Endocrine Abstracts

JOINT2325

Cardiovascular diseases (CVDs) remain a major global health concern, contributing to one-third of global mortality. Recent research highlights the role of cardiometabolic phenotypes in determining cardiovascular risk, particularly in patients with arterial hypertension (AH), type 2 diabetes mellitus (T2DM), and obesity (OB). The interplay between these conditions results in complex pathophysiological mechanisms that require further investigation to optimize risk stratification and management strategies. The study aimedto identify specific cardiometabolic phenotypes in patients with AH, T2DM, and OB and to determine early markers of cardiovascular and renal dysfunction. The study further sought to explore correlations between these conditions and biomarkers, including cardiotrophin-1 (CTF-1), neutrophil gelatinase-associated lipocalin (NGAL), N-terminal pro-brain natriuretic peptide (NT-proBNP), leptin, and cystatin C.

Materials and methods: A total of 211 patients were included in the study, divided into four groups based on comorbid conditions: 1. Group 1 (AH only) – 49 patients. 2. Group 2 (AH and OB) – 54 patients. 3. Group 3 (AH and T2DM) – 57 patients. 4. Group 4 (AH, OB, and T2DM) – 51 patients. Clinical, laboratory, and instrumental assessments were conducted, including lipid and carbohydrate profiles, renal function tests, and echocardiography. Biomarkers such as NGAL, NT-proBNP, and CTF-1 were measured using enzyme-linked immunosorbent assays (ELISA).

Results: The study identified three distinct cardiometabolic phenotypes: phenotype 1 (AH and OB, n =54): Characterized by progressive cardiac remodeling, increased leptin levels, and a moderate risk of renal impairment. Phenotype 2 (AH and T2DM, n =57): Associated with significant renal dysfunction, as evidenced by elevated NGAL and cystatin C levels, indicating early nephropathy. Phenotype 3 (AH, OB, and T2DM, n =51): Displayed the most severe metabolic disturbances, with high NT-proBNP levels reflecting heart failure progression and increased NGAL levels predicting renal complications. Lipid metabolism disturbances were more pronounced in groups with OB and T2DM, with significantly higher total cholesterol and triglycerides. Carbohydrate metabolism markers (insulin and HbA1c) were significantly elevated in patients with T2DM. Echocardiographic data showed increased left ventricular mass and reduced ejection fraction in patients with multiple comorbidities.

Conclusions: The findings highlight the importance of early detection of cardiometabolic phenotypes to prevent cardiovascular and renal complications. NGAL emerges as a strong predictor of nephropathy, while NT-proBNP serves as a marker for heart failure progression. The combination of AH, OB, and T2DM significantly worsens cardiometabolic status, necessitating personalized therapeutic strategies.

Key words: type 2 diabetes mellitus, obesity, arterial hypertension, cardiometabolic phenotypes.