Markers of bone remodeling, 25(ОH)D3 level and lipid metabolism parameters in elderly women with uncomplicated arterial hypertension

Abstract

The aim —f the work is to make a comparative analysis of the parameters of bone remodeling, lipid and calcium­phosphor exchange and 25(ОH)D3 level in elderly women with uncomplicated arterial hypertension (AH) and without it.Materials and methods. The study included 44 patients with stage I — II AH, of 1 — 2nd degree (mean age — 69.1 ± 0.7 years, average duration of the postmenopausal period — 18.4 ± 0.9 years) and 30 practically healthy women (mean age — 69.3 ± 1.2 years, the average duration of the postmenopausal period was 19.4 ± 1.2 years. All patients underwent general clinical and laboratory examination with determination of lipid level in blood, 25(ОH)D3, parathyroid hormone, propeptidprocollagen of type I (P1NP), b­terminal telopeptides of collagen type I (b­STx), ionized calcium and phosphorus in serum, daily monitoring of arterial pressure, echocardiography and applanation tonometry.Results and discussion. In patients of the main group, compared with the control group, hypercholesteremia was revealed (total cholesterol — 6.3 ± 0.2 and 4.6 ± 0.1 mmol/l, low density lipoproteins — 3.8 ± 0.8 and 2.1 ± 1.2 mmol/l, triglycerides — 1.8 ± 0.1 and 1.0 ± 0.1 mmol/l, all p < 0.001), insufficiency and deficiency 25(ОH)D3 (23.76 ± 1.1 and 28.2 ± 2.1 ng/ml, p < 0.05), secondary hyperparathyroidism (parathyroid hormone — 64.6 ± 3.9 and 39.6 ± 1.1 ng/ml, p < 0.001), accelerated resorption of bone tissue (b­CTx — 0.57 ± 0.03 and 0.45 ± 0.03 ng/ml, p < 0.01). A direct proportional correlation between the level of total cholesterol, low density lipoproteins and P1NP (r = +0.417 and r = +0.481, all p < 0.01) indicates a link between hypercholesterolemia and bone remodeling activity in elderly patients with uncomplicated hypertension.Conclusions. In elderly women with controlled uncomplicated hypertension, in contrast to healthy women of the corresponding age, an increase in vascular stiffness according to applanation tonometry is associated with a decrease in the level of 25(ОH)D3, secondary hyperparathyroidism and an increase in the content of markers of bone resorption.