Amylin and parameters of carbohydrate and lipid metabolism in patients with type 2 diabetes mellitus in the Azerbaijani population

Background: Hyperferritinemia associated with obesity and insulin resistance is a link between the components of the metabolic syndrome and a possible triggering factor in the pathogenesis of carbohydrate metabolism disorders and dyslipidemia.Aim: To establish possible relationships between ferrokinetic parameters, parameters of lipid and carbohydrate metabolism in overweight and obese patients, and to analyze the possibility of using iron metabolism parameters (ferritin and serum iron) as predictors of carbohydrate metabolism disorders in this cohort of patients.Material and Methods. The study included 52 overweight or obese patients. In the course of the study, patients were stratified into groups depending on the presence of carbohydrate metabolism disorders (CMD), and depending on the state of iron metabolism. Among all patients included in the study, an assessment of anthropometric data, a study of glycated hemoglobin, a standard glucose tolerance test with 75 g of glucose, a study of hematological parameters, as well as biochemical parameters of iron metabolism – the concentration of serum iron, transferrin and ferritin, was carried out.Results. Patients with CMD – impaired glucose tolerance or impaired fasting glycaemia – had significantly higher serum ferritin levels than obese patients without CMD (p = 0.019). In persons with a high level of ferritin, CMD developed significantly more often than in patients with a ferritin content in the range below the 75th percentile (χ2 = 5.278, p = 0.022). According to the ROC analysis, ferritin showed a rather high sensitivity – 75%, and specificity – 84.4% at a diagnostic threshold of 126.65 ng/ml (area under the curve = 0.738; p = 0.016) in the diagnosis of prediabetes (IGT/IFG) in overweight and obese individuals.Conclusion. High concentrations of iron and ferritin are positively associated with CMD, with ferritin being a promising predictor of prediabetes and type 2 diabetes mellitus.

202-LB: Effect of Testosterone Deficiency on Lipid Metabolism and the Severity of Type 2 Diabetes Mellitus Complications in Men

Obesity and type 2 diabetes mellitus (T2DM) are global epidemics at the present time, being a serious public health issue. An increased prevalence in the number of obese people promotes a risk for developing cardiovascular diseases (CVD) and some types of cancer. The ErbB signaling pathway plays a significant role in development of the disorders associated with metabolic dysfunction (e.g., T2DM, obesity, arterial hypertension). Neuregulin 4 (NRG4) is a new adipokine with similar effects to adiponectin. Interaction between the ErbB3, ErbB4 receptors and their ligand, NRG4, launches the processes required to maintain the energy balance in the cells. There are controversial literature data on NRG4 levels in blood circulation. In particular, the existing data concerning functions / mechanism of NRG4 action has been obtained in experimental animals and cell lines, which is not always reproducible in humans. According to some works, liver may be the key target organ for NRG4. The present article is devoted to assessment of relationships between the NRG4 level in blood, and the parameters of carbohydrate and lipid metabolism, as well as presence of diseases associated with obesity. The study included obese patients with and without type 2 diabetes. The content of NRG4, indices of carbohydrate and lipid metabolism in the blood was assessed by means of enzyme immunoassay and biochemical techniques, respectively. It was found that the level of NRG4 was increased in obese patients with T2DM compared with healthy donors, and obese patients without T2DM. Statistical evaluation by correlation and regression analysis revealed numerous relationships between NRG4 and the parameters of lipid and carbohydrate metabolism, as well as some correlations between the NRG4 levels and clinical disorders associated with obesity (type 2 diabetes and arterial hypertension). Thus, NRG4 may be involved into the development of dyslipidemia in obese patients. We consider an increase of blood NRG4 levels in obese patients with type 2 diabetes as a compensatory response to the increased insulin-mediated lipogenesis. The data obtained are important in search for new points of influence upon pathogenesis of diseases associated with metabolic disorders. Neuroregulin 4 and its receptors may be promising targets for the treatment of socially significant clinical disorders.

