Полиморфизм гена эндотелиальной синтазы оксида азота у подростков с гипоталамическим синдромом пубертатного периода и артериальной гипертензией

Abstract

The purpose of this study was to improve the early diagnosis of cardiovascular lesions in adolescents with diencephalic syndrome of puberty and arterial hypertension. It is known that hypothalamic syndrome is the most common endocrine disorder of puberty. This syndrome is caused by hypothalamic-pituitary dysfunction and characterized with puberty shifts in the neuroendocrine system. This syndrome is characterized by carbohydrate and lipid metabolic disorders and of varying degrees of obesity. Arterial hypertension may be included in the diencephalic syndrome of puberty and occurs in half of patients with this disease. In the case of diencephalic syndrome of puberty, the absence of proper monitoring and treatment methods may become progressive and lead to resistant hypertension, abdominal obesity, and metabolic disorders which can eventually damage target organs. Thus, it is important to perform proper diagnostics of diencephalic syndrome of puberty and arterial hypertension in young people to prevent cardiovascular disorders. The aim of this research was to improve early diagnosis of cardiovascular disorders in adolescents with diencephalic syndrome of puberty and arterial hypertension by studying endothelial nitric oxide synthase gene polymorphism and serum homocysteine level in different genotypes. The purpose of this study was to improve the early diagnosis of cardiovascular lesions in adolescents with diencephalic syndrome of puberty and arterial hypertension. The authors studied the gene polymorphism of endothelial nitric oxide synthase - 4/5x repeat 27 nucleotide pairs in the gene 4 (4b, 4a) – in adolescents with diencephalic syndrome of puberty and arterial hypertension. The level of homocysteine in the blood serum in different genotype patients with diencephalic syndrome of puberty was assessed. The highest level of homocysteine in the blood serum was identified in 4b4b and 4b4a genotypes in patients with diencephalic syndrome of puberty. This fact may suggest high-risk vascular complications due to the influence of hyperhomocysteinemia in patients with such genotypes. It was found that teens with genotype 4a4a have the highest levels of serum insulin, triglycerides and very low density lipoprotein. This fact deserves attention, as hyperinsulinemia is an early marker of insulin resistance, which, in turn, leads to blood lipid spectrum disbalance. All mentioned above makes young people with diencephalic syndrome of puberty and genotype 4a4a a subpopulation with the highest risk of developing atherosclerosis and progressive metabolic disorders.