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УДК:61.616.61-008.6
WAYS TO REDUCE OVERWEIGHT AND OBESITY IN CHRONIC LIVER
DISEASE
Djumaev B.Z.
Bukhara State Medical Institute
djumayev.bahodir@bsmi.uz.,https://orcid.org/0009-0007-3711-7914
Objective:
to analyze the distribution of genes and genotypes of chronic kidney diseases
depending on the degree of overweight and obesity.
Material and methods:
98 overweight and obese patients with chronic kidney diseases
treated in various departments of the multidisciplinary medical center of the Bukhara region
were examined. 30 patients formed the control group. 68 patients of the main group were
divided into 3 subgroups depending on the div mass index and degree: 38 had degree I, 16
- II, 14 - III.
Results:
the C/C genotype of the PPARG2 gene (rs1801282) was found in 68.7% of cases,
the G/G genotype was almost never detected in overweight and obese patients with chronic
kidney disease of stage III.
Conclusions:
in case of overweight and obesity, the chronic kidney disease index is 29, that
is, at the third level in most cases, the C/C genotype of the PPARG2 gene
(rs1801282)_C34G is detected.
Keywords:
kidney disease, overweight, obesity, health measures, nutrigenomics, ADRB3
gene (rs 4994), ADRB2 gene (rs1042713), PPARG2 gene (rs1801282).
Despite recent advances in the treatment of chronic diffuse kidney diseases, such cases are
rare in clinical practice, for which it is impossible to prescribe etiotropic therapy or for other
reasons, and at the same time it is necessary to slow down the development of the process.
Traditionally, drugs belonging to the group are used for this purpose. Hepatoprotectors,
which should increase the resistance of the kidneys to pathological influences, enhance their
neutralizing function by activating them. Various enzyme systems (including cytochrome
P450 systems and other microsomal enzymes), also contribute. Restoring various functions,
thereby slowing down the development of the disease, should be selected taking into account
the lack of a direct effect on the etiology of the disease. The hepatoprotective group is an
effect on the main pathogenetic mechanisms of kidney diseases [3,5,6].
Kidney diseases are an important clinical, epidemiological and socio-economic problem.
Among the diseases of the excretory system, chronic kidney diseases occupy an important
place. In the last decade, the health care system has been experiencing an increase in the
incidence of chronic kidney disease and renal failure, mainly among people of working age
[2,8,11,17]. For this purpose, the group of drugs traditionally used is hepatoprotectors,
which affect the pathological resistance of the kidneys, enhance their neutralization, work by
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activating various enzyme systems (including cytochrome P450 and other microsomal
enzymes), and also contribute to the restoration of various functions, thereby slowing down
the progression of damage. [7,13,15].
Kidney diseases are one of the most widespread groups of diseases, which are any damage
to anatomical structures that do not go outside the organ. Their treatment requires drugs with
various pharmacological mechanisms of action aimed at reducing pathological processes or
restoring physiological processes. Normal microflora participates in the formation of the
functional activity of the immune system and maintaining it in this state, but the immune
system, in turn, participates in the quantitative and qualitative control of the normal
microflora of the div [2,4,9,12].
However, despite numerous attempts to improve treatment outcomes and patient survival,
drugs used in almost 40% of patients with severe kidney damage fail to achieve clinically
significant improvement [1].
In this regard, there is a constant search for methods and means to increase the effectiveness
of pathogenetic therapy of exogenous toxic kidney damage and the use of drugs with
antioxidant and antihypoxant activity [10].
Despite the widespread prevalence of kidney diseases, not all pathogenetic mechanisms of
the chronic course of these diseases have been sufficiently studied. One of the most widely
accepted points of view is that various enzymatic activities of blood serum play an important
role in this process. One of the reasons for the change in enzymatic activity is considered to
be the disruption of the mechanisms of immune regulation, which is the basis for the
development of chronic diffuse kidney diseases. The most important ones in immunity are
involved in this process. One of the cytokines involved in fibrogenesis is interleukin-13 [4,
14,16].