Background: Patients with primary hyperparathyroidism (PHPT) have increased mortality risk predominantly attributed to cardiovascular disease. Taking the risk factors for cardiovascular disease into account, such as overweight, atherogenic dyslipidaemia, carbohydrate metabolism disorders and insulin resistance (IR), investigation on the the study of the state of carbohydrate and lipid metabolism in patients with PHPT will help to shed light on the pathogenic mechanisms of the disease and, perhaps, to complement the algorithm for selecting treatment strategies for patients with PHPT.
 Aims: To study the prevalence of carbohydrate and lipid metabolism disorders among patients with PHPT and to identify the relationship between these two disorders with the indicators of mineral metabolism.
 Materials and methods: A case-control study of a total of age-matched 256 female patients, 220 patients with PHPT and 36 healthy individuals. The group patients with PHPT were sub-divided into two groups, symptomatic and mild form of PHPT. To verify the form of PHPT, ultrasound examinations of the parathyroid glands and kidneys, two-energy x-ray absorptiometry, biochemical studies (concentration of total and ionised calcium, serum phosphorus and the activity of alkaline phosphatase) and assessment of parathyroid hormone concentration were performed. The relationship between form of PHPT and body weight were evaluated retrospectively according to the survey. Among the 109 participants with PHPT (symptomatic PHPT: 82 patients; mild PHPT: 27 patients) and healthy individuals, the biochemical and hormonal parameters of fat (lipid spectrum of blood) and carbohydrate metabolism (content of immunoreactive insulin, HOMA index, presence of fasting glycemia disorder, glucose tolerance disorders and type 2 diabetes mellitus) were evaluated.
 Results: The symptomatic PHPT was associated with low body mass index (BMI) while the mild PHPT with high BMI. During an oral glucose tolerance test, the postprandial glycemia in symptomatic PHPT was significantly higher than that in mild PHPT (p = 0.036). The content of immunoreactive insulin in the symptomatic PHPT was not correlated with the concentration of parathyroid hormone, but positively correlated with the concentration of ionised calcium in the blood (r = 0.31; p = 0.006). Patients with PHPT showed a direct positive correlation between BMI and IR index (r = 0.67; p 0.001). It is shown that patients with PHPT have increased LDL content in the blood, and the actual blood lipid concentration is associated with the state of kidney function.
 Conclusions: The obtained data confirm the relationship between phosphoruscalcium metabolism disorders in PHPT and carbohydrate and lipid metabolism disorders. Prospective, controlled studies are warranted to better elucidate the causal relationships of mineral, carbohydrate and fat metabolism disorders in PHPT.

BackgroundHypoxic and hypobaric conditions may augment the beneficial influence of training on cardiovascular risk factors. This pilot study aimed to explore for effects of a two-week hiking vacation at moderate versus low altitude on adipokines and parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome.MethodsFourteen subjects (mean age: 55.8 years, range: 39 – 69) with metabolic syndrome participated in a 2-week structured training program (3 hours of guided daily hiking 4 times a week, training intensity at 55-65% of individual maximal heart rate; total training time, 24 hours). Participants were divided for residence and training into two groups, one at moderate altitude (1,900 m; n = 8), and the other at low altitude (300 m; n = 6). Anthropometric, cardiovascular and metabolic parameters were measured before and after the training period.ResultsIn study participants, training overall reduced circulating levels of total cholesterol (p = 0.024), low-density lipoprotein cholesterol (p = 0.025) and adiponectin (p < 0.001). In the group training at moderate altitude (n = 8), lowering effects on circulating levels were significant not only for total cholesterol, low-density-lipoprotein cholesterol and adiponectin (all, p < 0.05) but also for triglycerides (p = 0.025) and leptin (p = 0.015), whereas in the low altitude group (n = 6), none of the lipid parameters was significantly changed (each p > 0.05). Hiking-induced relative changes of triglyceride levels were positively associated with reductions in leptin levels (p = 0.006). As compared to 300 m altitude, training at 1,900 m showed borderline significant differences in the pre-post mean reduction rates of triglyceride (p = 0.050) and leptin levels (p = 0.093).ConclusionsPreliminary data on patients with metabolic syndrome suggest that a 2-week hiking vacation at moderate altitude may be more beneficial for adipokines and parameters of lipid metabolism than training at low altitude. In order to draw firm conclusions regarding better corrections of dyslipidemia and metabolic syndrome by physical exercise under mild hypobaric and hypoxic conditions, a sufficiently powered randomized clinical trial appears warranted.Trial registrationClinicalTrials.gov ID NCT02013947 (first received November 6, 2013).

