Endocrine Abstracts

Background: Obesity is followed by insulin resistance (IR) and low grade inflammation. In patients with metabolic syndrome (MS) and clinicaly evident vascular complications homocystein values are higher. Hyperhomocysteinemia correlates with hyperinsulinemia and IR, resulting in oxidative stress, which causes endothelial lesions and dysfunction, promoting atherosclerosis and hypertension.

Objectives: To examine homocystein levels in patients with and without MS, and find correlation between factors of MS and homocystein values.

Methods: The study included 76 obese individuals (age over 30, BMI >25 kg/m²) classified into two groups: I- with MS (35 patients); II- without MS (41 patients). OGTT was used to evaluate the extent of glucoregulation disorder. IDF classification was applied for diagnosing MS. Si MS risk score by Soldatovic I et all 2016 was used. IR was determined by HOMA IR. Serum CRP was measured by immunometric assay. Microalbuminuria was determined immuno-nephelometrically. Homocistein was determined by immunoassay FPIA-Abbot.

Results: Patients with MS had increased WC:(I-110.6±15.4, II±15.4 cm), BMI:(I-35.3±6.6, II-30.4±7.4 kg/m²), blood pressure (I-136.4±13.9 /90.5±9.5, II-118.4±12.2/78.1±9.7 mmHg), glycaemia (I-5.4±1.6, II-4.8±0.8 mmol/l), HOMA IR (I-8.8±9.4, II-5.3±3.8 mmol/μU per ml), triglycerides (I-2.17±0.95, II-1.45±0.7 mmol/l), CRP (I-7.0±0.0, II-3.7±3.8 mg/l), microalbuminuria (I-87.4±81, II-56.4±56.9 mg/24 h), homocysteine (I-13.0±3.2, II-11.8±3.7 μmol/l) and decreased HDL (I-1.07±0.2, II-1.35±0.35 mmol/l). Statistical significance between groups was found for WC, BMI, systolic and diastolic pressure, triglycerides, HDL-cholesterol (P<0.01) and CRP, Apo B, HOMA IR (P<0.05). Correlations: Homocysteine with systolic and diastolic pressure, Apo B and hyperlipoproteinemia (P<0.05). Si MS risk score with homocysteine (P<0.01), r=0.263.

Conclusion: Abdominal obesity, hypertension, hypertriglyceridemia, inflammation factors, IR, homocystein and microalbuminuria as markers of endothelial dysfunction were increased in patients with MS. Correlation of homocystein values with si MS risk score indicates that it is significant co-founding factor of MS. Correlation of homocystein with hypertension and hyperlipoproteinemia indicates importance of homocystein as significant marker for atherosclerosis.