Carbohydrate Metabolism In Patients Research Articles

The features of correlations between gut microbiota and biochemical markers in patients with type 2 diabetes mellitus and thyroid dysfunction

The study aims to evaluate the correlations between gut microbiota and biochemical markers in patients with type 2 diabetes mellitus and thyroid dysfunction. The study included 82 patients with type 2 diabetes mellitus, obesity, and thyroid dysfunction. We performed various tests on the stool samples of the patients to analyze the composition of the gut microbiota and also measured several biochemical parameters related to carbohydrate, lipid, and thyroid metabolism, as well as insulin resistance. Statistical methods to compare and correlate the variables were used. A number of significant correlations were found between the gut microbiota and the biochemical markers in the patients. We observed that some bacteria and fungi, such as Bifidobacterium spp., Candida krusei, and Helicobacter pylori, were associated with thyroid parameters, such as TSH, fT4, and TRAb. It was also detected that some bacteria, such as Actinobacteria, Enterococcus spp., Shigella spp., and Salmonella spp., were related to carbohydrate metabolism parameters, such as glucose, HbA1c, and HOMA-IR. As a conclusion, the gut microbiota may impact the functioning of the thyroid gland and the carbohydrate metabolism in patients with type 2 diabetes mellitus and thyroid dysfunction. We suggest that further studies are needed to explore the mechanisms and implications of these interactions, and to evaluate the potential of modulating the gut microbiota as a therapeutic strategy.

Functional state of the kidneys in patients with acute coronary syndrome against the background of newly identified disorders of carbohydrate metabolism: a multidisciplinary problem

ABSTRACT Background Determining the relationship between cardiovascular risks, carbohydrate metabolism disorders, and renal dysfunction can help in creating new tools for their management and for better interaction of specialists in a multidisciplinary team. The purpose of this study was to determine the functional state of the kidneys and carbohydrate metabolism in patients with acute coronary syndrome without a history of such disorders. Methods 200 patients of the cardiology department of the City Clinical Hospital No. 7 in Almaty were examined using laboratory diagnostics and subsequent statistical data processing. Results Acute coronary syndrome develops in 63% of cases against the background of previous disorders of carbohydrate metabolism – prediabetes (45.5%) and type 2 diabetes mellitus (17.5%). In this group of patients, in the presence of disorders of carbohydrate metabolism, in all cases, it is accompanied by acute renal damage. It was noted that diabetes mellitus in newly diagnosed patients actually had a certain duration and occurred much earlier than cardiovascular complications – this was evidenced by an increased level of glycated hemoglobin. Conclusions Such results indicate the need for early diagnosis of cardio-reno-metabolic syndrome in patients with cardiovascular complications, as well as timely administration of drugs that simultaneously have antidiabetic, cardio- and nephroprotective effects.

Indices of carbohydrate metabolism in patients during the acute period of covid-19

Indices of carbohydrate metabolism in patients during the acute period of covid-19

THE VALUE OF HOLTER MONITORING AND THE LEVEL OF SYSTEMIC INFLAMMATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE COMBINED WITH TYPE 2 DIABETES, DEPENDING ON THE NUMBER OF AFFECTED CORONARY ARTERIES

