| Abstract [eng] |
Relevance of the problem: Metabolic syndrome is the dysregulation of metabolic processes in which hypertension, dyslipidaemia, obesity and insulin resistance occur. All these components lead to systemic low grade inflammation and increase cardiovascular risk. Such a low risk inflammation causes endothelial dysfunction in all blood vessels. The endothelial cells in kidney glomeruli are the part of their filtration barrier. When endothelial dysfunction occurs in kidney glomeruli albumin excretion increases. In this research we wanted to check whether endothelial dysfunction in brachial arteries correlates with albuminuria and kidney function in patients without diabetes and chronic kidney disease. Subjects and methods: This research included 1431 patients (623 men and 808 women) with metabolic syndrome. The average age was 53±6 years. All data was taken from Vilnius University Hospital Santaros Clinics archive from 2010 to 2014. The subjects were participants in Lithuanian high cardiovascular risk prevention programme. Skin microvascular endothelial function was measured with laser Doppler flowmetry during post-occlusive reactive hyperaemia. Albuminuria was evaluated from spot urine using albumin to creatinine ratio and estimated albumin excretion rate. Results: Urine albumin and creatinine ratio was higher in patients who had diabetes comparing with nondiabetic participants (p=0,002). However comparing women and men separately we did not find statistical difference (p=0,038, p=0,022). The correlation between endothelial dysfunction and albuminuria was not found. Although estimated glomerular filtration rate in nondiabetic patients was associated with rest flow, occlusion area, time to maximal flow and negatively associated with reactive hyperaemia index, rest and peak flow percent change in post-occlusive reactive hyperaemia. Urine albumin and creatinine ratio did not correlate with endothelial function. After we included estimated albumin excretion rate, we found its association with reactive hyperaemia index and percent change in rest to peak flow. Kidney to chronological age difference was associated with hyperaemia index (p<0.001), time to maximal flow (p=0.029) and rest flow to peak flow percentage change (p<0.001). Conclusions: Albuminuria did not correlate with endothelial dysfunction in middle-aged nondiabetic individuals with metabolic syndrome. The decrease in estimated glomerular filtration rate was associated with worse endothelial function in men, but not in women. Estimated albumin excretion rate corelated with a decrease in reactive hyperaemia index and increase in rest to peak flow percent change. Kidney to chronological age difference had an impact on endothelial function. |
