Indices Of Carbohydrate Metabolism Research Articles

Correction of carbohydrate metabolism by means of physical therapy of patients with metabolic syndrome

Purpose: to investigate the characteristics of carbohydrate metabolism indicators in patients with metabolic syndrome before the beginning of rehabilitation effects as well as to trace the dynamics of indicators in the process of application of our physical therapy comprehensive program. Material and methods. The survey involved 70 women with metabolic syndrome, who were divided into the main (MG) (35 women) and control (CG) (35 women) groups with the average age in the MG 31.49±0.71-year-olds, in the CG – 31,06±0,57 -year-old. In the main group, a physical therapy program was applied for patients with metabolic syndrome, which includes a hypo caloric diet with a hypolipidemic focus; therapeutic massage according to the method of P.B. Efimenko for patients alimentary-constitutional obesity; medical gymnastics using elements of sports-oriented aerobics and special physical exercises based on Pilates gymnastics using fitballs and expanders; morning hygienic gymnastics; limited walking in combination with breathing exercises, taking into account the activity of the autonomic nervous system. Result. As a result of a comprehensive and developed physical therapy program that was justified and applied for 4 months for patients with metabolic syndrome, the studied carbohydrate metabolism parameters changed significantly. Main group women showed significantly improved indicators of glycemia on empty stomach: from 8,85±1,54 to 5,98±0,81mmol / l, glycemia after eating: from 11,47±1,85 to 7,68±0,86mmol / l and reached the target levels of diabetes compensation and diagnostic criteria for the metabolic syndrome. Conclusions: physical exercises contribute to the improvement and normalization of carbohydrate metabolism. They restore adaptation to physical exertion and normalize the function of the cardiovascular system, motor activity and psychoemotional state as well.

HORMONAL AND VEGETATIVE FACTORS OF INSULIN RESISTANCE IN PATIENTS WITH HYPERTENSION

The combination of arterial hypertension (AH) and insulin resistance (IR) significantly increases the risk of cardiovascular complications. Research objective: Studying indices of carbohydrate metabolism, activity of renin-angiotensin-aldosterone system, calcium-regulating hormones, adrenal glucocorticoid function, the condition of the autonomic nervous system and their possible interrelation with hemodynamic parameters in AH patients with different insulin sensitivity. A comprehensive study of hormonal profile was held with use of radio immune method and that of central hemodynamics with use of echocardiography in 72 patients with arterial hypertension stage II, 1-2 degrees, male (mean age – 54.1±3.4 years), with a body mass index up to 30 kg / mІ and verified insulin resistance (IR), in 32 patients of which insulin resistance (IR) was revealed, and in 40 patients its absence was fixed. Insulin resistance was verified by the value of HOMA-IR in excess of 2,77. To assess the condition of the autonomic nervous system, studies of heart rate variability were performed. It is established that patients with hypertension with IR had increased level of plasma renin activity, levels of angiotensin II, cortisol, insulin, parathyroid hormone, decreased parasympathetic and increased sympathetic tonus. According to the results of factor analysis, AH with insulin resistance has a distinctive structure of neurohumoral regulation of the main indicators of central hemodynamics and interhormonal interactions; the direct regulatory effects of angiotensin II, insulin, progesterone, parathyroid hormone on the indicators of central hemodynamics, modulation of presorption action increases. The study not only revealed peculiarities of neurohumoral profiles in patients with hypertension depending on insulin resistance, but also determined distinctive features in structure of the regulatory process of central hemodynamics and interhormonal interactions. This should be taken into account when prescribing antihypertensive therapy.

Характеристика изменений показателей липидного и углеводного обменов у больных морбидным ожирением до и после оперативного лечения в зависимости от вида хирургического вмешательства

