Vascular endothelial growth factor as a marker of endothelial dysfunction in poly- and comorbidity: focus on hypertension, type 2 diabetes mellitus and subclinical hypothyroidism

Background. The goal of our study was to investigate the content and particularities of change of vascular endothelialgrowth factor-A (VEGF-A) levels as a marker of endothelial dysfunction (ED) in patients with hypertension(HT) with or without type 2 diabetes mellitus (T2DM) and with or without subclinical hypothyroidism (SH). Material and methods. Two hundred and eleven patients with hypertension stage II were divided into 3 groups:Group 1 — with HT (n = 55); Group 2 — with AH and T2DM (n = 97); Group 3 — with HT, T2DM and SH(n = 59). The patients in Group 3 were divided into 3 subgroups depending on TSH levels: 3a (n = 26) — TSH4.0–6.0 mIU/L; 3b (n = 20) — TSH 6.1–8.0 mIU/L; 3c (n = 13) — TSH 8.1–10.0 mIU/L. We evaluated lipids,carbohydrate metabolism, serum insulin concentration, insulin resistance index — HOMA, and the level ofVEGF-A in plasma. Results. The levels of VEGF-A in Group 2 was significantly lower vs. Group1 (323.94 ± 22.17 pg/mLand 413.15 ± 29.02 pg/mL, respectively (p < 0.05)). The patients in Group 3d had lower VEGF-A levels thanthe patients in Group 1, but higher than those in Group 2. Among Group 3 patients, the levels of VEGF-Awere the lowest in the 3a subgroup (375.91 ± 19.81 pg/mL), significantly different from 3b and 3c subgroups(p < 0.05), for which no differences were found (p > 0.05.). In the 3a subgroup VEGF-A levels were significantlyhigher than in Group 2 patients (p < 0.05). Conclusion. These data confirms the hypothesis of increasing ED in hypothyroidism even at the subclinical level

Effect of achieving blood pressure targets on the relative telomere length in hypertensive patients with and without type 2 diabetes mellitus

Background. The role of relative telomere length (RTL) as a marker of cardiovascular prognosis and quality controlof the disease course remains to be found out. The aim of the study was to determine the relationship betweenthe relative blood leukocyte telomere length (RLTL), relative buccal epithelium cell telomere length (RBTL) andachieving blood pressure targets (BPTs) in hypertensive (H) individuals with type 2 diabetes mellitus (T2DM) andwithout T2DM. Material and methods. In 156 patients with stage II hypertension (96 of them had T2DM), carbohydrate metabolismparameters and blood pressure levels were evaluated. RLTL and RBTL were determined by a real timequantitative PCR. Results. A combination of hypertension and T2DM was associated with significantly greater RLTL (p = 0.009) andRBTL (p = 0.001) compared with isolated hypertension. There was no convincing evidence of BPT influence onthe change in the RLTL in isolated hypertension. Achieving BP targets was associated with a paradoxical shorteningof RBTL. There was a significant shortening of RTL in hypertensive patients with T2DM when the BPTs were notreached. An analysis of variance revealed a significant influence of BPTs on the RBTL and RLTL. Conclusion. Patients with a comorbid course of hypertension and T2DM had more pronounced decrease in theRTL. Target levels of blood pressure have a more significant effect on the RLT than the glycemic control in patientswith concomitant T2DM. An additional determination of the RBTL enhances the diagnostic and prognostic powerwhen evaluating the effectiveness of correcting cardiovascular risk factors including blood pressure

Features of hemodynamic and metabolic disorders in obese patients with resistant hypertension

Background. The aim was to establish the features of hemodynamic and metabolic parameters in obese patients with true and pseudo-resistant arterial hypertension (AH). Material and methods. The study included 200 patients with uncontrolled AH and obesity. Patients were initially prescribed dual antihypertensive therapy. Those patients who did not reach target blood pressure (BP) levels after 3 months on dual therapy were additionally prescribed a third antihypertensive drug. Of the 98 patients who were assigned to triple therapy, 48 patients did not reach target BP (27 patients had pseudo-resistant and 21 patients had true resistant AH). These patients were additionally prescribed a fourth antihypertensive drug (spironolactone). The effectiveness of the treatment was evaluated 6 months after the start of antihypertensive therapy. Results. After 6 months of therapy, unlike patients without resistance, individuals with resistant AH had more pronounced cardiovascular remodeling and metabolic disorders, disbalance of oxidative stress-antioxidant protection, proinflammatory activity and higher activity of the renin-angiotensin-aldosterone system. Patients with true resistance differed from pseudo-resistant patients by having significantly lower body mass index (BMI); in the absence of differences in BP levels, cardiovascular remodeling, lipid and carbohydrate profiles, patients with true resistance had significantly higher levels of aldosterone, higher activity of oxidative stress system, lower levels of general antioxidant protection, higher adiponectin levels, and lower leptin level. Conclusions. Obese patients with true resistance differed from pseudo-resistant patients by having significantly lower BMI, higher aldosterone levels, more pronounced imbalance of the system of oxidative stress-antioxidant protection and less pronounced adipokine imbalance

The Actual and Potential Prospects for the Inclusion of Migrant Workers in the Labor Market (On Example of St. Petersburg)