Objective — to study the role of α‑lipoic acid (ALA) in the treatment of patients with gastroesophageal reflux disease (GERD) in combination with type 2 diabetes mellitus (T2DM).&#x0D; Materials and methods. The study involved 120 subjects, who were divided into four groups: 1st group included 60 patients with GERD against the background of T2DM, 2nd group consisted of 20 patients with GERD and 3rd group included 20 patients with isolated T2DM. Additionally, the 1st group was divided into 2 subgroups: 25 patients receiving standard treatment and 29 patients receiving standard treatment + ALA supplementation. The control group consisted of 20 practically healthy age‑matching subjects. Ghrelin and leptin levels were determined by enzyme‑linked immunosorbent assay (ELISA) on the analyzer «Labline‑90» (Austria).&#x0D; Results. The comparison of the standard treatment regimen and proposed treatment demonstrated significantly lower frequency of such symptoms as epigastric pain, regurgitation and symptoms, specific for ischemic heart disease, in the subgroup with the proposed treatment regimen (p &lt;0.05). Investigation of carbohydrate and lipid metabolism in a subgroup of patients receiving standard treatment, showed improvements in all parameters, but significant (p &lt;0.05) improvement in patients on the standard therapy was recorded in glucose, insulin, glycosylated hemoglobin (HbA1C) levels, and insulin resistance index (HOMA‑IR). In the subgroup receiving ALA, improvement was gained in the indices of glucose, glycosylated hemoglobin, HOMA‑IR, triglycerides, cholesterol, high and very low‑density lipoproteins and atherogenicity coefficient. After the treatment in the subgroups of standard therapy and therapy with the ALA addition, an increase in ghrelin levels was registered from 0.99±0.41 to 1.09±0.45 ng/ml and from 0.93±0.52 to 1.22±0.59 ng/ml, respectively, and decrease in leptin levels from 19.04±9.48 to 16.66±7.14 ng/ml and from 20.75±9.09 to 16.39±6.88 ng/ml. However, in the first subgroup, the difference between the indicators before and after treatment did not reach the level of statistical significance (p=0.421 and p=0.320, respectively), while in the subgroup where ALA was used, the difference was significant (p &lt;0.05).&#x0D; Conclusions. It has been established that ALA positively influences on the state of carbohydrate and lipid metabolism, improving these parameters. The addition of ALA to the standard treatment for GERD against the background of type 2 diabetes showed significant improvement in the studied parameters. Since reference values for ghrelin and leptin levels have not been established yet, it can be assumed that increase in ghrelin and decrease in leptin levels against the background of decrease in well‑studied parameters of lipid and carbohydrate metabolism, have a positive impact on the clinical manifestation of GERD against T2DM background. This assumption may be used as a marker for effective treatment of GERD in combination with T2DM.&#x0D;

Aim. To study the effect of forced treadmill exercise on lipid and carbohydrate metabolism parameters in liver and skeletal muscle tissues of mice with a model of type 2 diabetes mellitus, taking into account age and biological rhythm characteristics.Materials and methods. To create a model of type 2 diabetes mellitus (T2DM), a high-fat diet was used. Physical activity in the form of forced treadmill exercise was carried out for 4 weeks. Parameters of lipid and carbohydrate metabolism in muscle and liver tissues were determined by Western blotting.Results. A decrease in glycogen content in the muscles in T2DM was associated with activation of its breakdown rather than with its reduced synthesis. Significant and multidirectional changes were recorded in the content of glycogen phosphorylase in the liver and skeletal muscle tissues. These changes were significantly influenced by both the nature of diet and physical activity. The development of T2DM in mice was accompanied by a decrease in high-density lipoprotein (HDL) content in the liver along with an increase in low-density lipoprotein (LDL) and very-low-density lipoprotein (VLDL) levels. It is worth noting that physical activity provided partial normalization of the ratio of lipid fractions, despite the fact that the exercises were performed in the context of a high-fat diet. In the T2DM group, metabolic changes caused by both T2DM modeling and physical exercises were not only quantitative, but in some cases also qualitative. The effects of physical exercises performed at different times of the day on metabolic processes in the liver and muscle tissues varied significantly.Conclusion. Physical activity can help prevent not only metabolic disorders (obesity and insulin resistance), but also associated complications on the part of the liver and cardiovascular system.