Актуальность. Ожирение — хроническое заболевание обмена веществ, которое прогрессирует при естественном течении, имеет определенный круг осложнений и высокую вероятность рецидива после окончания курса лечения. Связь ожирения с различными метаболическими нарушениями делает его одной из наиболее важных проблем здраво­охранения как для развитых стран, так и развивающихся стран. Цель: проанализировать динамику показателей липидного и углеводного обмена у больных с морбидным ожирением (МО) до и после билиопанкреатического шунтирования (БПШ) в модификации Hess — Marceau и продольной резекции желудка. Материалы и методы. Выборку исследования составили 82 пациента с МО и сопутствующим метаболическим синдромом (МС) в возрасте от 21 до 62 лет (средний возраст — 40,60 ± 1,09 года), которые были про­оперированы по данному поводу и находились в послеоперационном периоде под наблюдением в клинике «Гарвис», которая является базой кафедры хирургии 1 ГУ «Днепропетровская медицинская академия МЗ Украины», в течение от 2 до 3 и более лет после операции. Распределение больных по группам проводилось в зависимости от примененного способа хирургического лечения. І клиническую группу составили 30 (36,6 %) больных с БПШ в модификации Hess — Marceau; II группу — 52 (63,4 %) пациента с продольной резекцией желудка. У разного количества больных в обеих группах в течение срока наблюдения проводили определение характеристик липидного и углеводного обмена с применением общих практических и клинических методов. Оценку результатов снижения массы тела, изменения со стороны маркеров липидного и углеводного обмена проводили в динамике наблюдения — при первом визите на этапе предоперационной подготовки, через 3, 6, 12, 18, 24 и 36 месяцев после оперативного вмешательства. Результаты. Анализ динамики показателей МО после оперативного лечения показал общие тенденции к достоверному (от p < 0,01 до p < 0,001) уменьшению показателей массы тела и индекса массы тела (ИМТ) у пациентов всех клинических групп уже через 3 месяца от начала лечения. В I группе существенное снижение показателей происходило в течение 18 месяцев, а во II — в период 6–12 месяцев. Дислипидемические нарушения у больных с МО достоверно коррелировали с показателями избыточной массы тела с различной степенью достоверности (от р < 0,05 до р < 0,01). Результаты исследования показателей углеводного обмена накануне оперативного лечения свидетельствовали о наличии существенной взаимозависимости уровней С-пептида, инсулина и глюкозы в крови от ИМТ пациентов (от p < 0,01 до p < 0,001). В динамике исследования установлены тенденции к нормализации показателей липидного и углеводного обменов у пациентов обеих групп в течение 2 лет после бариатрического вмешательства с наибольшими изменениями в группе после БПШ уже после 3 и 6 месяцев. Выводы. Прямая корреляционная зависимость, установленная между показателями липидного и углеводного обменов с показателем ИМТ и избыточной массой, доказывала необходимость применения у этих больных оперативного лечения. Тенденции к нормализации показателей липидного и углеводного обменов у пациентов обеих групп в течение 2 лет после бариатрического вмешательства свидетельствовали о его эффективности.

Вплив метформіну на показники тиреоїдної панелі, вуглеводний та ліпідний обмін у хворих на дифузний токсичний зоб та інсулінорезистентність

Метою дослідження було вивчення впливу метформіну на показники тиреоїдних гормонів, вуглеводного та ліпідного обміну хворих з дифузним токсичним зобом та наявною інсулінорезистентністю. У статті наводяться результати дослідження, у якому взяв участь 21 хворий з дифузним токсичним зобом. Лікування проводили у два етапи по 3 місяці кожен. На першому етапі усі пацієнти отримували тиреостатичну терапію тирозолом, а на другому етапі з метою корекції інсулінорезистентності додатково було призначено метформін. Отримані результати свідчать на користь нормалізації індексу HOMA-IR за рахунок зниження рівня глюкози та інсуліну натще, а також деякого підвищення тиреотропного гормона та зниження вільного тироксину в межах референтних норм на тлі комбінованого лікування тирозолом з метформіном.

Фармакотерапевтична ефективність і переваги комбінованого лікування хворих на цукровий діабет 2-го типу

Актуальність. На сьогодні актуальне раннє призначення комбінації цукрознижувальних препаратів, які впливають на різні ланки патогенезу цукрового діабету (ЦД) 2-го типу. Метою дослідження було вивчення фармакотерапевтичної ефективності, безпеки й переносимості препарату Дуглимакс виробництва «Кусум Фарм» (Україна) в терапії хворих на ЦД 2-го типу. Матеріали та методи. Під спостереженням перебували 46 хворих на ЦД 2-го типу, які були розділені на дві групи. 26 пацієнтам, які до цього часу отримували препарати метформіну в дозі до 2000 мг/добу, був призначений комбінований препарат Дуглимакс (метформін 500 мг і глімепірид 2 мг), а також метформін пролонгованої дії (Метамін SR) у вечірній час. Пацієнти другої групи (n = 20) продовжували прийом метформіну пролонгованої дії двічі на день в дозі 2000–2500 мг/добу. Результати. Через 12 тижнів терапії у хворих першої групи рівень НbА1с вірогідно знизився до 6,72 ± 0,29 %. Рівень імунореактивності інсуліну становив після лікування в першій групі 14,06 ± 1,81 мкОд/мл (при початковому 19,17 ± 2,05 мкОд/мл), індекс HOMA-IR — 3,14 ± 0,21 (проти початкового 5,92 ± 1,46). При цьому не зареєстровано гіпоглікемічних станів у пацієнтів на тлі прийому Дуглимаксу впродовж періоду спостереження. Висновки. Призначення комбінованої протидіабетичної терапії препаратом Дуглимакс упродовж 12 тижнів призводить до вірогідного зниження рівня HbA1c і досягнення цільових показників вуглеводного обміну у 80,8 % хворих на ЦД 2-го типу. Відзначаються добра переносимість і високий ступінь безпеки додаткового призначення препарату Дуглимакс упродовж періоду спостереження.