Research objective
To study and analyze the distribution of genes and genotypes in chronic kidney disease
according to the degree of overweight and obesity.
Materials and methods
98 patients with chronic kidney disease who were hospitalized in various departments of the
Bukhara Regional Multidisciplinary Medical Center and had overweight and obesity were
examined. Of the 98 patients examined, 30 were divided into the control group and 68 into
the main group. Patients in the 68 main group were divided into 3 groups according to the
index of overweight and obesity in chronic kidney disease. 38 patients had overweight I
degree of chronic kidney disease, 16 had II degree, and 14 had III degree.
In the above patients, height, div weight, chronic kidney disease overweight and obesity
index, blood cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL),
3 different types of genes in the blood and their 7 different genotypes were determined and
the results were analyzed.
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Results
In chronic kidney disease overweight and obesity stage I, 2 genotypes of the ADRB2
(rs1042713) A>G gene were also found in 19 patients (Table 1). The 2 genotypes of the
ADRB3 (rs 4994) Trp 64 Arg gene were the most common genotype type, Trp / Trp - 55%
of cases in 21 patients, and Trp / Arg - 45% of cases in 17 patients. The 3 genotypes of the
PPARG2 (rs1801282) C34 G gene were C / G - 35% in 13 patients, of which the most
common was C / C - 21 patients, 55%, and the least common was G / G genotype - 10% in 4
patients.
The frequency of occurrence of genotypes in chronic kidney disease in the I-th degree of
excess div weight in %.
Table 1
№
Gene
ge
no
ty
pe
N
um
be
r
of m
ee
tin
gs
A
ve
ra
ge
ag
e
M
al
e
W
om
an
A
ve
ra
ge
he
ig
ht
A
ve
ra
ge
bo
dy
w
ei
gh
t
TV
I
%
%
%
1
ADRB2
(rs1042713
) A>G
A/A
19
50 52.9
12
3
1.
6
26 68.4 163.3
72.6
27
A/G
19
50 49
26
6
8.
4
12 31.6 166.1
75.7
27
2
ADRB3
(rs 4994)
Trp 64 Arg
Trp/T
rp
21
55 49.3
6
1
5.
8
15 84.2 165
74.3
27
Trp/A
rg
17
45 60.3
11
8
4.
2
6
15.8 163.7
73
27
3
PPARG2
(rs1801282
) C34 G
C/G
13
35 50.4
10
2
6.
3
3
7.9
168
76.8
27
C/C
21
55 47.7
5
1
3.
1
16 42.1 163
72.7
27
G/G
4
10 43.5
2
5.
3 2
5.3
162.5
72.5
27
In chronic kidney disease, overweight and obesity of the second degree (Table 2) The first
genotype of the ADRB2 (rs1042713)A>G gene was found in 6 patients with AA-37.5% and
the second genotype was found in 10 patients with AG-62.5%. The first genotype of the
ADRB3 (rs 4994)_Trp 64 Arg gene was detected in 12 patients with Trp/Trp- 75%, the
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second genotype was found in 4 patients with Trp/Arg 25%. The 3 genotypes of the PPAR
G2 (rs1801282)_C 34 G gene were found in 5 patients with C/G 31.3%, in 11 patients with
C/C- 68.7%, and the third genotype, the most common of the 3 genotypes, G/G-, was almost
not found.
The number of genotypes in excess div weight in chronic kidney disease stage II,
expressed in %.
Table 2
№
Gene
ge
no
ty
pe
N
um
be
r
of m
ee
tin
gs
A
ve
ra
ge
ag
e
M
al
e
W
om
an
A
ve
ra
ge
he
ig
ht
A
ve
ra
ge
bo
dy
w
ei
gh
t
TV
I
%
%
%
1
ADRB2
(rs1042713)
A>G
A/A
6
3
7.
5
40
3 18
.7 3 18.7 169.2
80.6
28
A/G
10
6
2.
5
53.7
4 25 6 37.6 162.5
75.1
28
2
ADRB3
(rs
4994) Trp 64
Arg
Trp/Tr
p
12
7
5 47.3
5 31
.3 7 43.7 165.6
77.6
28
Trp/Ar
g
4
2
5 31.5
1 6.
