Abstract
The purpose of the study: to study the effect of bisoprolol and nebivolol on the spectrum of essential blood plasma AK in patients with concomitant diabetes mellitus (DM) type 2 in order to optimize drug treatment of this pathology in the future.Material and methods. The study involved 70 patients with NA with concomitant DM type 2, which was divided into two groups: group I (37 patients) as part of basic antianginal therapy received bisoprolol, group II (33 patients) received nebivolol. The control group (CG) consisted of 18 healthy individuals. All patients were tested for irreplaceable blood plasma AA by ion exchange liquid chromatography on an automatic analyzer AK T-339 produced by «Microtechna» (Czech Republic, Prague) at the Institute of Biochemistry named after OV Palladin NAMS of Ukraine. The following essential AAs were identified: arginine, valine, histidine, isoleucine, leucine, lysine, methionine, threonine, phenylalanine. Examination of patients was performed at the beginning of treatment and after 20 days. Results. It was determined that in patients with NA with concomitant DM type 2 under the influence of antianginal therapy in both groups significantly decreased the total amount of irreplaceable AA compared with control group, indicating an increase in intracellular metabolism as a compensatory response in coronary circulation. It should be noted that in patients of group II, in contrast to patients of group I, under the influence of treatment the level of histidine remained normal. The level of threonine significantly decreased compared to CG and the rate of patients in group I, the level of valine significantly increased compared to pre-treatment, the level of isoleucine significantly decreased compared with CG and with the rate of patients of group I. Importantly, ammonia levels returned to normal under the influence of basic therapy, which included nebivolol.Conclusion. The dynamics of changes in the levels of individual irreplaceable AA blood plasma, due to the mechanisms of their metabolic transformations in patients with NA with concomitant DM type 2 indicates greater effectiveness of nebivolol and the feasibility of its prescription іn complex of a basic antianginal therapy.
Highlights
Today, various links in the pathogenesis of atherosclerosis and coronary heart disease have been identified and substantia ted
In patients with NA with concomitant diabetes mellitus (DM) type 2 of both groups, the amount of essential AA in blood plasma decreased significantly compared with CG by 29.4 % and 28.5 %, respectively, and with a pre-treatment rate of 19.1 % and 21,2 %, respectively
In patients of group II, whose basic therapy included nebivolol, histidine remained at normal levels, which ensures the physiological course of transformations of this AA
Summary
Various links in the pathogenesis of atherosclerosis and coronary heart disease (dyslipidemia, endothelial dysfunction, impaired immunological status, exposure to infection, violation of the rheological properties of blood) have been identified and substantia ted. The study of amino acid balance (AА) disorders in blood plasma, as another possible pathogenetic link in the development of coronary heart disease, has attracted the attention of scientists and clinicians [5,6,7]. The authors guarantee absence of competing interests and their own financial interest when carrying out the research and writing the article. Клінічна ендокринологія on energy metabolism processes, as well as other possible ways of influence, which provide better adaptation of the heart to hypoxia, remain unexplored [9,10,11]
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