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

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. 

1. Adamenko G.P., Golovko E.S., Skrebo E.I., Tikhon T.V. Markers of intravascular inflammation and cytokine profile in hypertension. Problemi zdoroviya i ecologii = Health and Environmental Problems, 2014, Vol. 40, no. 2, pp. 40-44. (In Russ.)

2. Adamenko G.P., Skrebo E.I., Golovko E.S., Tikhon T.V. Correlation of laboratory parameters of hemostatic status, cytokine markers with peripheral blood lymphocytosis in arterial hypertension with left stomach myocardial hypertrophy. Kardiologiya v Belarusi = Cardiology in Belarus, 2015, Vol. 6, no. 43, pp. 73-83. (In Russ.)

3. Ayvazyan S.A., Enyukov I.S., Meshalkin L.D. Applied statistics: Fundamentals of modeling and primary data processing. Moscow: Finance and Statistics, 1983. 471 p.

4. Bocharova K.A. Study of the contribution of overexpression of proinflammatory and antiinflammatory cytokines to the pathogenesis of hypertension. Nauchnie vedomosti Belgorodskogo gosudarstvennogo universiteta = Scientific Bulletin of Belgorod State University, 2011, Vol. 117, no. 22, pp. 33-36. (In Russ.)

5. Vostrikova N.V., Fedorov D.V., Klimova E.E., Bishevsky K.M. Prognostic significance of inflammatory markers (c-reactive protein and interleukin-6) in arterial hypertension. Bulleten meditsinskoy nauki = Bulletin of Medical Science, 2019, Vol. 13, no. 1, pp. 44-46. (In Russ.)

6. Dragunov D.O., Sokolova A.V., Artutyunov G.P. et al. Relationship of IL-18, IL-6 level and sodium intake level in patients with hypertension and diabetes mellitus. Kardiologiya = Cardiology, 2017, Vol. 57, no. S1, pp. 335-339. (In Russ.)

7. Krasilnikov A.V., Azin A.L. Metabolic syndrome: pathogenesis and geriatric aspects of the problem. Prakticheskaya meditsina = Practical Medicine, 2011, Vol. 54, no. 6, pp. 31-35. (In Russ.)

8. International diabetes Federation (IDF): consensus on metabolic syndrome criteria. Ozhireniye i metabolizm = Obesity and Metabolism, 2005, no. 3, pp. 47-49. (In Russ.)

9. Recommendations of experts of the all-Russian scientific society of cardiologists on the diagnosis and treatment of metabolic syndrome. Second revision. Prakticheskaya meditsina = Practical Medicine, 2010, Vol. 44, no. 5, pp. 81-101. (In Russ.)

10. Ryzhak G.A., Zheltysheva Z.A. Features of metabolic syndrome in elderly women with coronary heart disease and arterial hypertension. Uspekhi gerontologii = Advances of Gerontology, 2012, Vol. 25, no. 1, pp. 48-50. (In Russ.).

11. Safronenko A.V., Maklyakov Yu.S., Sukhorukova N.V., Krishtopa A.V. Complex approach to pharmacotherapy of refractory arterial hypertension. Zhurnal fundamentalnoy meditsiny i biologii = Journal of Fundamental Medicine and Biology, 2014, no. 3, pp. 10-14. (In Russ.)

12. Sergeeva V.V., Rodionova A.Yu., Mikhailov A.A., Bobyleva T.A., Patsenko M.B., Liferov R.A. Principles of antihypertensive therapy in metabolic syndrome. Klinicheskaya meditsina = Clinical Medicine, 2013, Vol. 91, no. 6, pp. 91. (In Russ.)

13. Ribeiro I.S., Pereira Í.S., Santos D.P., Association between body composition and inflammation: a central role of IL-17 and IL-10 in diabetic and hypertensive elderly women. Exp. Gerontol., 2019, Vol. 127, pp. 110734.

14. Rodriguez-Iturbe B., Pons H., Johnson R.J. Role of the immune system in hypertension. Physiol. Rev, 2017, Vol. 97, no. 3, pp. 1127-1164.