The aim: To evaluate effectiveness of complex therapy in patients with comorbidity of type 2 diabetes (DM2) and essential hypertension (EH) depending on genetic polymorphism peroxisome proliferator-activating receptor-γ2 (PPARγ2). Before and after 3 months of treatment we examined 145 patients with EH stage II, grade and DM2 moderate, subcompensated aged 4560 years: group 1 (71 patients) received standart therapy (telmisartan, indapamide, metformin, gliclazide, atorvastatin, acetylsalicylic acid) and group 2 (74 patients) additionally received α-lipoic acid (α-LA). Both groups were matched for age, sex, EH stage and grade, the degree of compensation DM2. Methods: biochemical blood analysis, echocardiography evaluation of mitral diastolic blood flow and tissue Doppler spectral modes, reactive hyperemia, color Doppler mapping, enzyme immunoassay. We conducted genotyping of Pro12Ala polymorphism of PPARγ2.
Results: Patients with genotype Pro/Pro of PPARγ2 had significantly higher levels of total cholesterol, LDL, proinflammatory cytokines (TNF-α and IL-6), the values of intima-media thickness and significantly lower degree of endothelium-dependent vasodilatation as compared to genotype Pro12Ala/Ala12Ala. After standart therapy in patients with EH and concomitant DM2 (in all PPARγ2 genotypes) metabolic and hemodynamic parameters were improved. More pronounced dynamics was in patients with genotype Pro12Ala/Ala12Ala. Additional appointment of α-LA impacted more to vascular remodeling and levels of proinflammatory cytokines as compared to standard therapy. Decrease HbA1c and triglyceride levels in patients with additional appointment of α-LA was significantly more pronounced as compared to standard therapy only in genotype Pro12Ala/Ala12Ala.
Conclusions: Effectiveness of complex therapy in comorbidity of DM2 and EH depends on PPARγ2 genotype. Dynamics of metabolic and hemodynamic parameters was more pronounced in additional appointment of α-LA, especially in genotype Pro12Ala/Ala12Ala.
20 - 23 May 2017
European Society of Endocrinology