The relationship between body weight and the development of lipid and carbohydrate metabolism disorders in patients with gastrointestinal diseases

Abstract

Background. The purpose of the study is to investigate the peculiarities of lipid and carbohydrate metabolism in patients with gastrointestinal diseases depending on the body mass index (BMI). Materials and methods. Forty patients with digestive disorders were examined, 13 women (32.5%) and 27 men (67.5%) whose median age was 37 (24; 51) years. The patients were divided into 3 groups: I— 20 people with BMI exceeding the norm; II— 11 patients with a BMI below the norm; III— 9 patients with normal BMI. The control group for evaluating the results of laboratory tests consisted of 15 practically healthy people. Total cholesterol, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), glucose and insulin serum levels were evaluated. The atherogenic index (AI) and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were calculated. Statistical processing of the results was carried out using the Statistica 6.1 software package. Results. In patients with digestive diseases who had an increased BMI, the development of atherogenic dyslipidemia was detected, as indicated by a probable decrease in serum content of HDL-C by 1.7 times (p=0.003) and an increase in TG by 1.9 times (p=0.002), VLDL-C by 1.4 times (p=0.05), AI by 2 times (p=0.03) compared to the controls. No significant signs of the development of atherosclerotic processes were found in patients with reduced and normal BMI. Carbohydrate metabolism disorders were observed in 47.5% of patients with gastrointestinal diseases, and HOMA-IR in patients with increased BMI was 2.9 times higher (p<0.05) compared to those with reduced BMI and 2.5 times (p<0.05) higher— with normal BMI. It was found that an increase in BMI is associated with an increase in serum TG (r=0.381; p=0.017), LDL-С (r=0.383; p=0.016), AI (r=0.566; p<0.001), insulin (r=0.651; p=0.0001) and HOMA-IR (r=0.681; p=0.0001), as well as that BMI is negatively correlated with the content of HDL-С (r=–0.448; p=0.004). At the same time, an inverse correlation was found between HOMA-IR and the level of HDL-С (r= –0.389; p=0.016), and a direct relationship between the index of insulin resistance and AI (r=0.437; p=0.006). Conclusions. The revealed correlations confirm the hypothesis of the BMI influence on the development of dyslipidemia and insulin resistance in patients with gastrointestinal diseases. This substantiates the expediency of including bioimpedance measurements into the algorithm for predicting metabolic disorders in this category of patients.