Залежність літогенності жовчі від показників вуглеводного та ліпідного обмінів у хворих на цукровий діабет типу 2 із хронічним некалькульозним холециститом

Мета дослідження: виявити особливості зміни гомеостазу жовчі та основні каменеутворюючі субстрати при хронічному некалькульозному холециститі та цукровому діабеті (ЦД) типу 2. Матеріали та методи. Клінічне обстеження проведено в 60 осіб, хворих на ЦД типу 2 та хронічний некалькульозний холецистит, у 60 осіб, хворих на ізольований хронічний некалькульозний холецистит, та 20 практично здорових осіб. Проведено ретельне обстеження з використанням загальноприйнятих клінічних, лабораторних, біохімічних, інструментальних досліджень. Усім пацієнтам здійснено багатомоментне дуоденальне зондування. Визначено ліпідні спектри крові та міхурової порції жовчі. Результати. У хворих на хронічний некалькульозний холецистит, що перебігає на тлі ЦД типу 2, спостерігалися підвищення рівнів загальних ліпідів (у 1,61 раза в крові), холестеролу (у 2,04 раза у крові та 1,62 раза в жовчі), жовчних кислот (у 4,4 раза в крові) та зниження їх у жовчі (у 1,34 раза), тріацилгліцеролів (у 3,09 раза в крові), ліпопротеїнів низької щільності (у 1,2 раза в крові) і зниження вмісту ліпопротеїнів високої щільності (у 1,98 раза в крові) та фосфоліпідів (у 1,38 раза в крові та в 1,48 раза в жовчі), а також зниження двокомпонентних співвідношень «фосфоліпіди/холестерол» (у 1,8 раза) та «жовчні кислоти/холестерол» (у 1,9 раза), підвищення трикомпонентного індексу Ісаксона (у 1,85 раза), що свідчить про істотний дисбаланс ліпідного обміну як предиктора формування жовчних конкрементів у даної категорії хворих (р < 0,05). Висновки. У хворих на хронічний некалькульозний холецистит на тлі ЦД типу 2 спостерігаються вірогідно підвищені рівні загальних ліпідів, холестеролу, жовчних кислот, тріацилгліцеролів, ліпопротеїнів низької щільності на тлі зниження ліпопротеїнів високої щільності та фосфоліпідів у сироватці крові та жовчі. Встановлені кореляційні зв’язки між ліпідними спектрами сироватки крові та жовчі дають більш повну та детальну інформацію про порушення гомеостазу жовчі в різних групах пацієнтів. Основним каменеутворюючим субстратом в осіб першої групи виступав холестерол, а в осіб другої групи — знижений рівень ліпопротеїнів високої щільності.

Уровень витамина D и показатели углеводного обмена у женщин с синдромом поликистозных яичников

Актуальность. Синдром поликистозных яичников (СПКЯ) остается актуальной проблемой гинекологической эндокринологии, а его частота составляет примерно 11–17 % среди женщин репродуктивного возраста и достигает 75 % в структуре эндокринного бесплодия. Существуют доказательства, что витамин D влияет на обмен углеводов, а его недостаточность или дефицит повышают риск развития нарушения толерантности к глюкозе, инсулинорезистентности и сахарного диабета 2-го типа. Цель: определить связь между уровнем витамина D и показателями углеводного обмена у женщин с синдромом поликистозных яичников. Материалы и методы. Обследовано 60 женщин в возрасте от 19 до 26 лет: 30 женщин с диагнозом классического фенотипа СПКЯ; 30 здоровых женщин с нормальной менструальной и репродуктивной функцией. Исследовали содержание витамина D, секcстероид­связывающего глобулина (СССГ), иммунореактивного инсулина (ИРИ), индекс НОМА-IR, индекс массы тела (ИМТ), окружность талии/окружность бедер (ОТ/ОБ). В зависимости от концентрации витамина D обследованные были разделены на подгруппы: первая — 22 больные СПКЯ с витамином D ≤ 30 нг/мл (средний уровень — 12,9 ± 0,2 нг/мл); вторая — 8 больных с уровнем витамина D ≥ 30 нг/мл (31,4 ± 0,3 нг/мл); третья — 12 здоровых женщин с витамином D ≤ 30 нг/мл (24,2 ± 0,3 нг/мл); четвертая — 18 здоровых обследованных с уровнем витамина D ≥ 30 нг/мл (35,6 ± 0,3 нг/мл). Результаты. Установлено, что в общей группе пациенток с СПКЯ средний уровень витамина D (21,4 ± 0,4 нг/мл) был достоверно ниже (Р < 0,001) по сравнению с показателем группы здоровых женщин (29,6 ± 0,3 нг/мл). У больных с СПКЯ низкие концентрации витамина D сопровождались более высокими уровнями глюкозы (Р < 0,001), ИРИ (Р < 0,001), индекса НОМА-IR (Р < 0,001) и снижением СССГ (Р < 0,001). Установлена негативная ассоциативная связь витамина D с ИМТ (r = –0,399; Р < 0,05), ОТ/ОБ (r = –0,612; Р < 0,001), концентрацией ИРИ (r = –0,502; р < 0,001), показателем индекса НОМА-IR (r = –0,571; Р < 0,001), уровнем СССГ (r = –0,694; Р < 0,001). Выводы. Показана роль абдоминального ожирения в формировании дефицита витамина D, который усиливает нарушения углеводного обмена, а именно увеличивает гиперинсулинемию, инсулинорезистентность и снижает продукцию сексстероидсвязывающего глобулина у женщин с СПКЯ.

