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PURINE METABOLISM AND MICROALBUMURIA STATUS IN PATIENTS WITH
METABOLIC SYNDROME Abduvalieva G.T.1, Niyazova Ya.M.2, Soliev A.K.3
1Abduvalieva Gavkhar Tulkinovna - Assistant; 2Niyazova Yarkina Mirzakhamdamovna - Assistant; 3Soliev Alisher Kadirovich - Candidate of Medical Sciences, Assistant, DEPARTMENT OF GENERAL PRACTITIONERS № 1, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: the aim of this work was to study the state of purine metabolism and microalbuminuria in patients with metabolic syndrome. We examined 50 patients aged 30-55 years, who were randomized into 3 groups: I (control) -healthy persons, t - 15 people, II - patients with arterial hypertension - 18 people, group III - patients with arterial hypertension in combination with metabolic syndrome - 32 people. The results of the conducted studies showed, we noted that the concentration of MC in the blood significantly correlated with the severity of obesity, hyperinsulinemia, triglyceridemia and glycemia - parameters reflecting the state of IR.
Thus, the data obtained indicate that hyperuricemia is a metabolic disorder and one of the components inherent in metabolic syndrome.
Keywords: metabolic syndrome, hyperuricemia, microalbuminuria, arterial hypertension, insulin resistance.
МЕТАБОЛИЗМ ПУРИНА И СТАТУС МИКРОАЛЬБУМУРИИ У БОЛЬНЫХ С
МЕТАБОЛИЧЕСКИМ СИНДРОМОМ Абдувалиева Г.Т.1, Ниязова Я.М.2, Солиев А.К.3
1Абдувалиева Гавхар Тулкиновна - ассистент; 2Ниязова Яркиной Мирзахамдамовна - ассистент; 3Солиев Алишер Кадирович - кандидат медицинских наук, ассистент, кафедра врачей общей практики № 1, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: целью данной работы явилось изучение состояния пуринового обмена и микроальбуминурии у больных метаболическим синдромом. Было обследовано 50 больных в возрасте 30-55 лет, которые были рандомизированы на 3 группы: I (контрольная) - здоровые лица - 15 человек, II - больные артериальной гипертонией - 18 человек, III группа - больные артериальной гипертонией в сочетании с метаболическим синдромом - 32 человека. Результаты проведённых исследований показали, что концентрация МК в крови достоверно коррелировала со степенью выраженности ожирения, гиперинсулинемии, триглицеридемии и гликемии - параметрами, отражающими состояние ИР.
Таким образом, полученные данные свидетельствуют о том, что гиперурикемия является нарушением обмена веществ и одним из компонентов, присущих метаболическому синдрому.
Ключевые слова: метаболический синдром, гиперурикемия, микроальбуминурия, артериальная гипертония, инсулинорезистентность.
UDC 616-072.1+616-056.257+616.633.962.3
Introduction: Recently, we have faced a new pandemic, i.e. a new term metabolic syndrome (MS) has appeared in medicine and it summarizes the main factors leading to the development of atherosclerosis. In recent years, the literature provides a lot of information about the main role of MS in the development of various diseases. This is evidenced by the data on MS caused by multiple disorders [2, 4, 7, 11]. MS is a complex of interrelated disorders of carbohydrate and purine metabolism, as well as mechanisms of regulation of blood pressure and endothelial reticula. The development of these disorders is based on a decrease in tissue sensitivity to insulin - insulin resistance (IR) [2, 3, 4, 15].
According to studies carried out in the clinic of internal diseases of the PFUR, with daily monitoring, there was no decrease in blood pressure in patients with high hyperuricemia and a reliable relationship between the left ventricular myocardial mass index and the level of uric acid and blood serum in patients with metabolic syndrome. In patients with hypertension and left ventricular hypertrophy, the concentration
uric acid in the blood is one of the most significant determinants of left ventricular hypertrophy and indicates its resistance to standard antihypertensive therapy. The peculiarities of antihypertensive therapy in metabolic syndrome are associated with a high level of uric acid [7, 8, 12, 14].
Therefore, hyperuricemia (HUA) and microalbuminuria (MAU) are closely interrelated processes that characterize the clinical manifestation of MS. However, studies on the state of purine metabolism and microalbuminuria in patients with MS are insufficient and this problem needs further comprehensive research.
Purpose of the work: To study the state of purine metabolism and microalbuminuria in patients with metabolic syndrome.
Materials and methods. We examined 50 patients aged 30 to 55 years, suffering from MS, taking into account risk factors and lesions of target organs. In a hospital setting, 18 male (34.7%) and 32 female (65.3%) patients aged from 30 to 55 years old were examined, who were randomized into the following 3 groups: I (control) - healthy individuals aged 25- 40 years old - 15 people; II - patients with arterial hypertension -18 people aged 30-59; Group III - patients with MS -32 at the age of 30-59 years.
Results and discussion. In most patients with MS, the disease was associated with a hereditary factor (31.5%), obesity (30.0%), an alimentary factor (28.4%), and low physical activity (physical inactivity - 10.1%). In the alimentary factor group, patients indicate excessive consumption of carbohydrates and fats. Overweight and obesity are considered the main components of MS. And at the same time, the relationship between the components of the MS is of particular interest. The surveyed
patients were determined by the Quetelet index (IC), body weight and the degree of abdominal obesity (AO). Measurement of the waist circumference in group I showed 78.8 ± 1.14 cm, in group II 80.3 ± 0.46, and with MC-102.5 + ± 1.5 cm (Tab -1). In patients with AH, AO was 1.9% higher than in the control group, i.e. the figures were almost the same. When examining the IC in the control group, this indicator showed 24.3 ± 0.7 m2, and in the II group, IC was equal to 26.7 ± 1.3 m2. In the GB group, IC was higher by 4.9%, the indicators were almost the same. In MS, IC averaged 32.6 ± 0.8 m2, it was higher than the indicators of the control group by 35%, indicators of the second group by 28.6%. The results obtained suggest that blood pressure and blood glucose levels are related to body weight. Purine metabolism was assessed by determining the concentration of uric acid in fasting venous blood plasma samples.
Hyperuricemia, MK level above 0.45 mmol / L, was detected by us in 52.6% of patients with MS, and in 37.1% of patients with hypertension.
We did not reveal a significant relationship between the magnitude of uricemia and the level of blood pressure, but in persons with a clinical picture of metabolic syndrome without hypertension, the level of MC was statistically significantly lower than in patients with a clinical picture of MS, and there was also a tendency for a lower value of this parameter compared to all groups of patients. which MS proceeded with AG. After analyzing the individual distribution of the MC concentration values among individuals of all clinical groups, we came to the conclusion that the level of uricemia characteristic of MC is the MC value of 0.45 mmol / L and higher. Patients with MS had this level of MC significantly more often than those with AH (chi-square = 3.76, p <0.05).
Conclusion. Thus, the data obtained indicate that hyperuricemia is a metabolic disorder and one of the components inherent in metabolic syndrome. The severity of GU is directly proportional to the increase in the clinical picture of MS. In patients with MS, the presence of normoalbuminuria indicates an adaptive-compensatory reaction of the vessels aimed at overcoming the developing kidney pathology. The presence of MAU means that the MAU stage can be reversible with the timely initiation of treatment and will slow down the progression of DN and its transition to the stage of PU and CRF. The presence of MAU - about glomerular hypertension and a decrease in glomerular filtration.
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