Linkage of blood pressure, obesity and diabetes mellitus with angiotensinogen gene (AGT 704T>C/rs699) polymorphism in hypertensive patients

AIMS

The study aim was to analyse the frequency of polymorphic variants of angiotensinogen gene polymorphism (AGT 704T>C, rs699) in essential arterial hypertension (EAH) patients.

METHODS

Seventy-two individuals with EAH and hypertension‑mediated organ damage (stage 2), moderate, high or very high cardiovascular risks were involved in the case-control study. Among them, 70.84 % (51) were females and 29.16 % (21) were males; mean age was 59.87±7.98 y. The control group consisted of fifty practically healthy individuals at relevant age (49.13±6.28 y) and with relevant sex distribution (62 % were females, 38 % were males). AGT (704T>C) gene polymorphism was examined by RT-PCR.

RESULTS

The distribution of genotypes in the study group was as follows: TT - 14 %, TC - 60 %, CC - 26 %, which corresponded to the distribution in the control group - 16 %, 54 % and 30 %, respectively, and did not deviate from the Hardy-Weinberg equilibrium. Smoking, type 2 diabetes mellitus (DM2) and obesity increased the relative risk of EAH in the examined population 2.5 times [OR=2.81; p=0.049], 3.75 times [OR=4.68; p=0.005] and almost twofold [OR=2.90; p=0.004], respectively. The probability of EAH increases fourfold with the angiotensin II elevation in the serum. Genotypes and alleles of the AGT (704T>C) gene were not significant risk factors for EAH and DM2 in the studied population. However, the TC-genotype (lesser T-allele) increases the risk of obesity in EAH patients more than 1.5 times [OR=2.93; p=0.03]. In addition, the T-allele increases the risk for blood pressure (BP) to elevate up to grade 2-3 [OR=3.64; p < 0.001].

CONCLUSIONS

One-way ANOVA analysis confirmed the AGT (704T>C) gene polymorphism to be associated with systolic and diastolic BP elevation (F=7.80; p < 0.001 and F=4.90; p=0.01, respectively), especially in TT-genotype carriers (p < 0.05), and with body mass index increase, albeit only in women (F=13.94; p < 0.001) (Tab. 4, Fig. 3, Ref. 26). Text in PDF www.elis.sk Keywords: angiotensinogen gene (AGT 704T>C), diabetes mellitus type 2, arterial hypertension, obesity, risk.

Association of AGTR1 (rs5186), VDR (rs2228570) genes polymorphism with blood pressure elevation in patients with essential arterial hypertension

Essential arterial hypertension (EAH) is a polygenic disease due to environmental, genetic, and epigenomic factors. The study aimed to establish the association of single nucleotide polymorphism (SNP) of AGTR1 (rs5186) and VDR (rs2228570) genes with the blood pressure (BP) elevation in EAH patients. 100 EAH subjects with hypertensive-mediated organ damaging (2^nd stage), moderate, high, or very high cardiovascular risk were recruited into the case-control study. There were 70.83% females and 29.17% males, mean age 57.86±7.81 y.o. The control group included 60 healthy individuals of relevant age and gender distribution. Estimation of AGTR1 (rs5186) and VDR (rs2228570) gene polymorphism was performed by Real-Time Polymerase Chain Reaction. In EAH patients, the AGTR1 gene (rs5186) mutation occurs with a frequency of 2.78% in the absence of such among healthy individuals. The VDR (rs2228570) gene mutation occurs with a frequency of 23% cases. The C-allele carriers’ (AGTR1 gene) numbers with 2^nd and 3^rd BP values degree dominate over AA-genotype patients by 25.32% (_χ2=4.52; p=0.033). VDR gene (rs2228570) polymorphic variants do not link to BP elevation values. Thus, the C-allele of the AGTR1 gene (rs5186) is associated with BP elevation in hypertensive patients. BP values do not depend on VDR gene (rs2228570) polymorphic variants.