Prevalence of risk factors of cardiometabolic complications in latent autoimmune diabetes in adults

The aim of the study. To determine the prevalence of risk factors for cardiometabolic complications in latent autoimmune diabetes in adults compared to other types of diabetes depending on the phenotype of the disease.Materials and methods. A comprehensive examination of 106 patients with diabetes mellitus: 45 (main group) with latent autoimmune diabetes in adults (LADA), 26 - with type 1 diabetes mellitus (T1DM), 35 - with type 2 diabetes mellitus (T2DM). Complaints, anamnesis data, objective examination, results of general clinical, laboratory researches, indicators of carbohydrate metabolism, titers of antibodies to glutamic acid decarboxylase were evaluated.Results. The prevalence of metabolic syndrome (MS) in LADA was 51% and was significantly higher than in T1DM (19%), but was lower compared with T2DM (94%). The highest incidence of MS was found in patients with the LADA2 phenotype (87%). Of particular note is the fact that this figure was close to that in T2DM. At the same time in LADA1 the incidence of MS was lower (36%), but twice as high as in T1DM. In addition to hyperglycemia, abdominal obesity (62% of patients), hypertension (78%) and dyslipidemia (56%) were commonly reported in LADA.Conclusions. The prevalence of metabolic syndrome as a complex of cardiometabolic risk factors in LADA differs from that in classical types of diabetes, which requires a differential approach to their management.

Age-related changes in the parameters of carbohydrate metabolism and supply of vitamins B1, B2 in residents of two northern regions.

A great deal of research was being done in studying of the age-related characteristics of carbohydrate metabolism and the provision of vitamins B1, B2 among the population of the Subarctic (SR) and Arctic (AR) regions, differing in the extreme natural and climatic-geographic living conditions. The surveyed population was divided into five age groups: 16-21, 22-35, 36-45, 46-60 and 61-74 years old. The parameters of carbohydrate metabolism (glucose, lactate, pyruvate) were determined in the blood serum, the content of thiamine (thiamin diphosphate effect) and riboflavin - in hemolysates, and the values of the lactate/pyruvate ratio (Lac/Pyr) were calculated. Statistical data processing was performed by nonparametric methods. An increase in glucose levels was found in persons of older age groups. Age-related fluctuations of metabolites of carbohydrate metabolism were manifested by a lower content of lactate and the value of the Lac/Pyr ratio in persons aged 16-21 years. Regardless of the age and region of the survey, there were revealed high lactate concentrations, Lac/Pyr values and reduced pyruvate levels, as well as low glucose levels in group aged 16-21 year in AR. For vitamins B1, B2, no pronounced age-related changes were observed, while the content of riboflavin was higher in persons of SR. Moderate hypovitaminosis of thiamin was detected in 13-20,1% and 6,1-22,7% of cases in SR and AR, pronounced - 8,3-11,6% and 4,6-23,5%, respectively, vitamin B2 deficiency was noted in 19,4-23,9% of persons in the AR and in 33,8-42,9% of persons in the AR. Vitamins in both regions at different age periods contributed to the formation of levels of indicators of carbohydrate metabolism: glucose and pyruvate in SR, lactate in AR.

GCK-MODY diabetes course in persons over 18 years of age: prospective observation

Most young patients with hyperglycemia have type 1 diabetes and type 2 diabetes but up to 10% of all cases of the disease occur in MODY (Maturity Onset Diabetes of the Young). Published abstracts show features of the debut, laboratory and genetic characteristics of MODY in the Russian population. However there is a small amount of data on the clinical course of this nosology in the Russian Federation.Aim: To investigate the characteristics of the 3-year course of GCK-MODY diagnosed after 18 years.Materials and methods: 85 probands and 46 relatives of the first and second degrees of kinship with a clinical diagnosis of GCK-MODY were examined: biochemical and hormonal blood tests, ultrasound, molecular genetic studies. Patients were invited for a follow-up visit 3 years after verification of the pathogenic mutations associated with GCK-MODY. Examination, biochemical and hormonalanalyzes , ultrasound were done in second visit.Results: The diagnosis GCK-MODY was verified by a molecular genetic study in 25 probands (29.4%). In 33 of 46 (71.7%) relatives of patients with GCK-MODY were diagnosed identical mutations. In 31 patients with GCK-MODY diagnosed after 18 years, a dynamic observation was performed for three years. Most patients over 18 years of age did not have clinical manifestations of carbohydrate metabolism disorders when diagnosing GCK-MODY and follow up visit. Skin rashes and allergic reactions prevailed among concomitant pathologies. Patients with GCK-MODY had preserved β-cell secretion, HbA1c targets were achieved. Low fasting hyperglycemia prevailed which persisted even after treatment correction. Among the characteristics of carbohydrate metabolism, biochemical, lipid and hormonal parameters during GCK-MODY verification and after three years of observation no significant differences were obtained, which indicates a stable course of the disease. Half of the patients achieved normoglycemia by rational nutrition, two people with GCK-MODY within three years after determining the diagnosis were transferred from insulin therapy to oral glucose-lowering drugs. Among oral glucose-lowering drugs prior to GCK-MODY verification most patients used metformin, 3 years later — dipeptidyl peptidase-4 inhibitors.Conclusion. The results of a three-year follow-up of a group of patients with GCK-MODY demonstrate a non-progressive course of this type of diabetes with stable indicators of carbohydrate metabolism and low fasting hyperglycemia that persists after 3 years of observation. With the verification of GCK-MODY and the achievement of the target values of glycated hemoglobin and postprandial glycaemia by rational nutrition, even if a low level of fasting hyperglycemia is determined, the prescription of oral glucose-lowering drugs is not indicated in most cases.

