Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Δημήτριος Τούσουλης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αντώνιος Μανώλης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Τσιούφης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνα Αγγελή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σμαραγδή Μαρινάκη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Τσιαχρής, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σοφία Λιονάκη, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Επίδραση της νεφρικής συμπαθητικής απονεύρωσης στο μεταβολισμό της γλυκόζης σε υπερτασικούς ασθενείς με μεταβολικό σύνδρομο
Translated title:
Effect of renal sympathetic denervation on glucose metabolism in hypertensive patients with metabolic syndrome
Summary:
Objective:This study investigated the role of renal denervation(RDN) in glucose metabolism in hypertensive patients with metabolic syndrome.
Methods:40 patients underwent RDN (and 30 were the control group).Mean age was 56.87±7.12 years and 6.7% were women.Mean value of BMI was 31.23±4.37 kg/height2,waist circumference 108.62±10.82cm,hip 110.47±8.45cm and weight 94.50±14.97kg.Mean systolic blood pressure (SBP)was 165±17.33mmHg,diastolic blood pressure(DBP) 96.47±9.91mmHg and heart rate(HR) 75.22±10.86 beats/min.Ambulatory Blood Pressure Measurements(ABPM) for 24h SBP, DBP and HR were 144.67±12.25mmHg, 96.47±9.91mmHg, 75.22±10.86 beats/min respectively.47.5% were on 2 antihypertensives,40% on 3 and 12.5% on 4.All were receiving ACE/AA II 100%, β blocker 30%, AA 6.7% and 60% diuretics.Mean fasting glucose was 122.35±21.79mg/dl, HbA1c 6.17 ±0.84%, insulin 11.83±4.98μ IU/ml, HOMA-IR index 3.66±2.19 and ISQuicki 0.31±0.01.Μean value for GFR 93.79±21.33 ml/min.1.73m2,ΑC 32.84±78.18mg/g,CHOL, HDL, LDL, TG and VLDL were 196.87±40.53mg/dl, 45.32±10.04mg/dl, 121.37±35.55mg/dl, 168.30±120.46mg/dl and 32.85±23.75mg/dl respectively.
Results: RDN contributed to the reduction of office SBP (-11.13±16.30mmHg, p=0.001), DBP (-7.66±8.44, p=0.004) at 3 months and at one year (-19.23/-10.53 ± 14.31 /8.08, p=0.003/0.004 respectively).In the 24-hour recording we had a decrease in 24-hour SBP and DBP at 3 months (-7.40±14.20mmHg,p=0.008 and -3.06±3.71mmHg,p=0.029 respectively) and 12 months (-11.66 ±11.88,p=0.003 and -7.70±6.56,p=0.004 respectively).At 3 and 12 months after RDN the mean fasting glucose value compared to the initial visit was -7.20±12.13mg/dl (p=0.003) and at one year -13.60±20.38mg/dl (p=0.001). Insulin increased at 3 months by 0.87±4.57IU/μL(p=0.302) while at 12 months we had a decrease by -0.70±3.98(p=0.344). The RDN group had an increase in the HOMA-IR resistance index at 3 months by 0.04±1.65(p=0.895) while at 12 there was a decrease of -0.62±1.78(p=0.066). The ISQuicki sensitivity index showed a slight increase at 3 and 12 months by 0.0006±0.02(p=0.855) and 0.006±0.02(p= 0.095) respectively. No statistically significant difference was noted in the glucose and insulin values when performing the OGTT at 3 and 12 months.In control group we had no significant difference in 3 and 12 months.Patients had in all measurements reduction in blood pressure but without statistical significance.
Conclusion: RDN did not lead to an improvement in the glycemic profile of the patients. It contributed, as other studies have shown, to the reduction of BP values.
Main subject category:
Health Sciences
Keywords:
Sympathetic, Denervation, Metabolism, Glucose, Metabolic syndrome
Number of references:
267
