Transforming Growth Factor-β1 in the Formation of Pathological Remodeling of the Heart in Arterial Hypertension with Type 2 Diabetes Mellitus and Obesity
Authors:   Government Institution L.T. Malaya Therapy National Institute of the National Academy of Medical Science of Ukraine, Department of Hypertension and Prevention of Its Complications. 2A, Lyubovi Maloi Ave., Kharkiv 61039, Ukraine, Koval S. M. , Starchenko T. G. , Reznik L. A. , Bozhko V. V. , Penkova M. Yu. 
Published: November 2022

The purpose of the study was to investigate the role of transforming growth factor-β1 in the formation of pathological remodeling of the left ventricle of the heart in patients with arterial hypertension with and without type 2 diabetes mellitus against the background of abdominal obesity. Materials and methods. 58 patients with arterial hypertension of the II stage, 2-3 degree with abdominal obesity of the I-III degree were involved in the examination, of which 32 had type 2 diabetes. The control group consisted of 14 healthy people. Structural indicators of the heart were studied using an echocardiographic study. Determination of the level of transforming growth factor-β1 in blood serum was carried out by the immunoenzymatic method. Results and discussion. It was established that in the groups of patients with arterial hypertension with type 2 diabetes mellitus and abdominal obesity and arterial hypertension with abdominal obesity, probable differences in transforming growth factor-β1 between types of cardiac remodeling were not detected. Probable differences in the levels of transforming growth factor-β1 in CGLS and EGLS were established only between the groups of the examined and probably differed from the control group, which indicates a significant influence of abdominal obesity on the development of adverse remodeling, both in arterial hypertension with type 2 diabetes mellitus and with arterial hypertension without it. However, the most pronounced changes in transforming growth factor-β1 were observed in subjects with impaired carbohydrate metabolism (type 2 diabetes mellitus), which allows us to consider hyperglycemia as an additional factor in the formation of pathological geometry of the heart. Conclusion. The data obtained as a result of the study may indicate that in the formation of pathological types of cardiac remodeling in patients with arterial hypertension with abdominal obesity, from the point of view of the development of interstitial fibrosis, a significant contribution belongs to the transforming growth factor-β1, which is a key factor in the formation of hypertrophy of the myocardium of the left ventricle. Along with this, additional factors of the formation of cardiac remodeling should be noted in case of violation of carbohydrate metabolism in arterial hypertension with type 2 diabetes mellitus on the background of abdominal obesity. The association of a probable increase in the levels of transforming growth factor-β1 in concentric hypertrophy of the left ventricle and eccentric hypertrophy of the left ventricle and the consequences of hyperglycemia significantly increases the cardiovascular risk, which determines the expediency of earlier therapeutic intervention