EVALUATION OF INFLUENCE OF THE UNITED COMPLEX AND SURGICAL TREATMENT ON SOME INDEXES OF CARBOHYDRATE EXCHANGE FOR PATIENTS ON GENERALIZED PERIODONTITIS І-ІІ DEGREE OF DEVELOPMENT

The dynamics of the inflammatory process in the periodontium, its generalization and chronization are determined not only by the composition of the microflora, but also by the state of the protective reactions of the organism (the pro-atherogenic spectrum of lipids and the disturbance of the carbohydrate metabolism) and the reactivity of the immune system in response to the pathogenic factor.
 Purpose of the study. The study of changes in the parameters of carbohydrate metabolism in the oral fluid of patients with generalized periodontitis (GP), before and during the different terms after the complex and surgical treatment, was determined the relevance of the direction which was chosen by us.
 Materials and methods. Somatically healthy people were examined and treated: 30 patients with chronic generalized periodontitis – group І, 32 patients – with exacerbation of chronic generalized periodontitis – group II and 30 persons with a healthy parodontium. Indicators of carbohydrate metabolism were determined in the oral liquid: content of glucose, pyruvate (pyruvic acid) and lactate (lactic acid) and lactate dehydrogenase (LDG) activity before, immediately and after 6 and 12 months after the treatment. A significant increase of all studied by us carbohydrate metabolism parameters (p<0.001) was found, which confirms its imbalance. In order to regulate the revealed violations, initial periodontal therapy was prescribed; oral dishes with the solution of St. John’s wort, gum applications and application of the gel were developed by us on the basis of medicinal herbs (extract of Echinacea purpureum, tincture of Eleutherococcus and St. John’s wort) and sorbent, and inside – the herbal syrup “Immuno-tone” and surgical treatment.
 Conclusions. The regulation of the parameters of carbohydrate metabolism in the oral liquid of patients of groups I and II with the achievement of these standards, especially after 6 and 12 months after the treatment, showed the effectiveness of the developed by us therapeutic complex and surgical treatment allowed us to recommend it for the widespread introduction into practice.

Influence Of Different Hypoglycemic Therapy Schemes On Carbohydrate Exchange Indicators In Type 2 Diabetes Mellitus

Aim of the study: To study the effect of prescribing inhibitors of sodium glucose cotransporter type 2 (iSGLT-2) and inhibitors of dipeptidyl peptidase-4 (iDDP-4) on the parameters of carbohydrate metabolism in patients with type 2 diabetes. Materials and methods: A prospective study included 80 patients with type 2 diabetes. The average age was 52.7 ± 3.78 years; diabetes experience - 8 years; BMI-30 ± 0.17; Hb1C-9.2 ± 0.4%; fasting glycemia –10.2 mmol/; eGFR-78 ml/min; TG-2.7 ± 0.44; total cholesterol-3.4 ± 0.72; MAU 32 ± 0.125. The patients were divided into 2 groups: group 1 - 30 patients with DN with impaired renal function and 30 patients with diabetic nephropathy without renal dysfunction in the presence of metformin + iSGLT- 2; 2 group of 30 patients with impaired renal function and 30 patients with diabetic nephropathy without impaired renal function on the background of metformin + iDPP-4. Results: The study of the effect of the inclusion of drugs iSGLT-2 (group 1) and iDPP-4 (group 2) showed a positive dynamics of carbohydrate metabolism indicators in patients with type 2 diabetes. So if the initial indicators in the groups were comparable in terms of glycemic control indicators, then by the 3rd month of treatment there was a significant decrease in HbA1c in the 1st group of patients in relation to the 2nd group. The result of the correction performed within 3 months was the achievement of the state of compensation in the 1st group in 36.7%, and in the 2nd group in 28.3%, 48.3% of the patients of the 1st group were brought into the state of sub compensation and 31.7 % of patients of the 2nd group. Conclusion: On the combination of metformin and INGLT-2, a larger number of patients managed to achieve the set goals of therapy with a lower risk of overt hypoglycemia, then this combination should be considered not only more effective.

