Why the study?
The study was conducted to evaluate the association of TNF-alpha and IL-10 with the development of fatal and non-fatal complications in patients with essential hypertension during mid-term follow-up.
Higher baseline levels of IL-10 are associated with a reduced risk of fatal and non-fatal cardiovascular complications in patients with essential hypertension, whereas TNF-alpha levels do not show a significant prognostic association.
TNF-α/IL-10 levels may signal higher complication risk in EHTN; leaves open added prognostic value beyond conventional factors.
Objective. To study the association of tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10) with the development of fatal and non-fatal complications in patients with essential hypertension (EHTN) in the process of mid-term follow-up. Design and methods. 90 patients with EHTN aged 40 to 75 years (average age 56,4 ± 8,1 years) were observed, including 47 women and 43 men. The follow-up period ranged from 20 to 26 months (median observation — 24 months). At baseline, we assessed height, weight, body mass index, waist circumference, blood pressure and heart rate, fasting glucose, serum creatinine with the estimated glomerular filtration rate by CKD-EPI, lipid profile, serum levels of TNF-α and IL-10 by enzyme-linked immunosorbent tests (“CITOKIN — STIMUL — BEST”, Novosibirsk, Russia). Results. A cumulative decrease in the proportion of patients with EHTN without development of fatal and non-fatal cardiovascular complications at follow-up was 70,73 %. When analyzing the associations between cytokines and the development of fatal and non-fatal complications in EHTN patients at term follow-up, we found no difference in TNF-α levels in EHTN patients who reached the end-point and patients without complications (8,31 ± 0,97 vs 8,37 ± 1,33 pg/ml, respectively, p > 0,05), while IL-10 level was higher in patients without complications compared to n patients with complicated EHTN (15,9 ± 3,3 vs 13,5 ± 2,3 pg/ml, respectively, p < 0,01). Logistic regression analysis showed that only systolic blood pressure was an independent risk factor associated with the development of EHTN complications during mid-term follow-up: hazard ratio (HR) — 1,03; 95 % confidence interval (CI) 1,00-1,05. In addition, an increase in IL-10 level was an independent anti-risk factor associated with a significant 25 % reduction in the risk of EHTN complications (HR 0,75; 95 % CI 0,57-0,99). Conclusions. An increased IL-10 concentration was an independent anti-risk factor for the complicated EHTN during mid-term follow-up associated with a 25 % reduction in the risk of fatal and non-fatal complications. At the same time, we did not find the association of the TNF-α level with prognosis in EHTN patients during mid-term follow-up.
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Полупанов et al. (2020) studied this question.
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