Metabolic syndrome in patients with arterial hypertension living in the Far North (on the example of the Khanty-Mansi Autonomous Okrug — Yugra)

Abstract

BACKGROUND: Metabolic syndrome currently continues to occupy a leading position in medicine and remains one of the main reasons for discussions among scientists around the world. WHO experts defined the problem of metabolic syndrome as an «epidemic of the 21st century», since its prevalence is currently, according to some estimates, from 10% to 40% among the adult population of the planet.AIM: To study the metabolic syndrome in patients with arterial hypertension living in the Far North; to determine the main variants of the metabolic syndrome that are characteristic of people with arterial hypertension in harsh climatic and geographical conditions and to analyze the frequency of occurrence of the identified variants of the metabolic syndrome depending on the degree of arterial hypertension and gender differences.MATERIALS AND METHODS. This study is presented in the form of 4 main stages: determination of metabolic syndrome variants characteristic of patients with AH living in the North, analysis of the frequency of occurrence of the identified main variants of the metabolic syndrome depending  on gender, degree of AH and time spent in the Far North. Study period: March 2018–February 2019.The main inclusion criteria for this study were: the presence of metabolic syndrome, a confirmed diagnosis  of arterial hypertension  (AH) of 1–3 degrees based on generally accepted  criteria (ESH / ESC, 2018), residence in the Far North for at least 1 year. For the diagnosis  of MS, the IDF criteria, 2005, were adopted. By design, the work is in the nature of an observational one-sample  study, which was conducted  in the Khanty-Mansiysk Autonomous  Okrug — Yugra, Nizhnevartovsk (KhMAO-Yugra).RESULTS. The study involved 235 people, of which: men — 109 people (46.4±4,77%), women — 126 people (53.6±4,44%). The age of the study participants was 38±7.1 years. According  to the degree of AH (according  to the criteria, ESH / ESC from 2018), patients are presented as follows: 1st degree AH — 59 people (25.1± 2,83%); 2nd degree AH — 73 people (35.1± 3,11%);  3rd degree AH — 103 people (39.8± 3,19%). By the time of residence in harsh climatic conditions, all patients who took participation in this study were divided into three groups: group 1 — the residence time was from 1 year to 5 years. This group included 56 people (23.8±5,7%). 2 group — the period of stay in the Far North was from 6 to 11 years and this group is represented by 81 patients (34.5±5,3%) , group 3 — patients living in CS conditions for more than 11 years — 98 people (41.7±4,9%). № 1 — WC ≥ 94 cm in men and ≥ 80 cm in women + BP level ≥ 130/85 mm Hg + decrease in HDL cholesterol ≤ 1.03 mmol / L. This combination  of the main structural units of MS was observed in 43 +/-3.23% of cases (p<0.0016). Option number 2 — waist ≥ 94 cm in men and ≥ 80 cm in women + BP level ≥ 130/85 mm. rt. Art. + decrease in HDL-C ≤ 1.03 mmol/l + increase in triglycerides ≥ 1.7 mmol/l + increase in fasting glucose ≥ 5.6 mmol/l* — this combination of MS components occurred in 57+/-3.23 % of cases in all patients participating in the study (p<0.0011).CONCLUSION. With an increase in the time spent in the Far North in patients with hypertension, who initially have a 3-component variant of the metabolic syndrome, there is a tendency towards an increase in the main components of the metabolic syndrome.