Association of leptin receptor gene Gln223Arg polymorphism with insulin resistance and hyperglycemia in patients with metabolic syndrome.

Introduction: Worldwide, there has been an increase in the incidence of metabolic syndrome. The search for genetic markers of this syndrome is ongoing. The leptin receptor has recently received attention. One of the polymorphisms (Gln223Arg) is possibly associated with the development of obesity and insulin resistance. However, the results of studies on this polymorphism remain equivocal. Gln223Arg polymorphism has not been studied previously in the Kyrgyz population. Thus, we aimed to investigate the possible association of the Gln223Arg polymorphism of the leptin receptor gene with metabolic syndrome components in the Kyrgyz population. Material and methods: 237 Kyrgyz subjects, aged 35-70 years, were studied. For the analysis anthropometric data, glucose, insulin, lipid spectrum, leptin were obtained. The genotype of the Gln223Arg leptin polymorphism was evaluated using TaqMan real-time PCR. Results: The distribution of genotypes was as follows: Gln223Gln 46.4%, Gln223Arg 40.1%, Arg223Arg 13.5%. In the study no association was found with abdominal obesity, arterial hypertension, hypertriglyceridemia or low-density cholesterol levels. Relationships of Gln223Arg and Arg223Arg genotypes with insulin resistance (p < 0.03) were found. Gln223Arg polymorphism was associated with a higher level of glycemia (5.54 vs. 5.39 mmol/l, p < 0.05) and insulinemia (8.3 vs. 7.1 µIU/ml, p < 0.05). Correlation analysis showed that carriers of the Arg223 allele demonstrated a higher risk of insulin resistance (odds ratio (OR) = 1.83, 95% CI: 1.03-3.24; p < 0.03) than carriers of the Gln223 allele. Conclusions: Gln223Arg polymorphism of the leptin receptor gene may be a marker of predisposition to insulin resistance in the Kyrgyz population. Further studies are necessary to confirm these results in populations from other regions.

May Measurement Month 2019: analysis of blood pressure screening in Bishkek, Kyrgyzstan.

High blood pressure (BP) is one of the leading causes of death in Kyrgyzstan. The world's largest event in the field of increasing awareness of raised BP is the May Measurement Month (MMM) campaign. Kyrgyzstan joined MMM in 2019. The inclusion criteria for participants in the study were: age ≥18 years and providing informed consent. Hypertension was defined as the presence of systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg based on the mean of the second and third of three sitting BP measurements or on treatment for hypertension. Most of the participants (96.9%) were surveyed inside two large shopping malls of Bishkek. The total number of people who took part in the screening was 2013. The mean age was 38.8 (± 12.6) years, and 1006 were women (50.0%) and 1007 men (50.0%). One-hundred eighty-four participants had hypertension (9.1%), of whom 59 (32.0%) were aware of their diagnosis, and hypertension was controlled in 25 participants (13.7%). The mean BMI was 24.0 (± 4.1) kg/m2, 34 (1.7%) participants had diabetes mellitus, 12 (0.6%) had a history of myocardial infarction, 4 (0.2%) had a history of stroke, 314 (15.6%) were smokers. 41 (2.0%) drank alcohol 1-3 times a month, 46 (2.3%)-once per week. MMM screening allows us to gather up-to-date data on the prevalence, awareness and control of hypertension among volunteer screenees in Bishkek, Kyrgyzstan.

Association between the intima-media thickness of the extracranial carotid arteries and metabolic syndrome in ethnic Kyrgyzs.

BACKGROUND: It is known that atherosclerosis is the leading cause of cardiovascular disease. We aimed to study the correlation between components of metabolic syndrome (MS) and subclinical carotid atherosclerosis in a group of ethnic Kyrgyzs. METHODS: In а descriptive study we assessed 144 ethnic Kyrgyzs (69 males, 75 females) aged 36-73 years (average age 51.03 ± 8.2). All participants underwent a clinical investigation and an anthropometric evaluation (weight, height, waist circumference (WC)). Abdominal obesity (АО) was confirmed at WC ≥ 94 cm in males and ≥ 88 cm in females. Fasting plasma glucose and lipid spectrum tests were performed. An ultrasound assessment of carotid intima-media thickness (IMT) was performed using a 7.5 MHz transducer (Phillips-SD 800). RESULTS: MS was revealed in 61 (42.4%; 47.8% in men and 37.3% in women) of the investigated patients. IMT was significantly increased with the presence of MS components in males (no components vs 2 components of MS: 0.67 ± 0.007 and 0.81 ± 0.009 respectively; р < 0.05) and females (no components vs 3 components of MS: 0.63 ± 0.007 and 0.76 ± 0.01 respectively; р < 0.01). IMT trended towards an increase in the presence of a greater number of MS components in patients with and without AO (р < 0.01). In order to identify independent factors affecting IMT we carried out a multifactorial logistic regression analysis. Arterial hypertension was found to have the greatest influence on the development of MS (OR = 3.81, p < 0.0001). CONCLUSION: In the group of ethnic Kyrgyzs, a greater number of MS components, with AO or without AO, is associated with higher carotid IMT.