Gender differences in lipid metabolism

The search for early markers of atherosclerosis is an effective method for providing personalized medicine allowing the prevention of the progression of this pathology. The aim of this study was the determination of the total indices of dyslipidemia and the identification of the gender indices of the extended lipid profile in the population of residents of the Southern and Central Federal Districts (Voronezh, Belgorod, Lipetsk, Kursk and Rostov regions) for the identification of early markers of atherogenicity. In a simultaneous clinical study, involving 339 patients (mean age 48 years), the concentrations of total cholesterol, triglycerides, LDL (low density lipoproteins), HDL (high density lipoproteins), apolipoproteins B and A1, the ApoB/ApoA1 ratio and the atherogenic coefficient were determined. For the identification of the relationship between changes in lipid profile indicators with cytolysis syndrome and indicators of carbohydrate metabolism, the activity of ALAT (alanine aminotransferase), GGTP (gamma-glutamyl transpeptidase) and glucose contentwere also studied. Analysis of the results of the lipid spectrum of the population sample of the middle age group revealed significant metabolic disorders of lipid metabolism with a predominance of atherogenic lipid fractions and a significant excess of indicators of atherogenic lipid fractions in middle-aged men in comparison with women. It has been shown that the apoB/apoA1 index can be used as an auxiliary marker for early assessment of the prevalence of atherogenic lipid fractions, allowing the identification of risk groups for the development of diseases associated with metabolic disorders

Relationship between chronic hyperglycemia and contrast extravasation in revascularization of symptomatic intracranial atherosclerotic stenosis: A retrospective single-center study

Background and purposeContrast extravasation is one of the most common perioperative complications in symptomatic intracranial atherosclerotic stenosis (ICAS) patients after percutaneous transluminal angioplasty and/or stenting (PTAS). This study aimed to investigate the correlations between the relevant serum biochemical indicators of carbohydrate metabolism and the occurrence of contrast extravasation. MethodsPatients’ demographic characteristics, vascular risk factors and laboratory examination data were collected. Blood routine test, blood biochemical examination and hormone level test within 1 week before surgery were measured in all enrolled subjects. Patients underwent non-contrast CT scans immediately after the endovascular procedure. Follow-up non-contrast CT scans were performed in the next 24 h and repeated as per clinical condition. Results104 patients who have undergone effective PTAS were involved in this study. 18 patients have identified as contrast extravasation and there was no obvious abnormality in another 86 cases. There were significant differences in the pre-operative HbA1c, fasting blood sugar and cortisol levels in the subjects regardless of gender between two groups (p < 0.001, p < 0.001 and p = 0.001, respectively). Furthermore, there were statistical differences in E2 and testosterone levels between two groups in both male population (p = 0.035 and p = 0.028, respectively) and female population (p = 0.036 and p = 0.003, respectively). Besides, the AUC value of HbA1c, fasting blood sugar and cortisol levels were all over 0.7 (0.858, 0.780 and 0.752, respectively). The highest AUC value of various combinations was obtained from the combination of HbA1c and cortisol level, which was 0.898. ConclusionsPatient with chronic hyperglycemia is closely related to contrast extravasation after PTAS. Specific mechanisms might be explored and regarded as promising candidates to prevent contrast extravasation.

Seasonal variation of 25-Hydroxyvitamin D and indices of carbohydrate and lipid metabolism in postmenopausal women.

BackgroundSome studies indicate vitamin D’s significant contribution to metabolic processess. Therefore, the purpose of this study was to evaluate the level of carbohydrate and lipid metabolism indices in relation to seasonal changes in 25-hydroxyvitamin D (25(OH)D) concentration in postmenopausal women.MethodsSixteen postmenopausal women meeting health criteria and not using vitamin D supplementation were included in the study. Seasonal variation of somatic features and the serum concentration of 25(OH)D, glucose, insulin, parathormon, sclerostin and lipid profile were determined on two terms (autumn-winter).ResultsComparative analysis of the variables between the study terms revealed a marked decrease in the concentration of 25(OH)D (p ≤ 0.0001), insulin (p < 0.05), insulin resistance index (HOMA-IR), (p < 0.05). The significant positive correlations of changes (Δ) between autumn and winter in 25(OH)D with body mass (p < 0.05), and fat mass (p ≤ 0.01), measured in the first study term, in the group of women with normal body mass index (BMI), and negative correlation with fat mass (p < 0.05) in women with a BMI value above the reference values, were found. The relationship analysis showed that in women with normal BMI, the decrease in 25(OH)D concentrations was greater when the body fat percentage was higher, whereas in women with a BMI value above the reference values, the higher the fat percentage, the smaller was the decrease in 25(OH)D concentration.ConclusionsSeasonal changes in 25(OH)D concentration did not significantly affect the concentration of carbohydrate and lipid metabolism indices. The magnitude of decline in 25(OH)D levels depends on the fat mass. We suppose that environmental or lifestyle-related factors, e.g., nutritional behaviours, may have had more influence on metabolic indices than changes in 25(OH)D.