Diabetes mellitus (DM) is one of the significant medical and social problems of modern society, which is due to high morbidity and prevalence, frequent occurrence of chronic micro- and macrovascular complications. Coronary heart disease (CHD) in patients with type 2 diabetes is 2-4 times more common than in people of the same age without diabetes [1]. In the absence of apparent signs of atherosclerosis, the risk of developing coronary artery disease in the next 10 years is 30% [2]. To date, the course and prognosis of this group of patients have not been sufficiently studied, objective clinical and diagnostic criteria for the development of complications of myocardial infarction have not been developed, and the problem of choosing pathogenetically based methods of treatment of CHD in combination with type 2 diabetes remains unresolved [3].The aim of the work was to investigate the informativeness of Holter monitoring (HM), the correlation of HM indicators, C-reactive protein (CRP) and carbohydrate metabolism in patients with stable coronary heart disease (CHD) in combination with type 2 diabetes for the prognosis of the course of this pathology, timely individual treatment and prevention occurrence of endpoints.Material and methods. The study involved 95 patients with coronary heart disease with angina pectoris functional class (FC) III and heart failure (HF FC III with a preserved left ventricular ejection fraction (LVEF); of them, 60 patients had concomitant type 2 DM in the compensation stage.Results. In patients with comorbidity (a combination CHD and type 2 diabetes), episodes of ST depression/elevation, tachycardia, and extrasystoles were more often registered in patients with multivessel lesions of CA (р<0.05), according to HM; the content of CRP in blood serum increased in proportion to the severity of the course of the disease, which depended on the number of affected CA.Conclusions. The nature and severity of the course of CHD correlate with comorbid pathology and the number of CAs affected by atherosclerosis. In the case of multivessel damage, according to the data of clinical, functional and laboratory research, an aggressive progression of cardiac pathology was noted.

Carbohydrate metabolism in patients with erysipelas

Objective. To determine the frequency of erysipelas and the frequency of carbohydrate metabolism disorders in patients of the purulent–septic centre in Zaporizhzhya.
 Materials and methods. We analysed 15 612 case histories of patients with purulent–septic diseases treated at the purulent–septic centre in Zaporizhzhia in 2003–2023.
 Results. It was found that 359 (2.3%) patients had erysipelas inflammation in the setting of type 1 or type 2 diabetes mellitus. Destructive forms of erysipelas were recorded in 315 (87.7%) patients, in 30 (9.5%) of them the disease was complicated by sepsis. In uncomplicated forms of erysipelas, diabetes mellitus was observed in 29 (65.9%) patients, and in destructive forms – in 246 (78.1%).
 Conclusions. Patients with diabetes mellitus have a significantly higher risk of developing septic complications than patients without carbohydrate metabolism disorders.

Effect of renal replacement therapy on glycaemic variability and indices of carbohydrate metabolism in patients with diabetes mellitus

Background. Patients with diabetes mellitus (DM) on renal replacement therapy (RRT) have high glycaemia variability (GV), the severity of which may depend on the dialysis method.The aim: To study GV in patients with type 1 diabetes and type 2 diabetes (on baseline-bolus insulin therapy) receiving RRT with programmed hemodialysis (PHD) and continuous ambulatory peritoneal dialysis (CAPD).Patients and Methods: Twenty-seven patients with terminal chronic renal failure and DM receiving RRT from July 2022 to March 2023 were studied. Patients underwent flash glucose monitoring (FGM) using FreeStyle Librе portable system with further evaluation of GV parameters and indices, median days of measurement – 14.Results. In the total group, 7 patients (23,3 %) had TIR > 70 %, mean TIR value was 56,3 %±22,0 %, 66,7 % of patients had CV > 36 %, mean CV value was 38,5 %±9,6 %. All indices of GV (MAGE, LBGI, HBGI, M-value, J-index, Conga, LI) exceeded the reference values. When comparing GV indices in patients on PHD and CAPD, it was revealed that LBGI in PHD group was 10,1±5,71 vs CAPD – 5,58±4,22, p=0,025. The critical point of glucose reduction on PHD was the fourth hour from the beginning of the procedure (57.1 % of patients had glycemia < 3.9 mmol/l). Higher median glucose values were found in the first three days of FGM compared to the last three days in both PHD group (p=0.002) and CAPD group (p=0.022).Conclusions. Patients with diabetes on RRT have high GV, low percentage of achieving TIR due to high risk of hypoglycemic conditions in patients on PHD. The critical point of glycaemia reduction is fourth hour after the start of the PHD session. Patients on CAPD have a lower risk of hypoglycemia. FGM improves glycaemic control.

