Naslov (srp)

Uticaj aterogene dislipidemije na subkliničku aterosklerozu kod pacijenata sa metaboličkim sindromom

Autor

Kostić, Svetlana, 1969-

Doprinosi

Tasić, Ivan, 1962-
Deljanin-Ilić, Marina, 1957-
Simić, Dragan, 1962-
Pešić, Milica, 1961-
Jevtović-Stoimenov, Tatjana, 1970-

Opis (srp)

Objectives: Determine the presence of atherogenic dyslipidemia (AD) insubjects with MetS and the relationship between MetS components and thepresence and severity of asymptomatic atherosclerosis; Determine thepresence of atherogenic lipid subfractions and their association with thepresence of asymptomatic atherosclerosis.Methodology: The study included 130 subjects with no cardiovascularcomplaints. The clinical group consisted of subjects with MetS (n=65), andthe control group comprised (KG) subjects without MetS (n=65). Within thegroups, subjects with atherogenic dyslipidemia were defined. Non-invasivecardiac diagnostics were performed on all participants: Color dopplerultrasonography of the main blood vessels of the neck with measurement ofthe intima-media thickness and detection of atherosclerotic plaques,echocardiographic examination, and exercise stress test. Standard andspecific laboratory analyses were conducted (oxidized LDL-C, PAI-1, NOmetabolites - NO2-/NO3, iNOS) and determination of lipid particles usingnuclear magnetic resonance spectroscopy.Results: The number of components defining MetS correlates well withsubclinical atherosclerosis of the carotid arteries. The average intima-mediathickness of the carotid arteries, the average number of plaques, and theaverage stenosis in subjects with MetS were significantly greater than in thecontrol group (p<0.001 for all), as was the frequency of thickened intimamediathickness ≥0.9 mm and carotid plaques. Intima-media thicknesscorrelates with AD components. The presence of plaques in the carotidarteries is associated with age, fatty liver, values of total and LDL cholesterol,HgA1C, NO metabolites, iNOS, and systolic blood pressure, with the mostsignificant association shown with Non-HDL-C. In subjects with MetS andAD, a higher percentage of triglyceride-rich lipoproteins, VLDL, andchylomicrons were present compared to individuals without MetS (43.91 vs.23.91%, p<0.001), as well as the total content of all atherogenic lipidsubfractions - VLDL, HM, LDL (67.74 vs. 50.40%, p<0.001). The MetSgroup subjects have higher values of oxLDL-C, PAI-1, and iNOS comparedto the control group. The prevalence of fatty liver is statistically significantlyhigher in patients with AD (90.9% vs. 66.7%, p=0.03). The presence of fattyliver correlates with remnant cholesterol, PAI-1, and the waist/hip ratio.Individuals with asymptomatic carotid stenosis more frequently havemoderate microalbuminuria, stage A2, and a higher albumin/creatinine ratio.Diastolic relaxation disorder is more common in MetS compared to KG andthey have a larger left ventricular mass. ST segment depression on exercisestress testing is statistically significantly more frequent in patients withasymptomatic carotid atherosclerosis.Conclusion: A high percentage (63%) of individuals with MetS have AD.Asymptomatic individuals with newly diagnosed MetS at routine check-upsalready exhibit early vascular damage (asymptomatic atherosclerosis of thecarotid arteries), heart (impaired diastolic relaxation), liver (non-alcoholicfatty liver), and kidneys (microalbuminuria). Non-invasive diagnosticmethods, such as Color doppler of neck blood vessels and echocardiography,enable the identification of individuals with the earliest target organ changes,providing opportunities for implementing preventive and therapeuticmeasures. The method of nuclear magnetic resonance spectroscopy allowsdirect determination of atherogenic lipid subfractions, offering additionalbenefit in cardiovascular risk assessment.

Opis (srp)

Biografija autora: list 181Bibliografija: list. 135-176 Datum odbrane: 16.7.2025. Cardiology

Jezik

srpski

Datum

2024

Licenca

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