3
3 18.7 168.1
78.9
28
3
PPARG2
(rs1801282)
C34 G
C/G
5
3
1.
3
50.8
3 18
.7 2 12.6 171
82.5
28
C/C
11
6
8.
7
47.5
7 43
.7 4 25
164.6
76.8
28
G/G
-
-
-
-
-
-
-
-
-
28
In the III degree of excess div weight of chronic kidney disease (Table 3), the first
genotype of the ADRB2 (rs 1042713) A>G gene was found in 6 patients with AA-42.9%
and the second genotype was found in 8 patients with AG - 57.1%. The first genotype of the
ADRB3 (rs4994)_Trp64 Arg gene was the most common genotype type, Trp/Trp- 64.3%
was detected in 9 patients and the second genotype was Trp/Arg-35.7% in 5 patients. The 3
genotypes of the PPARG2 (rs1801282)_C34 G gene were C/G-21.4% in 3 patients, the least
of this gene was detected, C/C- 78.6% was detected in 11 patients, the most, the third
genotype G/G- was not detected at all.
Table 3. Percentage of genotypes in chronic kidney disease stage III overweight.
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Table 3
№
Gene
ge
no
ty
pe
N
um
be
r
of m
ee
tin
gs
A
ve
ra
ge
ag
e
M
al
e
W
om
an
A
ve
ra
ge
he
ig
ht
A
ve
ra
ge
bo
dy
w
ei
gh
t
TV
I
%
%
%
1
ADRB2
(rs1042713
) A>G
A/A
6
42.
9
46.6 3 21.
4
3 21.4 166.7
88.4
29
A/G
8
57.
1
47.7 2 14.
3
4 28.6 172.5
84.8
29
2
ADRB3 (rs
4994) Trp
64 Arg
Trp/Tr
p
9
64.
3
47.6 3 21.
4
6 42.9 175.3
80.9
29
Trp/A
rg
5
35.
7
45
4 28.
6
1 7.1
175.8
91
29
3
PPARG2
(rs1801282
) C34 G
C/G
3
21.
4
38.2 3 21.
4
2 14.3 172.6
79.9
29
C/C
11
78.
6
48
4 28.
6
5 35.7 174.3
80.4
29
G/G
-
-
-
-
-
-
-
-
-
29
In patients with chronic kidney disease, overweight and obesity index of 27, that is, primary
overweight patients, the most frequently detected genotypes were ADRB3(rs 4994)_Trp64
Arg, PPAR G2 (rs1801282)_C34 G genes, Trp/Trp-55%, C/C-55%, and 2 genotypes of
ADRB2 (rs 1042713) A>G gene, AA-50% and AG-50% were detected in 2 cases. Of the 3
genotypes of PPAR G2 (rs1801282)_C34 G gene, only the genotype was C/C-55% in the
most cases, while the remaining 2 genotypes were C/G-35% and G/G-10%.
In the case of chronic kidney disease, where physical education and nutrition measures were
implemented according to Abu Ali ibn Sino's health measures, when the overweight and
obesity index was 28, that is, the second-degree ADRB2 (rs1042713)A>G, genotype AG-
62,%, PPAR G2 (rs1801282)_C34 G gene C/C-68.7%, and Trp/Trp- 75% genotype were the
most common. ADRB3(rs 4994)_Trp64 Arg gene Trp/ Arg -25% was the least common of
these genes, and the third genotype of PPARG2 (rs1801282)_C34 G gene G/G- was not
found at all.
Conclusions
When the overweight and obesity index of chronic kidney disease was 29, that is, the third
degree, the C/C genotype of the PPARG2 (rs1801282)_C34 G gene was found in the most
frequent cases - 78.6%. The first genotype of the PPAR G2 (rs1801282)_C34 G gene, the
C/G genotype, was found in the least frequent cases - 21.4%, among this gene. C/C- was
found in the most frequent cases - 78.6%, the third genotype, G/G- was not detected at all.
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