Post-COVID syndrome: status of carbohydrate metabolism in patients with hypertension and stable ischemic heart disease

Background. Post-COVID syndrome is associated with a wide range of chronic symptoms or conditions. Coronavirus di­sease 2019 (COVID-19) causes metabolic disorders such as hyperglycemia, insulin resistance. Insulin-like growth factor 1 (IGF-1) is associated with an impaired glucose tolerance and a higher risk of developing type 2 diabetes. Currently, the study of molecules regulating carbohydrate metabolism as potential biomarkers of post-COVID syndrome and targets for therapeutic influence is relevant. The purpose of the study was to assess the level of IGF-1 and its relationship with regulation of carbohydrate metabolism, as well as the dynamics of the evaluated indicators under the influence of drug treatment in patients with hypertension and stable coronary heart disease who suffered from COVID-19. Materials and methods. Fifty-five patients who had a mild and moderate COVID-19 were included in the study; their average age was 55.87 [40; 75] years. The results of routine laboratory tests were registered and analyzed. The content of insulin and IGF-1 was assessed by enzyme immunoassay. The HOMA-IR was calculated. Results. In patients with a mode­rate COVID-19 compared to those with a mild one, a significant decrease in the level of IGF-1 (р = 0.008) was found against the background of increased reference values of glucose, insulin, and HOMA-IR (р < 0.01). The influence of the degree of hypertension on the IGF-1 level was revealed (р = 0.004). An inverse relationship between IGF-1 and glucose level was noted (r = –0.28, p = 0.034). The use of meldonium contributed to a significant decrease in glucose and insulin content (p < 0.001), and an increase in IGF-1. Against the background of taking meldonium, the dynamics of the shift towards a decrease in the HOMA-IR was more significant. Conclusions. An inverse relationship was found between IGF-1 and blood glucose, regardless of the level of insulin and HOMA-IR, in patients with hypertension and stable ischemic heart disease in the post-COVID period. Meldonium has been shown to improve carbohydrate metabolism by normalizing insulin levels and redu­cing the phenomena of insulin resistance as a potential drug target. Meldonium improved the clinical course of ischemic heart disease and demonstrated good tolerability and safety.

Effect of various pharmacotherapy regimens on the state of carbohydrate metabolism in patients with urination disorders

Aim. To evaluate the efficacy and safety of various pharmacotherapy regimens in patients with urination disorders and type 2 diabetes mellitus during their preparation for surgery.Materials and methods. In total, 130 people (56 men and 74 women) aged from 18 to 81 years (average 65 years) were included in the research. All the patients were on standardized hypoglycemic therapy in combination with alpha1-blockers (doxazosin, terazosin) and vitamin-like drugs (alpha-lipoic acid, levocarnitine). Patients were divided into male and female subgroups, as well as into age subgroups, including under 65 years and over 65 years. Tabular methods of assessing the clinical symptoms of urinary disorders were used, along with instrumental, laboratory, and statistical methods (Mann-Whitney test, Spearman rank correlation coefficient).Results. The duration of therapy averaged 16± 2 months. The observation found that alpha1-blockers lead to a number of positive changes in the composition of carbohydrate metabolism, i.e., the level of serum glucose and insulin. In the general observation group, a significant decrease in blood glucose from 6.64 to 6.27 mmol/L, insulin from 18.07 to 14.03 mU/mL, and C-peptide from 3.67 to 2.98 ng/mL was detected. In the male subgroup, glucose levels decreased from 6.45 to 6.00 mmol/L, insulin from 18.92 to 13.99 mU/mL, and C-peptide from 3.76 to 2.97 ng/mL. In the female subgroup, blood glucose levels decreased from 6.98 to 6.77 mmol/L, insulin from 16.41 to 14.1 mU/mL, and C-peptide from 3.51 to 2.99 ng/mL. In the group of patients younger than 65 years of age, a decrease in glucose from 6.22 to 5.93 mmol/L, insulin from 17.87 to 14.36 mU/mL, and C-peptide from 3.49 to 3.01 ng/mL were also observed. In the group of patients older than 65 years of age, similar dynamics of the above parameters was established.Conclusions. The data obtained suggest that alpha1-blockers in combination with vitamin-like drugs contribute to reducing the level of serum glucose, insulin, and C-peptide during a long-term (at least 1 year) therapy, which may be promising in the correction of metabolic disorders during preparation of patients for surgery.