In the article the analysis of the inclusion of migrants to labor activity taking into account the real needs of the labour market and targeted approach to their recruitment, as well as revealed an effective mechanism for attracting labour migrants in accordance with the real needs of businesses in the form of organized recruitment of foreign workers that can be used in regions with low employment potential. The study of complex of measures on improvement of regulation of labor migration in the aspect of formation of the effective mechanism of attracting skilled workers from migrant workers to provide basic sectors of economy in labor force (by example of St. Petersburg)

"Feed from the Service": Corruption and Coercion in the State-University Relations in Central Eurasia

Education in Central Eurasia has become one of the industries, most affected by corruption. Corruption in academia, including bribery, extortions, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region’s media and addressed in few scholarly works. This paper considers corruption in higher education as a product of interrelations between the government and academia. A substantial block of literature considers excessive corruption as an indicator of a weak state. In contrast to standard interpretations, this paper argues that in non-democratic societies corruption is used on a systematic basis as a mechanism of direct and indirect administrative control over higher education institutions. Informal approval of corrupt activities in exchange for loyalty and compliance with the regime may be used in the countries of Central Eurasia for the purposes of political indoctrination. This paper presents the concept of corruption and coercion in the state-university relations in Central Eurasia and outlines the model which incorporates this concept and the “feed from the service” approach. It presents implications of this model for the state-university relations and the national educational systems in Central Eurasia in general and offers some suggestions on curbing corruption

Age-associated features of oxidative stress as marker of vascular aging in comorbid course of hypertension and type 2 diabetes mellitus

Aim: To evaluate activity of oxidative stress (OS) as marker of vascular aging in different age groups of patients with combined course of arterial hypertension (HT) and type 2 diabetes mellitus (T2DM).Methods: 126 patients (average age 57.8 ± 6.2 years) with stage II HT and compensated T2DM were divided into 2 subgroups: 2a (n = 59) - aged 45-60 years; 2b (n = 97) - aged 61-75 years; 30 patients with isolated stage II HT (comparison group), 20 practically healthy individuals (control group). The activity of antioxidative [glutathione peroxidase, sulfhydryl groups (SH-groups)] and oxidative [malonic dialdehyde (MDA)], 8-hydroxy-2-deoxyguanosine (8-OH-dG) systems in blood serum, were studied.Results: A significant increase in MDA levels (P < 0.05) and SH-groups (P < 0.05) compared with healthy volunteers was observed. Patients in 2b group had lower MDA values than in 2a (6.25 ± 0.33 μmol/L, 7.07 ± 0.44 μmol/L, respectively, P > 0.05). In the 2b group, in comparison with 2a patients, a decrease in thiol status was observed (P > 0.05). The level of 8-OH-dG was increased in patients with HT and T2DM, but there was also an age-associated increase in the average 8-OH-dG in the 2b group.Conclusion: The age-associated changes in the OS in comorbid course of HT and T2DM did not have significant differences. Nevertheless, the presence of correlations between various indexes that are included in the concept of “vascular aging” and indicators of oxidant-antioxidant systems in different age groups allows us to make an assumption about the significant influence of the oxidative status on the status of vascular age, especially in the older age group persons

Role of plasma 8-OXO-2’-deoxyguanosine in target organ damage in patients with hypertension and type 2 diabetes

Background: The aim of the study was to determine the prognostic value of 8-oxo-2’-deoxyguanosine (8-OHdG) plasma levels for cardiovascular complications (CVC) development in hypertension (HTN) and type 2 diabetes mellitus (T2DM) comorbidity. Material and methods: One hundred fifty-six patients (mean age 61.71 ± 0.87 years) with the combined course of HTN stage II and T2DM (group 1) and 100 non-diabetic patients with HTN stage II (mean age 60.59 ± 0.87 years, group 2) were examined. Lipid, carbohydrate metabolism, plasma insulin, plasma 8-OHdG (by ELISA), blood pressure levels were measured. Observation period was 12 months. Results: Plasma levels of 8-OHdG in the patients’ groups were significantly higher than in the controls (p < 0.001), in the group 1 higher than in group 2 (15.37 ± 0.27 ng/L vs. 14.00 ± 0.29 ng/L, respectively, p = 0.002). Plasma levels of 8-OHdG in group-2 patients who developed cardiovascular complications during observation period were significantly higher than in those without cardiovascular complications (16.47 ± 0.62 ng/L vs. 15.11 ± 0.29 ng/L, respectively, p = 0.046). The ROC analysis made it possible to propose the 8-OHdG plasma level ≥ 15.68 ng/L as an identifier for the cardiovascular complications in patients with studied comorbidity. In group 1, in patients with 8-OHdG plasma level ≥ 15.68 ng/L such cardiovascular risk factors as total cholesterol (TC) (p = 0.034), low density lipoprotein cholesterol (LDL-C) (p = 0.035), systolic blood pressure (p = 0.022), HOMA-IR (p = 0.046) were significantly higher compared with those whose level of this indicator was < 15.68 ng/L. Conclusion: Determination of the plasma 8-OHdG allows not only for assessment of the severity of oxidative stress, but also for determination of the course and prognosis in comorbidity of HTN and T2DM