Адіпонутрін як маркер метаболічних порушень у пацієнтів на гіпертонічну хворобу з надмірною масою тіла та ожирінням

Hypertension is a leading risk factor for coronary heart disease, stroke, peripheral arterial disease, kidney disease, vascular cognitive impairment, and mortality worldwide. Obesity in combination with hypertension continues to attract considerable attention from scientists. Despite the presence of experimental and clinical evidence of mutual burdening of hypertension and obesity, the mechanisms of formation of pathophysiological consequences of such a combination remain insufficiently defined. That is why in recent years an important role is given to the adiponutrin protein. The purpose of the study is to assess the nature of the relationship between adiponutrin levels and lipid and carbohydrate metabolism depending on the duration and degree of hypertension and the degree of obesity in patients with this comorbid pathology. Material and methods. The study included 107 patients with hypertension who were hospitalized in the cardiology department of Municipal noncommercial enterprise "Kharkiv City Clinical Hospital No.27" of Kharkiv municipal council. The age of patients ranged from 32 to 79 years (mean age was 58.6±9.88), who had not previously received regular antihypertensive therapy. The control group consisted of 20 age- and sex-appropriate healthy individuals. The level of adiponutrin was determined in 58 patients with hypertension of the 1st - 3rd degrees, aged from 32 to 79 years (mean age was 57.5±10.11 years), while hypertension of the 1st degree was diagnosed in 12 (20.7%) patients, hypertension of the 2nd degree - in 16 (27.6%), and hypertension of the 3rd degree - in 30 (51.7%) of the examined patients. Blood pressure was measured in patients in a sitting position after 5 minutes of rest, anthropometric measurements were performed, lipid profile and indicators of carbohydrate metabolism were evaluated, adiponutrin levels (pg/mL) were determined by enzyme immunoassay method using The RayBio® Adiponutrin Enzyme Immunoassay (EIA) Kit, (USA). Results and discussion. In all groups of patients with hypertension with overweight and obesity, adiponutrin levels were significantly elevated, and lipid and carbohydrate profiles tended to increase. Significant direct correlations were found between adiponutrine and triglycerides, with very low-density lipoprotein cholesterol of a moderate nature, and draws attention with a very high body mass index. In considering the differences in adiponutrin levels depending on gender, it was found that men have higher adiponutrin levels than women. Conclusion. Thus, we have the opportunity to consider adiponutrin as a marker of metabolic disorders

Complex Effects of Round-The-Clock Light and High-Calorie Carbohydrate-Lipid Diet on Carbohydrate and Lipid Metabolism in Rats

Background. Experimental and clinical studies show that hypomelatoninemia is accompanied by alterations in carbohydrate and lipid metabolism, the development of systemic inflammatory response, hypertension, endothelial dysfunction and oxidative stress. The purpose of this study was to investigate complex effects of round-the-clock light and HCCLD on carbohydrate and lipid metabolism in rats. Materials and methods. The experiment was carried out on 28 male adult rats of Wistar line weighting 215-255 g. The animals were divided into 4 groups of 7 animals in each: control, exposed to the round-the-clock light (with an intensity of 1500 lx), kept on HCCLD (20 % fructose solution and the diet), and the mixed group exposed to the combined effect of the round-the-clock light and HCCLD. The experiment in the groups 2 and 4 lasted 60 days. We assessed the melatonin concentration, indices of carbohydrate and lipid metabolism. Results. The study has demonstrated that the combination of HCCLD and the round-the-clock light course reduces the melatonin concentration in the blood serum by 55.6 % compared with the results obtained in the animals exposed to the round-the clock light only. Herewith, the animals developed the insulin resistance, which was accompanied by more marked manifestations of its characteristic metabolic symptoms as hyperinsulinemia, dyslipoproteinemia, hypo-α-lipoproteinemia, hypertrialcylglycerolemia, and increased visceral fat mass in comparison with the animals kept on the HCCLD only. Conclusions. High-calorie carbohydrate-lipid diet through the period of the round-the-clock light exposure aggravates hypomelatoninemia, enhances insulin resistance, and lipid metabolism disorders.

Prescribing frequency and adherence to statins in outpatients with type 2 diabetes mellitus and comorbid cardiovascular diseases

BACKGROUND: Due to the high rate of growth in the incidence and burden of cardiovascular complications, type 2 diabetes mellitus (T2DM) is a significant medical problem in the world. Even in the absence of cardiovascular disease (CVD), patients with T2DM are classified as high and very high risk. In addition to glycemic control, an extremely important aspect of managing this group of patients is prevention of cardiovascular complications. T2DM and hyperlipidemia determines the target group for statins. At the same time, little is known about the frequency of administration of this class of drugs among people with T2DM.AIM: To study prescribing frequency and adherence to statins in outpatients with T2DM and comorbid cardiovascular diseases.METHODS: 156 patients with type 2 diabetes (87.2% — women, average age — 65.2 years) were examined as part of an outpatient appointment with an endocrinologist at the city polyclinic ofTomsk. We used a standard questionnaire compiled on the basis of adapted international methods, including information on cardiac pathology, medications, income level, and Morisky-Green test. Anthropometric parameters, fasting plasma glucose, glycated hemoglobin, lipid spectrum parameters were measured. Methods of parametric and nonparametric statistics were used for comparisons.RESULTS: Statins were prescribed to 45.0% of the surveyed, and 47.0% of them were constantly taking statins. In 41 and 39% of cases, statins were prescribed by an endocrinologist and a cardiologist, respectively. Those taking statins were characterized by a more severe functional class of angina pectoris (p=0.03), a higher prior myocardial infarction rate (p=0.01). For other concomitant diseases, and also indicators of carbohydrate metabolism, differences between the groups were not revealed. One third of patients were adherent (3–4 points), 2/3 were not adherent to treatment (0–2 points), respectively. Patients with incomes between 1 and 2 cost of living took statins more often than the rest (p=0.021).CONCLUSION: An insufficient frequency of prescription and adherence to statin therapy in patients with T2DM was revealed. In most cases, statins were prescribed by an endocrinologist or cardiologist. Functional class of angina pectoris, prior myocardial infarction and moderate income were associated with more frequent use of statins. To increase the coverage of patients with T2DM with statin treatment, more attention needs to be paid to the issues of CVD prevention from both medical professionals and patients.

