Informative significance of serum cytokines and their importance for development of metabolic syndrome with arterial hypertension in elderly persons

N. M. Agarkov, V. Kolomiets, S. I. Korneeva, E. Moskaleva, K. Makkonen
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Abstract

Metabolic syndrome (MS) is among the main public health challenges worldwide, leading to significant labor losses, increased costs for treatment and rehabilitation of the patients. The aim of the present study was to identify the informative serum interleukins, by determining the odds ratio in elderly patients with MS and hypertension. The main group of 86 patients with MS and arterial hypertension (AH) aged 60-75 years was examined under clinical conditions. The inclusion criteria were as follows: age of 60-75 years, presence of MS, primary hypertension (grade II-III), absence of acute myocardial infarction, malignant neoplasms, disorders of cerebral circulation, kidney failure over last 6 months. Diagnostics of MS and hypertension was carried out in accordance with Expert Guidelines from the Russian Research Society of Cardiology on the MS Diagnosis and Treatment. Our first study of a large range of serum interleukins in elderly patients with MS and hypertension allowed us to reveal the inversely directed changes in pro- and anti-inflammatory cytokine contents. Combined AH/MS in elderly persons is accomplished by sufficient increase of the most proinflammatory cytokines, and vice versa, by significant decrease in anti-inflammatory cytokines in blood serum. This finding clearly points to importance of immunological regulatory systems for initiation of AH with MS at older age. Pro- and anti-inflammatory serum interleukins are actively involved into the AH/MS development in elderly accompanied by their pronounced imbalance. The mentioned immune reactions could underlie the MS/AH condition. High risk of this disorder is connected with changed production of proinflammatory cytokines (IL-8, IL-1β), like as anti-inflammatory serum interleukins (IL-4, IL-10), with predominance of the former. The above interleukins should be considered dominant diagnostic markers of AH/MS in elderly persons. Measurement of serum interleukins and discriminant-based approach allows highly reliable differentiation of elderly patients with AH/MS from similar individuals without this disorder.
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血清细胞因子的信息意义及其在老年人合并高血压代谢综合征发展中的重要性
代谢综合征(MS)是世界范围内主要的公共卫生挑战之一,导致大量劳动力损失,增加了患者的治疗和康复费用。本研究的目的是通过确定老年多发性硬化症合并高血压患者的优势比来确定血清白细胞介素的信息。主组86例60 ~ 75岁MS合并动脉高血压(AH)患者进行临床检查。纳入标准如下:年龄60-75岁,存在多发性硬化症,原发性高血压(II-III级),无急性心肌梗死,恶性肿瘤,脑循环障碍,过去6个月内肾功能衰竭。MS和高血压的诊断按照俄罗斯心脏病研究学会MS诊断和治疗专家指南进行。我们对老年MS合并高血压患者大范围血清白介素的首次研究使我们揭示了促炎性和抗炎性细胞因子含量的反向变化。老年人合并AH/MS是通过血清中大多数促炎细胞因子的充分增加来实现的,反之亦然,通过血清中抗炎细胞因子的显著减少来实现的。这一发现清楚地指出了免疫调节系统对老年多发性硬化症AH发病的重要性。促炎性和抗炎性血清白细胞介素积极参与老年AH/MS的发展,并伴有明显的失衡。上述免疫反应可能是MS/AH发病的基础。这种疾病的高风险与促炎细胞因子(IL-8, IL-1β)的产生改变有关,如抗炎血清白细胞介素(IL-4, IL-10),以前者为主。上述白细胞介素应被认为是老年人AH/MS的主要诊断标志物。血清白细胞介素的测量和基于判别的方法可以高度可靠地将老年AH/MS患者与没有这种疾病的相似个体区分开来。
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