Delayed breast reconstruction with tram-flap and various modifications after radical mastectomy

This study describes the experience of radical mastectomies with simultaneous breast reconstruction using TRAM flap in patients with inflammatory breast cancer. The study aimed to evaluate the effectiveness of primary breast reconstruction using the TRAM-flap procedure in patients with an inflammatory form of breast cancer. Our work is associated with some deviation from generally accepted standards: delayed breast reconstruction after radical mastectomy for inflammatory breast cancer. We describe the experience of radical mastectomies with the simultaneous reconstruction of the breast using a TRAM flap in patients with inflammatory breast cancer. This study included 12 patients diagnosed with breast cancer stages IIIB and IIIC. Almost all patients (eleven out of twelve patients) underwent radical mastectomy with one-stage reconstruction using a TRAM flap after chemotherapy. Two years later, one patient (8.3%) showed disease progression in the form of distant metastases in the bones of the spine. One patient (8.3%) had a regional relapse in the displaced flap near the postoperative scar. The rest of the patients (83.4%) showed no signs of continuing the disease. Patients with one-stage breast reconstruction improved socially, and their subjective well-being was better than those who underwent radical mastectomy without reconstruction. Experience in performing one-stage reconstructions in the surgical treatment of patients with inflammatory breast cancer is a reason for restrained optimism regarding the possibility and feasibility of these operations.

Assessment of Comorbidity as a Risk Factor for Edematous Pancreatitis Considering IL-4 (C-590T) Gene Polymorphism

The comorbidities affect the course of pancreatitis significantly; however, this effect has not been evaluated from the perspective of genetic component.The objective of the research was to analyse concomitant chronic diseases as potential risk factors for edematous pancreatitis considering genetic predictors.Materials and methods. The epidemiological analysis of comorbidities (cholelithiasis, urolithiasis, ischemic heart disease, past viral infection) as risk factors for edematous pancreatitis was performed. Polymorphic variants of the IL-4 (rs 2243250) gene being identified in 123 patients and 40 healthy individuals were also involved.Results. In patients with edematous pancreatitis, urolithiasis was observed more frequently than in the control group - by 37.30% (χ2=18.62, p<0.001). The presence of cholelithiasis insignificantly increases the risk of edematous pancreatitis in the future (RR-1.156; 95% CI: 0.972-1.374). The presence of urolithiasis increased the risk of edematous pancreatitis twofold (RR-2.039; 95% CI: 1.346-3.090; p<0.05).Conclusions. 1. Cholelithiasis increases the probability of developing edematous pancreatitis in carriers of the mutant T-allele of the IL-4 gene by 3.7 times (RR=3.69; OR=10.13; 95% CI OR: 3.17-32.42; p<0.05). 2. In the C-allele carriers of the IL-4 (C-590T) gene, the risk of developing acute pancreatitis is twice higher in the presence of urolithiasis or ischemic heart disease, and almost five times higher in case of past viral infection (p<0.05).

Association of the blood serum cytokines' rate and lymphocytes' apoptosis with polymorphic variants of the BCL-2 (rs17759659), CTLA-4 (rs231775) and APO-1÷FAS (rs2234767) genes in patients with nodular goiters in autoimmune thyroiditis and thyroid adenoma

The paper analyses results of serum cytokines and lymphocyte apoptosis study in patients with nodular goiter against the background of autoimmune thyroiditis (NGAIT) and thyroid adenoma (TA) based on the cell preparedness to apoptosis (content of lymphocytes carrying apoptosis marker - CD95+-receptor), the number of apoptotic lymphocytes (annexin V+-lymphocytes) and the content of proapoptotic tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β and IL-6, as well as anti-inflammatory IL-4 cytokine in serum, considering the polymorphism of BCL-2 (rs17759659), CTLA-4 (rs231775) and APO-1÷FAS (rs2234767) genes. The results show that under the damaging action of peroxidation products in the thyroid structures, activation of Fas- and caspase-dependent mechanisms of influence on pro- and anti-apoptotic targets, the induced hyperproduction and release of TNF-α from thyroid-stimulated lymphocytes stimulate an additional synthesis of other pro-inflammatory cytokines IL-1β and IL-6, as well as compensatory anti-inflammatory proteins including IL-4. There is a synchronized increase in secretion of the soluble form of TNF-α receptor (sTNFR), which prevents binding the corresponding cytokine to a specific membranous shedding of a number of receptors and separates the apoptotic signals. The above-mentioned changes associate with the polymorphic variants of BCL-2 (rs17759659), CTLA-4 (rs231775) genes and only for some figures, they are almost three times weaker with FAS (rs2234767).