Salivary Redox Biomarkers in Insulin Resistance: Preclinical Studies in an Animal Model.

Insulin resistance (IR) is a condition of impaired tissue response to insulin. Although there are many methods to diagnose IR, new biomarkers are still being sought for early and noninvasive diagnosis of the disease. Of particular interest in laboratory diagnostics is saliva collected in a stress-free, noninvasive, and straightforward manner. The purpose of the study was to evaluate the diagnostic utility of salivary redox biomarkers in preclinical studies in an animal model. The study was conducted on 20 male Wistar rats divided into two equal groups: a standard diet and a high-fat diet (HFD). In all rats fed the HFD, IR was confirmed by an elevated homeostasis model assessment (HOMA-IR) index. We have shown that IR is responsible for the depletion of the enzymatic (↓superoxide dismutase) and nonenzymatic (↓ascorbic acid, ↓reduced glutathione (GSH)) antioxidant barrier at both the central (serum/plasma) and salivary gland (saliva) levels. In IR rats, we also demonstrated significantly higher concentrations of protein/lipid oxidation (↑protein carbonyls, ↑4-hydroxynoneal (4-HNE)), glycation (↑advanced glycation end products), and nitration (↑3-nitrotyrosine) products in both saliva and blood plasma. Salivary nonenzymatic antioxidants and oxidative stress products generally correlate with their blood levels, while GSH and 4-HNE have the highest correlation coefficient. Salivary GSH and 4-HNE correlate with body weight and BMI and indices of carbohydrate metabolism (glucose, insulin, HOMA-IR) and proinflammatory adipokines (leptin, resistin, TNF-α). These biomarkers differentiate IR from healthy controls with very high sensitivity (100%) and specificity (100%). The high diagnostic utility of salivary GSH and 4-HNE is also confirmed by multivariate regression analysis. Summarizing, saliva can be used to assess the systemic antioxidant status and the intensity of systemic oxidative stress. Salivary GSH and 4-HNE may be potential biomarkers of IR progression. There is a need for human clinical trials to evaluate the diagnostic utility of salivary redox biomarkers in IR conditions.

Assessment of relationship of lipid and carbon profile indicators with vitamin D supply in children depending on body mass index

Overweight children represent a particularly vulnerable group for hypovitaminosis D. Clinical studies on the relationship between vitamin D (VD) deficiency and metabolic risk factors for cardiovascular disorders are controversial, and for children of primary school age who have overweight and obesity are insufficient. The aim of the research was to study the relationship between lipid and carbohydrate metabolism indicators and VD status in children, depending on the body mass index. Material and methods. A cross-sectional (one-step) study was carried out on a sample of 154 children with different weight of 8-10 years old (74 girls, 80 boys). Three groups of research participants were identified: group 1 - 44 obese, group 2 - 58 overweight, group 3 - 52 children with normal body weight. For all children, the serum level of 25(OH)D, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), ß-lipoproteins, glucose, insulin was determined, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was also calculated. Results. VD deficiency in obese children was found almost 2.3 fold more often than in overweight (p=0.002) and 2.8 fold more often than in children with normal body weight (p=0.001). Indicators of lipid and carbohydrate metabolism were within physiological limits. However, in obese children they significantly exceeded the indicator of healthy children (p<0.05). When comparing the results of biochemical studies, it was revealed that children with VD deficiency [25(OH)D <20 ng/ml] had statistically significantly higher medians of PTH, TC, TG, ALT, AST, glucose, insulin, HOMA-IR and lower P and Ca level compared with children with normal micronutrient blood content (p<0.05). The medians of ALT, AST, TC, ß-lipoproteins, TG, glucose, insulin and HOMA-IR levels in obese children with VD deficiency were statistically significantly higher than in children with normal body weight and VD deficiency and in healthy children with an optimal concentration of 25(OH)D. At the same time, there was no statistically significant difference between the indicators of lipid and carbohydrate metabolism in the group of healthy children with normal VD status and its deficiency. Conclusion. VD deficiency is an important predictor of obesity complications and it exacerbates the risk of cardiometabolic disorders in children who are obese in the early school years.