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

Features of compensation of carbohydrate metabolism in patients with type 2 diabetes mellitus hospitalized with coronavirus infection

Features of compensation of carbohydrate metabolism in patients with type 2 diabetes mellitus hospitalized with coronavirus infection

Особливості ліпідного та вуглеводного обмінів у пацієнтів з гастроезофагеальною рефлюксною хворобою на тлі цукрового діабету 2-го типу залежно від наявності ожиріння

Особливості ліпідного та вуглеводного обмінів у пацієнтів з гастроезофагеальною рефлюксною хворобою на тлі цукрового діабету 2-го типу залежно від наявності ожиріння

The relationship between zonulin level and indicators of carbohydrate metabolism in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

The relationship between zonulin level and indicators of carbohydrate metabolism in patients with metabolic-associated fatty liver disease combined with type 2 diabetes mellitus

Long-term outcomes of renal denervation in the treatment of comorbid patients with hypertension, diabetes and coronary atherosclerosis

Aim. To study the clinical effects and long-term outcomes of catheterbased renal denervation (CRD) in patients with cardiovascular disease and diabetes.Material and methods. This single-center prospective observational study included 60 patients with uncontrolled hypertension, type 2 diabetes, and coronary artery disease after complete endovascular revascularization. Patients were divided into 30 groups into the CRD group and the control group. CRD was performed via femoral access using a Spyral catheter (Medtronic, USA). The primary endpoint was the change in glycemic levels after 12 months.Results. In the CRD group, a significant decrease in basal glycemia level from 9,3 (7,67-10,12) to 6,05 (5,2-8,3) mmol/l, glycated hemoglobin from 7,6 (6,98,4) to 6,6 (6,2-7,2)%, Homeostasis Model Assessment Insulin Resistance (HOMA-IR) from 6,6 (3,73-11,2) to 4,76 (2,73-7,1) — in the absence of significant changes in the control group. A significant decrease in the average level of office systolic (-14 (-24; -10) mm Hg, p=0,0002) and diastolic blood pressure (-10 (-10; -6) mm Hg, p=0,0002), p=0,0007) was also revealed — in the absence of significant changes in the control group. There were no significant differences in late lumen loss between the groups: 21,8% (17,3-28,8) in the CRD group vs 26,3% (19,5-34,0) in the control group (p=0,09).Conclusion. A positive effect of CRD on carbohydrate metabolism in patients with type 2 diabetes, hypertension and coronary artery disease was revealed. The hypothesis of the pleiotropic effects of CRD was confirmed.

Targeted metabolomics reveals the aberrant energy status in diabetic peripheral neuropathy and the neuroprotective mechanism of traditional Chinese medicine JinMaiTong

