Metabolic Status in Patients with Ischemic Heart Disease and Obesity with Different Genotypes of Leptin Receptor Gene (Arg223Glu)

The purpose of the study was to assess the metabolic status, namely carbohydrate and lipid metabolism, in patients with coronary heart disease and obesity with different genotypes of the leptin receptor gene (Arg223Glu). Materials and methods. The study included 220 patients with coronary heart disease and obesity. The comparison group consisted of 113 patients with coronary heart disease with normal body weight. The control group included 35 healthy individuals. Additionally, patients with coronary heart disease and obesity were divided into subgroups depending on the genotype of the leptin receptor gene (Arg223Glu): the first subgroup included carriers of the A/A genotype (n=57), the second – G/A genotype (n=90), the third – G/G genotype (n=73). Results and discussion. The analysis of carbohydrate metabolism depending on the genotypes of the leptin receptor gene (Arg223Gln) in patients with coronary heart disease and obesity showed that carriers of the G/G genotype have more pronounced disorders of carbohydrate metabolism in the form of hyperinsulinemia and decreased tissue sensitivity to insulin while carriers of the genotypes G/A and A/A have greater resistance to glucose-metabolic disorders. Body mass index in carriers of G/G genotype had the highest value, which is 19.19% and 19.53% more than in carriers of genotypes G/A and A/A. Thus, the G/G genotype in patients with coronary heart disease and obesity was associated with body mass index. The impaired lipid metabolism in patients with coronary heart disease in combination with obesity was defined as hypertriglyceridemia, which is associated with the G/G genotype of the leptin receptor gene polymorphism (Arg223Gln). The results obtained in our work indicate the involvement of the polymorphic locus of the leptin receptor gene (Arg223Gln) in the formation of disorders of carbohydrate and lipid metabolism, which corresponds to the literature. It has been suggested that structural changes in the leptin receptor gene are associated not only with the development of obesity but also with the development of type 2 diabetes mellitus. Conclusion. The features of the combined course of coronary heart disease and obesity were identified: hyperinsulinemia and insulin resistance are associated with the G allele and G/G genotype of the polymorphic locus Arg223Gln leptin receptor gene (r=0.76, p<0.05); the rearrangement of the lipid spectrum due to hypertriglyceridemia is influenced by the homogeny of the G allele of the polymorphic locus of the Arg223Gln gene of the leptin receptor gene (r=0.73, p<0.05)