The association of leptin with dyslipidemia, arterial hypertension and obesity in Kyrgyz (Central Asian nation) population.

BACKGROUND: Leptin, an adipocytokine produced by adipose tissue, along with the traditional cardiometabolic risk factors, contributes to the development of cardiovascular complications. At the same time, ethnic features of adipocytokines have been insufficiently investigated, especially among Asians, who have an increased risk of cardiovascular complications compared with Europeans. Aim of study was to investigate the relationship between leptin levels and age, gender, anthropometric parameters, lipid parameters, arterial hypertension (AH), and obesity in the adult population of ethnic Kyrgyz people living in Central Asia. RESULTS: In total, 322 ethnic Kyrgyz (145 men, 177 women) aged ≥ 30 years were studied. Waist and hip circumference, body mass index, blood glucose, lipids, leptin, and homeostatic model assessment were measured. Patients in the upper quartile of leptin levels had high values of BMI, WC, systolic and diastolic blood pressure, glucose, and HOMA index compared with patients with lower leptin levels. The prevalence of metabolic syndrome and AH increased with higher levels of leptin. Leptin positively correlated with BMI, WC, triglycerides, and glucose concentrations in patients of both sexes. According to the multivariate logistic regression analysis, elevated leptin levels increased by 30 times the risk of obesity in men, regardless of the presence of type 2 diabetes, and 17.7 times in women. CONCLUSION: Leptin is associated with general and abdominal obesity, dyslipidemia, and insulin resistance in Kyrgyz patients.

Lipids and leptin level in natives of Kyrgyzstan.

OBJECTIVES: A possible link between obesity and impaired lipid metabolism is leptin, the 167-amino acid protein, secreted by adipocytes. The content of leptin in the body is closely associated with body mass index (BMI). Data obtained from studies on the association of leptin with dyslipidemia are contradictory. The level of leptin has not been studied in the ethnic Kyrgyz population previously. The purpose of this study was to investigate the relationship between leptin and lipid parameters in a group of ethnic Kyrgyz. STUDY DESIGN: The study included 322 ethnic Kyrgyz (145 males, 177 females) aged ≥30 years, living in Kyrgyzstan. Measurement of anthropometric parameters (height, weight, waist circumference [WC], hip circumference [HC]) and blood pressure (BP) was done. Laboratory tests included blood glucose (fasting) in plasma, lipid profile (total cholesterol [TC], triglycerides [TG], high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol), and serum leptin. RESULTS: Leptin was positively correlated with BMI, WC and TG in both sexes and with TC in males. CONCLUSION: Leptin is associated with BMI, WC and TG in both sexes of Kyrgyz and with TC in Kyrgyz males.

Cut off values for abdominal obesity as a criterion of metabolic syndrome in an ethnic Kyrgyz population (Central Asian region).

BACKGROUND: People of different racial and ethnic backgrounds have a distinct pattern of central fat deposition, thus making it necessary to devise a race based approach for the diagnosis and evaluation of abdominal obesity (AO). This is the first study to determine the optimal waist circumference (WC) cutoff values for definition of AO in an ethnic Kyrgyz population. METHODS: 323 persons of Kyrgyz ethnicity (183 women and 140 men), with a mean age of 51.8 ± 9.5 years old were included in the study. Measurement of blood pressure (BP), anthropometric data (including body mass index calculation and WC measurement), fasting blood sugar, serum lipid parameters and insulin were performed in all examined individuals. Insulin resistance (IR) was considered as HOMA index (insulin × fasting glucose/22.5) ≥ 2.77. Sensitivity and specificity for the presence of IR or two other criteria of MS (according to the international classification, 2009) were calculated by using receiver operating characteristic (ROC) curves for men and women separately. RESULTS: The optimal sensitivity and specificity obtained from the ROC curves for IR were 88 cm in women (sensitivity of 0.85, 95%CI (0.72-0.93), specificity of 0.58, 95%CI (0.49-0.66)) and 94 cm for men (sensitivity of 0.8, 95% CI (0.65-0.91), specificity of 0.61, 95% CI (0.51-0.71)). The data from the ROC curve for any two other MS criteria confirmed the results and the WC 88 cm in women (sensitivity of 0.82, 95% CI (0.72-0.9), specificity of 0.72, 95% CI (0.62-0.8)) and 94 cm in men (sensitivity of 0.74, 95% CI (0.62-0.84), specificity of 0.73, 95% CI (0.61-0.83)) were corresponded to the optimal sensitivity and specificity. CONCLUSION: WC ≥ 88 cm and ≥ 94 cm should be used as a criterion for the diagnosis of AO for Kyrgyz women and men respectively based on these results.