Diabetic peripheral neuropathy (DPN) is a common and devastating complication of diabetes, for which effective therapies are currently lacking. Disturbed energy status plays a crucial role in DPN pathogenesis. However, the integrated profile of energy metabolism, especially the central carbohydrate metabolism, remains unclear in DPN. Here, we developed a metabolomics approach by targeting 56 metabolites using high-performance ion chromatography-tandem mass spectrometry (HPIC-MS/MS) to illustrate the integrative characteristics of central carbohydrate metabolism in patients with DPN and streptozotocin-induced DPN rats. Furthermore, JinMaiTong (JMT), a traditional Chinese medicine (TCM) formula, was found to be effective for DPN, improving the peripheral neurological function and alleviating the neuropathology of DPN rats even after demyelination and axonal degeneration. JMT ameliorated DPN by regulating the aberrant energy balance and mitochondrial functions, including excessive glycolysis restoration, tricarboxylic acid cycle improvement, and increased adenosine triphosphate (ATP) generation. Bioenergetic profile was aberrant in cultured rat Schwann cells under high-glucose conditions, which was remarkably corrected by JMT treatment. In-vivo and in-vitro studies revealed that these effects of JMT were mainly attributed to the activation of adenosine monophosphate (AMP)-activated protein kinase (AMPK) and downstream peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). Our results expand the therapeutic framework for DPN and suggest the integrative modulation of energy metabolism using TCMs, such as JMT, as an effective strategy for its treatment.

Results of a 12-month follow-up of patients with type 2 diabetes mellitus after hospitalization with COVID-19: gliclazide MR use in the hospital and metabolic status at the posthospital stage

BACKGROUND: The role of antidiabetic drugs in inpatient with COVID-19 and type 2 diabetes mellitus (T2DM) is usually considered in the context of target glycemiа maintaining. Except for insulin therapy sulfonylurea may be used in moderate COVID-19. The use of original gliclazide MR has advantages due to low risk of hypoglycemia and established cardio- and nephroprotective effects. But it is not clear whether the choice of antidiabetic drugs during hospitalization may affect patient’s condition in post-COVID period.AIM:. To assess the 12-month dynamics of carbohydrate metabolism in patients with T2DM after hospitalization for COVID-19 considering the character of hypoglycemic therapy in the hospital and the use of gliclazide MRMATERIALS AND METHODS: A 12-month prospective study was performed; T2DM patients were observed after hospitalization for COVID-19. They received in hospital: 1) original gliclazide MR (Diabeton MR, n=20) and 2) insulin (control group, n=20). Changes in antidiabetic therapy, glycemic control and biochemical tests were assessed at baseline and after 3, 6, 12 months. RESULTS: In the main and control groups the intensification of T2DM therapy was observed: the proportion of patients without hypoglycemic drugs decreased within a year by 3.0 (p = 0.001) and 2.8 (p =0.010) times respectively. Mean HbA1c values,the dynamics of inflammation markers and transaminases in both groups were similar (p>0.05 at all visits). Blood creatinine was at baseline 82.9±18.67 and 120.9±45.52 µmol/l (p=0.010), after 3 months — 88.0±18.77 and 104, 5±17.99 µmol/l (p=0.024), after 6 months — 89.3±12.17 and 97.5±9.03 µmol/l (p=0.072), after 12 months — 86.7±10.50 and 93.9±16.76 µmol/l (p=0.16). According to the data obtained during «3 months» visit, the dose of original gliclazide MR was directly correlated with the improvement in renal function in terms of glomerular filtration rateGFR (R=0,59, р=0,010). In addition, there was a close-to-significance correlation between continued gliclazide MR at visit 3 and improvement in GFR at visit 6 (R=0.31, p=0.076).CONCLUSION: The post-hospital period in patients with COVID-19 and T2DM was characterized by a tendency to hyperglycemia and increased need for hypoglycemic therapy. The use of original gliclazide MR by in patients with moderate COVID-19 and T2DM is appropriate and safe in terms of clinical and metabolic parameters dynamics during long-term post-hospital follow-up. When original gliclazide MR is continued during the post-hospital period its nephroprotective properties may contribute to the process of renal functions normalization which should be confirmed by further research.

