Aldosterone synthase gene C-344Т polymorphism as a risk factor of early left ventricular remodeling in young hypertensive patients with obesity

Abstract

The purposes of the research were to study the prevalence of C-344T polymorphism and the distribution of aldosterone synthase gene (CYP11B2) genotypes, to analyze the association of aldosterone concentration with aldosterone synthase gene genotypes, to study the features of left ventricular hypertrophy (LVH) by echocardioscopy and identify their association with different genotypes of the aldosterone synthase gene in young patients with arterial hypertension (AH), depending on the presence or absence of concomitant obesity (or overweight). 123 young patients with essential AH (18-44 years old) were examined, the average age was (32,83±0,58) years old, the male/female ratio was 72/51 respectively. All patients were divided into 3 groups: group 1 (n=41) with normal body weight; group 2 (n=40) with overweight; group 3 (n=42) -with obesity. It was revealed that the "pathological" genotypes (CC+CT) of the aldosterone synthase gene C-344T polymorphism were significantly more frequent in patients as with normal body weight and with concomitant obesity or overweight. In concomitant overweight and obesity the average blood aldosterone concentration was significantly higher, that confirms the presence of additional activation of aldosterone synthesis in such comorbid combination and requires further study of the exact mechanism of this type of hyperaldosteronism. Concomitant overweight and obesity significantly influenced on the echocardiographic parameters characterizing LVH processes in young patients with AH with the significant increased proportion of eccentric LVH. "Pathological" genotypes (CT+TT) of the C-344T polymorphism of the aldosterone synthase gene are associated with a higher blood aldosterone concentration and more expressed LVH processes in young patients with AH.

Цель исследования – изучить распространенность полиморфизма С-344Т и распределение генотипов гена альдостерон-синтазы, определить особенности гипертрофии левого желудочка и их связь с различными генотипами гена альдостерон-синтазы у молодых пациентов с артериальной гипертензией в зависимости от наличия или отсутствия сопутствующего ожирения или избыточной массы тела. Обследовано 123 молодых пациента с эссенциальной артериальной гипертензией (АГ) в возрасте 18–44 года, средний возраст 32,83±0,58 года, соотношение мужчин/женщин – 72/51. Выявлено, что "патологические" генотипы (СС+СТ) полиморфизма гена альдостерон-синтазы С-344Т достоверно чаще встречаются у пациентов как с нормальной массой тела, так и с сопутствующим ожирением или избыточной массой тела.