Was studied the relationship between the parameters of carbohydrate and lipid metabolism, body mass index, HOMA-IR index and leptin concentration in patients with diabetes mellitus type 2 diabetes mellitus with normal motor-evacuation function of the stomach and gastroparesis (groups 1 and 2), as well as a comparison group with functional dyspepsia (Group 3). In patients with a high leptin content of 52.34 ± 4.31 ng / ml, according to the results of gastric ultrasound, there were signs of diabetic gastroparesis, predominantly moderate and severe (64.3%). Analysis of factors affecting the concentration of leptin among the studied groups showed the relationship of this hormone with BMI, insulin resistance, HOMA-IR index, and lipid metabolism disorders. In patients with diabetes mellitus type 2 and a BMI above 30.0 kg / m2, there was a significant (p &lt;0.05) gastric motility disorders and hyperleptinemia when compared with patients of the first group without gastroparesis, who showed a statistically insignificant (p&gt; 0.05) increase in leptin. The results of this study indicate a high content of leptin in the blood serum of patients with diabetic gastroparesis associated with a slowdown in metabolism due to gastric motility disorders, carbohydrate and lipid metabolism disorders and is a reliable diagnostic marker of the development and progression of complications in patients with type 2 diabetes mellitus.

Objective — to analyze the effects of the proposed therapy regimen with the use of alpha‑lipoic acid on the dynamics of the adipokines’ levels: vaspin, TNF‑a, parameters of carbohydrate and lipid metabolism and the thickness of the intima‑media complex of the common carotid artery in patients with type 2 diabetes mellitus and chronic pancreatitis.Materials and methods. The investigation involved 60 patients (38 women and 22 men, aged 53 to 61 years, the mean age 56.7 years) with type 2 diabetes mellitus combined with chronic pancreatitis. The parameters of lipid and carbohydrate metabolism, the functional state of the pancreas, levels of c‑reactive protein and adipocytokines — vaspin and tumor necrosis factor‑a, have been evaluated. The condition of the wall of the common carotid artery was assessed by the ultrasound method. All parameters were assessed twice, before and after completion of the therapy (after 3 months), which included hypoglycemic and hypolipidemic therapy and an alpha‑lipoic acid. All drugs were used at an individually adjusted dosage, except for alpha‑lipoic acid, which was administered at a dose of 600 mg per day for 3 months.Results. Against the therapy background, the positive dynamics of the main parameters of carbohydrate and lipid metabolism and the main laboratory indices of pancreas execratory dysfunction has been established. In patients administered alpha‑lipoic acid, the significant increase in the vaspin levels and decrease in TNF‑a levels have been revealed, as well the improvement of parameters of functional pancreas state. In patients with and without atherosclerotic plague who were taken alpha‑lipoic acid, a tendency was established towards a decrease in the thickness of the IMC CA (1.17 ± 0.09 mm vs 1.11 ± 0.08 mm) and (1.26 ± 0, 08 vs 1.22 ± 0.05 mm), respectively.Conclusions. The effects of the proposed treatment scheme with the use of alpha‑lipoic acid have been established in terms of activation of the compensatory mechanisms of the reduction in the levels of insulin resistance, TNF‑a, activity of inflammatory process and improvement of sensibilization to the endogenous insulin resulting from the increased vaspin levels.

The purpose of the study was to analyze the association of gene polymorphisms of leptin, adiponectin, tumor necrosis factor alpha (TNF-α), insulin-induced gene, and the parameters of carbohydrate and lipid metabolism, level of C-reactive protein (CRP) in patients with type 2 diabetes mellitus (T2DM) with anthropometric data. A total of 95 patients with T2DM of Azerbaijan population. The average age at the time of the survey was 50,4±0,51 years. Duration of the disease was 5,8±1,5 years. We found that patients with T2DM and obesity in the Azerbaijan population have most common polymorphism of insulin-induced gene in the homozygous form (GG), a mutant version of the gene in heterozygous form of leptin, adiponectin gene mutant variant in homozygous form and the normal version of the gene TNF-α in homozygous form. In 47.3% of cases there was a high level of CRP, a linear body mass index with normal homozygous GG allele of the TNF-a gene , insulin-induced gene, and a mutant version of the adiponectin and leptin genes.