The efficacy of L-carnitine in patients with nonalcoholic steatohepatitis and concomitant obesity

BackgroundIn light of the high prevalence of nonalcoholic fatty liver disease and obesity, treatment options for nonalcoholic steatohepatitis are of particular interest. The purpose of the study is to assess the efficacy of L-carnitine and its effects on the functional state of the liver, as well as on lipid and carbohydrate metabolism in patients with nonalcoholic steatohepatitis and concomitant obesity.MethodsPeople in the control group followed a hypocaloric diet and received 1 tablet of simvastatin 20 mg once a day and 2 capsules of essential phospholipids 600 mg three times a day for 90 days. People in the experimental group followed a hypocaloric diet and received 1 tablet of simvastatin 20 mg once a day and L-carnitine 10 mL orally two times a day for 90 days.ResultsL-carnitine normalized the blood lipid profile of subjects, as demonstrated by a significant decrease in the blood levels of total cholesterol, triglycerides, low-density lipoproteins, atherogenic index, and insulin resistance. The use of L-carnitine in patients with nonalcoholic steatohepatitis and concomitant obesity contributes to the steady reduction of the main clinical and biochemical symptoms of nonalcoholic steatohepatitis.ConclusionsL-carnitine produces positive effects on the blood lipid profile and carbohydrate metabolism.

Effect of newly detected hyperglycemia on the course of coronary heart disease

Mechanisms and causes of hyperglycemia (HG) during coronary heart disease (CHD), particularly in its unstable forms, remain not fully investigated. The study aimed to determine the effect of newly detected HG on the course of CHD and examine the features of carbohydrate metabolism in patients with CHD. The study was conducted in Moscow (Russia) in 2018-2021. A total of<b> </b>139 patients with CHD aged 43 to 79 years were examined. All participants were divided into comparison groups, including 34 patients with average glucose levels, 28 patients with fasting HG, 46 patients with impaired glucose tolerance (IGT), and 31 patients with newly diagnosed type 2 diabetes. The range of laboratory examinations included general clinical tests of blood and urine, determination of blood urea, creatinine, C-reactive protein, bilirubin and its fractions, the activity of hepatic transaminases, the study of carbohydrate metabolism, lipidogram, ionogram, and coagulogram. First-time diagnosed HG was a fairly frequent diagnosis in CHD patients (in 105 (75.5%) of 139 patients examined). IGT and type 2 diabetes mellitus recently detected in CHD patients have common disease-causing factors: insulin resistance, lipid metabolism disorders, and sympathetic nervous system activation against the background of reduced parasympathetic effects. All of this should be considered in developing treatment regimens for CHD patients and controlling risk factors.

Оценка макулярного кровотока с помощью оптической когерентной томографии-ангиографии у беременных женщин, страдающих сахарным диабетом

Purpose. To study retinal blood flow in pregnant women with disorders of carbohydrate metabolism using optical coherence tomography angiography (OCTA) in order to determine the criteria for the manifestation and progression of diabetic retinopathy (DR). Material and methods. 203 pregnant women in the third trimester were examined: 24 – with type 1 and 2 diabetes (T1D and T2D), 143 – with gestational diabetes (GD), and 36 apparently healthy women with physiological pregnancy, who consisted the control group. OCTA imaging was performed using the RTVue XR Avanti OCT 6 mm × 6 mm «Angio Retina» scan protocols (Optovue, USA). The whole image vessel density (wiVD), foveal vessel density (FVD), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. FVD in pregnant women with diabetes was significantly less than in pregnant women with GD and in the control group. In this connection, it can be assume changes of the retinal microvascular regulation, due to chronic disorders of carbohydrate metabolism in patients with diabetes, and development of microangiopathy. Enlargement of FAZ area and decrease of wiVD were revealed in patients with DR, relative to datas obtained in the group of pregnant women with diabetes and absence of DR, in the absence of differences in FVD indexes. In 2 patients with T1D and the absence of ophthalmoscopic signs of DR, OCTA revealed areas of nonperfusion in the posterior pole of the eye. Conclusion. OCTA helps to identify areas of retinal nonperfusion in the posterior pole of the eye in pregnant women with diabetes in the absence of ophthalmoscopic signs of DR and allows determining objective indications for timely retinal laser coagulation. Keywords: optical coherence tomography angiography, pregnancy, diabetic retinopathy, gestational diabetes, foveal avascular zone, retinal blood flow

