The presence of metabolic syndrome (MS) in a patient allows him to be assigned to a group at high risk for atherosclerosis, cardiovascular events, coronary heart disease, and type 2 diabetes mellitus. In addition, MS negatively affects not only the heart and vessels, but also kidney function, which leads to chronic kidney disease (CKD). MS is pathogenetically associated with CKD and is an independent prognostic factor of the development of the latter, namely, the involvement of the kidney frequently determines prognosis and quality of life in these patients. The paper gives a modern view on the concept of MS and CKD and considers its main diagnostic criteria, etiology, and pathogenesis. The study of the relationships between MS and CKD may suggest that the high prevalence of kidney dysfunction in the general population is largely determined by metabolic nephropathies, including obesity-related nephropathy. The identification of risk factors and poor prognostic markers in this category of patients seems to be extremely important for the early diagnosis of the disease and their timely elimination is one of the main approaches to the comprehensive prevention of CKD in these patients.
Aim. To assess the influence of retinol-binding protein synthetized by adipose tissue, on clinical course and prognosis of arterial hypertension (AH).Material and methods. Totally, 168 patients included, with AH of 1-3 grade. Study protocol included general clinical investigation (at inclusion, in 1, 4 and 9 months) with analysis of complaints, anamnesis, physical examination, additional laboratory and instrumental methods. In 78 patients among the included, the level of retinolbinding protein RBP4 was measured in blood serum.Results. Increased level of RBP4 correlated significantly with the age, body mass index, duration of AH, raised level of uric acid, pulse wave velocity signs, endogenic nitrite. Only in the group with raised RBP4 there was stroke anamnesis noted, and obesity of III grade. Dynamics of the level of RBP4 during 9 months treatment, depending on cardiometabolic risk, showed some specifics: at inclusion, in the group with high cardiometabolic risk there was significantly increased RBP4 comparing to the groups of patients with low and moderate cardiometabolic risk.Conclusion. Increased level of retinol-binding protein is associated with higher cardiometabolic risk and adverse prognosis.
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