To establish genetic polymorphisms associated with the development of comorbidity of essential hypertension (EH) and type 2 diabetes (DM2).Design and Method:
We examined 320 patients with EH and DM2, 90 patients with EH without DM2, 31 healthy individuals. We evaluated genetic polymorphisms: Pro12Ala of PPARγ2, A1166C of AGTR1, rs1801278 of IRS-1, rs7903146 of TCF7L2.Results:
Genotypes A/C and C/C of AGTR1 gene characterized by significantly higher levels of blood pressure (BP), more expressed disorders of structural and functional parameters of the heart and blood vessels, adypokines levels than the A/A genotype. In patients with EH without DM2 AGTR1 polymorphism was associated with the difference of BP, severity of cardiac remodeling and less vessel remodeling (significant difference only for intima media thickness (IMT)), carbohydrate and lipid profiles, but it didn’t affect adypokines levels. Pro/Pro genotype of PPARγ2 in patients with EH and concomitant DM2 was associated with more pronounced hemodynamic and metabolic disorders than Pro12Ala/Ala12Ala genotype that was proved by significantly higher levels of cholesterol, values of IMT and pulse wave velocity of the carotid artery, HOMA insulin resistance (IR) at significantly lower endothelium-dependent vasodilation. In patients with EH without DM2 this polymorphism was less associated with the severity of vascular remodeling, atherosclerotic processes and IR than in comorbidity. Genotypes Arg/Arg and Gly/Arg of IRS-1 gene both in presence and absence of DM2 were associated with increased levels of atherogenic lipoproteins and more pronounced IR. Patients with genotypes T/T and C/T of TCF7L2 gene had more pronounced carbohydrate disorders than patients with genotype C/C; unlike patients with comorbidity, patients with EH without DM2 had no significant difference of blood lipid spectrum.Conclusions:
A/C and C/C genotypes of AGTR1, Pro/Pro PPARγ2, Arg/Arg and Gly/Arg genotypes of IRS-1, T/T and C/T genotypes of TCF7L2 can be considered as polymorphisms that are associated with the development of comorbidity.