty cells deposit into adipocytes occurs in the form of nonpolar triglycerides in lipoprotein composition, but their release - only in the form of polar NEFA.

Phylogenesis, arterial hypertension, atherosclerosis, insulin resistance, fatty acids