Changes in metabolic parameters in ischemic heart disease against the background of metabolic syndrome

For many years, and to this day, cardiovascular disease has been and remains the leading cause of death worldwide. Cardiovascular diseases mainly affect people in countries with middle and low living standards.
 The aim of the study was to find out the peculiarities of lipid, carbohydrate, and hormonal changes in patients with coronary heart disease against the background of metabolic syndrome.
 Materials and methods: 120 patients with verified coronary heart disease were examined, including 60 patients with coronary heart disease without metabolic syndrome and 60 patients with coronary heart disease with metabolic syndrome. The control group consisted of 30 practically healthy individuals of appropriate age and sex. The content of HbA1c, glucositol C-peptide, triacylglycerols, total cholesterol, leptin, HDL-cholesterol, and LDL-cholesterol in blood serum was determined by modern methods.
 Results: The analysis of the results of laboratory tests of patients' blood revealed more pronounced changes in carbohydrate and lipid metabolism in patients with coronary artery disease against the background of metabolic syndrome, which indicates the severity of the clinical course in such patients. The results obtained indicate that in coronary heart disease with metabolic syndrome, there are more pronounced dysmetabolic changes: hyperleptinemia, glucosemia, elevated HbA1c, and decreased C-peptide content. Studies have shown that obesity is accompanied by high levels of leptin, which exacerbates insulin resistance and is a trigger for the development of coronary heart disease.
 Conclusions: 1. Leptin resistance is a potential cause of insulin resistance and, consequently, obesity, which ultimately leads to metabolic syndrome and the development of coronary heart disease. The data obtained indicate a greater tendency to obesity in women with coronary heart disease complicated by metabolic syndrome.
 
 The data obtained may indicate a latent disorder of carbohydrate metabolism in patients with coronary artery disease without metabolic syndrome.
 The detected deviations in lipid metabolism indicate the presence of type II dyslipoproteinemia in patients of group 1 and type IV dyslipoproteinemia in patients of group 2

Результаты изучения ретинального кровотока у беременных с сахарным диабетом с помощью оптической когерентной томографии-ангиографии

Purpose. To study retinal blood flow in pregnant women with disorders of carbohydrate metabolism using optical coherence tomography angiography (OCTA). Material and methods. 203 pregnant women in the third trimester of pregnancy were examined: 24 — with type 1 and 2 diabetes (T1D and T2D), 143 — with gestational diabetes (GD), and 36 healthy women with physiological pregnancy, who consisted the control group. OCTA imaging was performed using the RTVue XR Avanti OCT 6 mm × 6 mm «Angio Retina» scan protocols (Optovue, USA). The vascular density (VD), vascular density in the fovea (VDF), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. Among studied patients no significant differences in VD and in FAZ area were found. VDF in pregnant women with diabetes was significantly less than in pregnant women with GD and in the control group. There were no significant differences in the studied parameters in groups with different periods of GD manifestation. In pregnant women with diabetes with presence and absence of DR, retinal blood flow did not differ significantly. Given the absence of differences of studied parameters in pregnant women with diabetes without DR and with DR, it can be assumed that the retinal microvascular regulation changes due to chronic disorders of carbohydrate metabolism in patients with diabetes and the development of microangiopathy. In 2 patients with T1D and the absence of ophthalmoscopic signs of DR, OCTA revealed areas of nonperfusion in the posterior pole of the eye. Conclusion. OCTA helps to identify areas of retinal nonperfusion in the posterior pole of the eye in pregnant women with diabetes in the absence of ophthalmoscopic signs of DR. Keywords: optical coherence tomography angiography, pregnancy, diabetic retinopathy, retinal blood flow