Although Hepatitis C virus (HCV) infection has become a curable disease, the aftermath of the infection remains an important aspect to be evaluated. HCV infection is well known for its extrahepatic manifestations, mostly the tight relationship between HCV, type 2 diabetes mellitus (T2DM) and dyslipidemia. Not only HCV increases the risk of T2DM, but it also affects its control in diabetic patients, increasing the risk of diabetes related complications. Furthermore, HCV hijacks the lipid metabolism resulting in abnormalities in circulating lipids which can lead to multiple complications, such as increased atherosclerotic risk and hepatic steatosis. Objectives. The aim of this study was to evaluate the dynamics of the parameters of carbohydrate and lipid metabolism in HCV-infected diabetic patients compared to non-diabetic patients after viral eradication. Material and methods. This is a prospective study conducted on 100 patients with chronic HVC infection who obtained viral clearance after interferon-free treatment. 58 patients had type 2 diabetes mellitus and 42 were non-diabetic. We evaluated serum total cholesterol, triglycerides, blood glucose and glycosylated hemoglobin in both groups at treatment initiation and 1 year after. Continuous variables were expressed as mean values ± standard deviation or median, categorical variables were represented as relative or absolute frequencies. Characteristics were compared using the Mann-Whitney method or the two-sample Student's T-test method for continuous variables, Chi-square and Fischer's test for categorical variables. A p value &lt; 0.05 was considered statistically significant. Outcomes. The study analyzed and compared lipid and glycemic profiles of diabetic and non-diabetic HVC patients before and after viral cure. Conclusions. 1 year after treatment initiation the changes in lipid metabolism seem to persist, carbohydrate metabolism seems to remain unchanged, with no differences between diabetic and non-diabetic patients.

Aims. To assess plasma level of N-terminal precursor for brain natriuretic peptide (proBNP) in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension without overt heart failure ? and further estimation of its correlation with data from echocardiog- raphy and clinical parameters (severity of ischemic heart disease (IHD), age, sex, duration of T2DM and hypertension experience, characteristics of glucose and lipid metabolism, renal function. Materials and methods. We examined 94 patients with T2DM and arterial hypertension (aged 40?65 years), determining character- istics of glucose and lipid metabolism and renal function. We also performed six minute walk test, ECG, echocardiography and blood tests for N-terminal proBNP (NT-proBNP) in all study subjects. Acquired data was compared to the group of 30 healthy controls. Results. We observed an increase in plasma NT-proBNP in patients with IHD, history of left venctricular (LV) myocardial infarction or clinical signs of heart failure (II NYHA class and higher). Results from patients with T2DM and arterial hypertension but without IHD did not significantly differ from control group. Plasma NT-proBNP levels correlated with left ventricular ejection fraction, left ventricular EDD and ESD, but not with LV diastolic function parameters. Duration of T2DM and arterial hypertension, HbA1c levels,27Сахар ный диабет КардиологияСахарный диабет. 2013;(1):27?32BMI, lipid and uric acid metabolism parameters had no influence on plasma NT-proBNP in diabetic patients. Conclusion. According to our study, NT-proBNP was elevated in T2DM patients with IHD (and a history of LV myocardial infarc- tion in particular) or clinical evidence for heart failure beyond II NYHA class, thus indicating unfavorable prognosis for this group of patients and need for correction of therapy with subsequent re-evaluation of plasma NT-proBNP.

