[Clinicogenetic aspects of carbohydrate metabolism disorders and efficacy of their correction with moxonidine and metformine in patients with arterial hypertension].

Abstract

AIM:

To study effects of monotherapy with moxonidine and metformine on metabolic parameters in hypertensive patients with carbohydrate dysbolism (CD) regarding polymorphic markers of genes PPARalpha, PPARgamma and IRS type 1 and 2.

MATERIAL AND METHODS:

A total of 83 patients (31 male and 52 female patients aged 40-75 years) with untreated arterial hypertension stage I, obesity and CD (by glucose tolerance test) entered the trial. The patients were randomized into two groups. Patients of group I (n=42) received moxonidin in a dose 0.4 mg/day, of group 2 (n=41)--metformin in a dose 1000 mg/day. Measurement of arterial pressure, blood count and biochemistry, oral test for glucose tolerance with glucose and insulin measurement before meal and 1, 2 and 3 hours later was made initially and on the treatment week 16 Genotypes of polymorphic markers of genes PPARA, PPARG2, IRS1 and IRS2 were defined in all the patients.

RESULTS:

Changes in basic hemodynamic and metabolic indices in therapy with moxonidine depending on polymorphic markers of genes PPARA, PPARG2, IRS1 and IRS2 in patients with AH and CD showed that G allele PPARG2 is associated with greater weight loss, G allele PPARA--with weight loss, C allele PPARA--with maximal fall of diastolic blood pressure.

CONCLUSION:

Genetic factors participate in development of metabolic disturbances in hypertensive patients, obesity and CD and determine treatment efficacy in each individual patient.

• Authors: Zh D Kobalava, V V Tolkacheva, I V Ignat'ev, M G Glezer, A I Kuzin, Iu A Karpov, A O Konradi, E A Zheleznykh
• Journal: Terapevticheskii arkhiv (Ter Arkh) Vol. 77 Issue 1 Pg. 46-51 ( 2005) ISSN: 0040-3660 [Print] Russia (Federation)
• PMID: 15759454 (Publication Type: Clinical Trial, Comparative Study, English Abstract, Journal Article, Randomized Controlled Trial)

Chemical References

• Antihypertensive Agents
• Genetic Markers
• Hypoglycemic Agents
• IRS1 protein, human
• IRS2 protein, human
• Imidazoles
• Insulin
• Insulin Receptor Substrate Proteins
• Intracellular Signaling Peptides and Proteins
• PPAR alpha
• PPAR gamma
• Phosphoproteins
• DNA
• Metformin
• moxonidine

Topics

• Adult
• Aged
• Alleles
• Antihypertensive Agents (therapeutic use)
• Blood Pressure (drug effects, physiology)
• Carbohydrate Metabolism
• DNA (drug effects, genetics)
• Female
• Follow-Up Studies
• Genetic Markers (drug effects, genetics)
• Glucose Metabolism Disorders (blood, complications, drug therapy, genetics)
• Humans
• Hypertension (blood, complications, genetics)
• Hypoglycemic Agents (therapeutic use)
• Imidazoles (therapeutic use)
• Insulin (blood)
• Insulin Receptor Substrate Proteins
• Intracellular Signaling Peptides and Proteins
• Male
• Metformin (therapeutic use)
• Middle Aged
• PPAR alpha (blood, drug effects, genetics)
• PPAR gamma (blood, drug effects, genetics)
• Phosphoproteins (blood, drug effects, genetics)
• Polymerase Chain Reaction
• Polymorphism, Genetic (drug effects, genetics)
• Treatment Outcome