An association between TRP64ARG polymorphism of the B3 adrenoreceptor gene and some metabolic disturbances.

BACKGROUNDS: B3 adrenoreceptors (ADRB3) are abundant in adipose tissue and play the role in its metabolism and lipolysis. Some variants of the ADRB3 gene may predispose subjects for the development obesity and metabolic abnormalities in the setting of modern sedentary lifestyle. ADRB3 gene polymorphism association with metabolic disturbances has never been studied before in the ethnic Kyrgyz population. AIM: To study an association between Trp64Arg polymorphism of the ADRB3 and metabolic syndrome (MS) components in an ethnic Kyrgyz group. MATERIALS AND METHODS: 213 Ethnic Kyrgyz volunteers over the age of 30 were enrolled in the study. The assessment plan for each individual comprised of general physical and anthropometric exams as well as laboratory tests (glucose, lipid panel, insulin) and genotyping by Trp64Arg polymorphism of the ADRB3. MS diagnosis was consistent with modified ATP III criteria (2005). Logistic regression analysis was performed to test the potential independent association between Arg64 allele with obesity, abdominal obesity (AO) and arterial hypertension (AH). RESULTS: Trp64Arg polymorphism of the ADRB3 was assessed in 213 individuals (145 men, 68 women) aged 30-73 (mean age 50.7 ± 7.6). Arg64 allele frequency was 0.239; ADRB3 genotype distribution among participants was: Trp64 homozygotes 54.5%, Trp64Arg 43.2% and Arg64 homozygotes 2.3%. There was an association between Trp64Arg и Arg64Arg genotypes and higher BMI, WC and obesity frequency (p < 0.00009), AO (p < 0.01), type 2 diabetes mellitus (DM) (p < 0.005) and lower high density cholesterol (HDL-C) level (p < 0.03). The logistic regression analysis showed the correlation of the Arg64 allele with obesity (OR 3.159; 95% CI 1.789-5.577) and AO (OR 1.973; 95% CI 1.118-3.481). The association between Arg64 allele and AH lost its significance after adjustment for obesity. CONCLUSION: Arg64 allele of the ADRB3 gene in the studied group has an association with MS components such as obesity, AO and decreased HDL-C level.

Influence of one-year treatment with lovastatin on myocardial remodeling and ischemia in patients with coronary artery disease.

OBJECTIVE: Emerging evidence assumes that statins have a benefit to influence the myocardial remodeling and ischemia in patients with coronary artery disease (CAD). Our aim was to investigate the possible and direct favorable effects of lovastatin on left ventricular (LV) systolic, diastolic function and myocardial ischemia in patients with CAD. METHODS: This randomized prospective study consisted of 83 patients (46 males; mean age 54.3 ± 6.5 years) with CAD and dyslipidemia. All patients were randomized to following groups: the 1st group (n=44) received lovastatin (20-60 mg/day), hypolipidemic diet and physical training; the 2nd group (n=39) - hypolipidemic diet and physical training. Lipid spectrum, Doppler-echocardiography, bicycle exercise test and 24-hour ambulatory electrocardiographic monitoring were done at baseline and were repeated after 12 months of treatment. The data were analyzed by using the paired and unpaired Student's t-tests. RESULTS: In the 1st group there was an improvement of lipid spectrum (p=0.05) without significant changes of liver transaminases and other side effects. After treatment LV ejection fraction increased from 59.8 ± 8.04 to 62.9 ± 4.43% in lovastatin alone group (p=0.01). Unlike 2nd group, the 1st group's patients had also reduction of myocardial ischemia: increased exercise time (5.21 ± 1.81 vs. 5.96 ± 1.76 min; p=0.05), METS (4.42 ± 0.6 vs. 4.78 ± 0.7; p=0.05), magnitude (1.12 ± 0.34 vs. 0.81 ± 0.19 mm; p=0.05) and duration (2.16 ± 0.67 vs. 1.04 ± 0.46 min, p=0.01) of ST segment depression , as well as number of leads with ST segment depression (2.18 ± 0.72 vs. 1.31 ± 0.67; p=0.05). CONCLUSION: Lipid-lowering therapy with lovastatin improved the LV systolic function and decreased myocardial ischemia.