The aim of the study was to assess the impact of manual lymphatic drainage (MLD) on the parameters of carbohydrate metabolism, lipid metabolism and the level of selected adipokines and cytokines in people with abnormal body mass index (BMI). In addition, an attempt was made to assess the optimal cut-off values of serum concentrations of the biochemical parameters studied in identifying the risk of obesity and insulin resistance (IR). The study included 60 subjects who underwent 10 and 30 min long MLD sessions three times a week. The study group included 15 patients with a normal body mass index (group I; n = 15), overweight patients (group II; n = 15) and obese patients (group III; n = 10). The control group was IV; n = 20 subjects not undergoing MLD. Biochemical tests were carried out on all subjects at stage 0' (before MLD therapy) and at stage 1' (one month after MLD therapy). In the control group, the time between the sample collection at stage 0' and stage 1' was the same as in the study group. Our results showed that 10 MLD sessions may have a positive effect on the selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR values in normal weight and overweight patients. In addition, in the study group, the highest AUCROC values in identifying the risk of obesity were found for leptin (AUCROC = 82.79%; cut-off = 17.7 ng/mL; p = 0.00004), insulin (AUCROC = 81.51%; cut-off = 9.5 µIU/mL; p = 0.00009) and C-peptide (AUCROC = 80.68%; cut-off = 2.3 ng/mL; p = 0.0001) concentrations as well as for HOMA-IR values (AUCROC = 79.97%; cut-off = 1.8; p = 0.0002). When considering the risk of IR, we observed the highest diagnostic value for insulin (AUCROC = 93.05%; cut-off = 1.8 ng/mL; p = 0.053), which was followed by C-peptide (AUCROC = 89.35%; cut-off = 17.7 ng/mL; p = 0.000001), leptin (AUCROC = 79.76%; cut-off = 17.6 ng/mL; p = 0.0002) and total cholesterol (AUCROC = 77.31%; cut-off = 198 mg/dL; p = 0.0008). Our results indicate that MLD may have a positive effect on selected biochemical parameters, including insulin, 2h-PG, leptin and HOMA-IR, in normal weight and overweight patients. In addition, we successfully established optimal cut-off values for leptin in the assessment of obesity and insulin in the assessment of insulin resistance in patients with abnormal body mass index. Based on our findings, we hypothesize that MLD, when combined with caloric restriction and physical activity, may serve as an effective preventive intervention against the development of obesity and insulin resistance.

Effect of testosterone on lipid metabolism and endothelium in men with type 2 diabetes mellitus and hypogonadism

Heart and metabolic diseases are very common in society today. There are many special features in their manifestation that have influence on prognosis and therapy approaches. Among them are gender characteristics. The aim of the research was to determine the gender peculiarities of disorders of lipid metabolism in patients with coronary heart disease and type 2 diabetes mellitus (T2DM). The study of the blood lipid spectrum in patients with coronary heart disease and T2DM was conducted in 72 patients aged 37 to 85 years old. The patients with coronary heart disease were divided into 2 groups depending on the presence or absence of T2DM: 1 group (n = 40) – patients with coronary heart disease only (Stable Angina Pectoris); group 2 (n = 32) – patients with coronary heart disease and T2DM. Each group was divided into subgroups depending on the gender of the patients: 1A and 2A – males, 1B and 2B – females. Despite the presence of T2DM, a majority of patients with coronary heart disease were overweight and obese. At the same time, obesity was more common in the female subgroups (1B – 45.0%, 2B – 64.7%) than in the male subgroups (1A – 35.0% and 2A – 33.3% respectively). There was an increase in the levels of total cholesterol, triglycerides and low-density lipoproteins for impaired lipid metabolism in patients with coronary heart disease. There was a slightly higher level of total cholesterol (6.12 ± 2.06 mmol/L) and low-density lipoproteins (4.24 ± 1.79 mmol/L) and a lower level of triglycerides (1.63 ± 0.65 mmol/L) in females than in males (5.15 ± 1.29, 3.71 ± 1.14 and 2.40 ± 1.06 mmol/l, respectively). Disruption of lipid metabolism was characterized predominantly by an increase in levels of triglycerides and low-density lipoproteins in blood in patients with coronary heart disease and T2DM regardless of gender. About a quarter of males (25.0% with coronary heart disease and 26.7% with coronary heart disease with T2DM) and females with T2DM (23.5%) reached the target total cholesterol level (&lt;4.0 mmol/L), less frequently females with coronary heart disease (15.0%). The incidence of low-density lipoproteins target (&lt;1.8 mmol/L) was significantly lower than total cholesterol: about 5.0% in males (regardless of the presence of T2DM) and 10.0% in females with coronary heart disease. Women with coronary heart disease and T2DM did not reach the target low-density lipoproteins level (&lt;1.8 mmol/L). In most patients with coronary heart disease dyslipidemia grade II by Fredrickson was observed regardless of the presence of T2DM: in 100% of patients with coronary heart disease and 81.1% of patients with coronary heart disease and T2DM. A distinctive feature of impaired lipid metabolism in patients with coronary heart disease and T2DM is the presence in some of patients of Dyslipidemia grade IV by Fredrickson (6.7% of males and 5.9% of females) and the absence of Dyslipidemia class IIa in males in this group. Analysis of the achievement of the target levels of total cholesterol and low-density lipoproteins indicates insufficient prescribing of adequate hypolipidemic therapy for patients with coronary heart disease and T2DM.