[МОRPHOLOGY OF THE DIABETIC FOOT SYNDROME]

Local morphological changes were studied in dynamics in 215 patients, suffering diabetic foot syndrome. While an adequate local treatment conduction, in accordance to the standards elaborated, the histological investigations data have shown the oedema, the cellular infiltration and microcirculatory disorders reduction in the wound boundary zone. In 1 week of treatment in biopsies a young granulating tissue was observed, consisting of big quantity of vascular loops, oriented perpendicularly towards the wound surface and multiple bundles of fibroblasts. In a period of 2 weeks an active multilayered wound defect epithelization was seen. The stratum creeps, right from the skin secured, covering the wound surface.

[GENES ALLELE STATUS OF ANGIOTENSINCONVERTING ENZYME (I/D) AND ENDOTHELIAL NITRIC OXIDE SYNTHASE (894 G > T) IN PATIENTS WITH ACUTE CORONARY SYNDROME]

The association of genes polymorphism of angiotensin-converting enzyme ACE (I/D) and endothelial nitric oxide synthase eNOS (894 G > T) with acute myocardial infarction (MI) among residents of North Bukovina region was evaluated. II/GG and ID/GG haplotypesre associated with more frequent presence of Q-MI, with localization on anterior wall and primary appearance. ID/TT, or II/TG haplotypes are associated with the presence of a severe re-Q-MI, with localization on the posterior wall. ID/TG variant is associated in 93.7% of cases with Q-MI, regardless of its location and times of occurrence. ID/TG increased relative risk of Q-MI by 2,93 times (OR = 4,79; P = 0,002), which confirmed the severity of the disease and increases the risk of MI inanterior and higher in posterior walls of the left ventricle (OR = 4.31; P = 0.007 and OR = 4.6; P = 0.005, respectively) increases the likelihood of the first Ml by 2.88 times (OR = 4.62; P = 0.003) and its re-occurrence or recurrence--by 2.67 times (OR = 4; P = 0.022). Mutations absence: in haplotypes (II/GG) is a protective factor of Q-MI appearance (OR = 0.19; P = 0.004) and makes the chances for the first MI the lowest in observed population (OR = 0.36; P = 0.045).

[Effect of special regulated respiratory exercises on autonomic support of functional state of the cardio-vascular system]

48 healthy people have been observed to determine the influence of individually chosen special regulated respiratory exercises on functional state of the cardio-vascular system. The findings showed that special regulated respiratory exercises considerably enhance vegetative supply to the cardio-vascular system thus increasing its functional state.

[Effect of the special breathing exercises on the autonomic regulation of the functional state of respiration and muscular systems]

58 healthy and practically healthy persons were observed in order to determine the influence of the special breathing exercises on the vegetative support of the breathing and muscular systems functional state. As a result it was found that special breathing exercises significantly improve vegetative support of breathing and muscular systems thus resulting in rising their functional abilities.

[Effect of voluntary regulation of the respiration on the functional state of the autonomic nervous system]

48 healthy persons have been observed to determine the influence of individually and differentially prescribed specific respiratory exercises on the vegetative nervous system state. The specific and controlled respiratory exercises were established to restore reliably a functional state of the vegetative nervous system. These respiratory exercises enable the sympathetic and parasympathetic nervous systems to regain the balance.