Indices Of Carbohydrate Metabolism Research Articles

Sleep disorders and diabetes mellitus. Literature review and own data

The article presents analysis of current research on sleep disorders in patients with type 2 diabetes mellitus (T2DM). The mechanisms underlying the relationship between insomnia and glycemic control are complex, as both DM can cause sleep disorders and insomnia can worsen the course of diabetes. It is well known that both short (< 6 hours) and long (> 8 hours) sleep durations are associated with an elevated risk of diabetes development. The reported prevalence of sleep disorders in diabetes patients ranges between 28.0% and 59.1%. Our investigation performed in Lviv with the use of Pittsburgh Sleep Quality Index (PSQI) questionnaire, identified that 46.2% of T2DM patients experienced sleep disorders. A comprehensive literature review also unveils association between DM and diverse sleep disorders such as insomnia, circadian rhythm disturbances, obstructive sleep apnea (OSA), and restless legs syndrome (RLS). The article furnishes insights into the classification, diagnostic principles, and treatment modalities for these disorders. Referral of patients to sleep specialists for the management of sleep disorders and the integration of sleep hygiene into diabetes care can effectively mitigate symptoms, forestall DM complications, and enhance patients’ quality of life. Circadian molecules like nobiletin, REV‑ERB agonists, and CRY stabilizers have demonstrated efficacy in preclinical studies and hold potential for the development of novel treatments for conditions associated with circadian dysregulation. Considering the frequency of detection of sleep disorders in T2DM patients according to the modern literary sources and own research, the study of this problem is important for the development of an algorithm for the examination of such patients, namely the need for endocrinologists to pay attention to the sleep status of patients and, if necessary, to refer them to somnologists. Further investigation into the etiology of sleep disorders in T2DM patients and their correlation with carbohydrate metabolism indicators exhibits promise. It is imperative to explore avenues to address these causes by complementing the primary therapy for T2DM.

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

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.

CORRELATIONS OF INDICATORS OF THE IMMUNE SYSTEM, CARBOHYDRATE AND LIPID METABOLISM IN DIABETIC RETINOPATHY IN PATIENTS WITH DECOMPENSATED DIABETES DIABETES

Introduction. Pathogenetic mechanisms of the development of diabetic retinopathy are related to the toxic effect of hyperglycemia on the development of oxidative stress with subsequent activation of stress-sensitive systems
 The aim of the study. To find out the presence of correlations in patients with diabetic retinopathy against the background of decompensated diabetes
 Research methods. A clinical and laboratory examination of 70 diabetic retinopathy patients with decompensated diabetes mellitus was carried out. In order to identify correlations, the coefficient of linear correlation |r| was determined between all studied indicators
 Results and discussion. The analysis of these correlations indicates the formation of a block of strong correlations of peripheral blood leukocytes (except lymphocytes) and natural killers with indicators of lipid metabolism and pro-inflammatory cytokines.
 Strong correlations of T-lymphocyte subpopulations with indicators of carbohydrate metabolism and non-atherogenic fraction of lipoproteins were revealed.
 In the analysis of the correlations of the B-link of immunity, a positive strong correlation of the relative content of B-lymphocytes (CD19+) with CIC (r = 0.96, p < 0.05) was revealed, which indicates the dependence of the occurrence of type III hypersensitivity reactions with indicators of humoral immunity.
 Probable positive correlations of pro-inflammatory cytokines with atherogenic fractions of lipids and glucose, negative correlation of TNF-α with the acute phase marker C-peptide were revealed
 Conclusions. When analyzing the correlations of the studied indicators in patients with decompensated diabetes, 13 probable strong positive and 9 probable strong negative correlations were established).
 The increase in the pro-inflammatory component is manifested in the correlations of peripheral blood leukocytes (except lymphocytes) and natural killers with indicators of lipid metabolism and pro-inflammatory cytokines, strong correlations of T-lymphocyte subpopulations with indicators of carbohydrate metabolism and the non-atherogenic fraction of lipoproteins, type III hypersensitivity reactions with indicators of humoral immunity , pro-inflammatory cytokines with atherogenic fractions of lipids and glucose, negative relationship of TNF-α with acute phase marker C-peptide

PECULIARITIES OF CARBOHYDRATE METABOLISM INDICATORS, THE FUNCTIONAL STATE OF THE THYROID GLAND IN THE COURSE TREATMENT WITH TELMISARTAN AS PART OF THE COMPLEX THERAPY OF PATIENTS WITH CORONARY ARTERY DISEASE, TYPE 2 DIABETES MELLITUS ON THE BASIS OF METAB

Aim. Is to study the characteristics of carbohydrate metabolism indicators, the functional state of the thyroid gland in the course treatment with Telmisartan as a part of the complex therapy of patients with Coronary Artery Disease, type 2 Diabetes Mellitus on the basis of Metabolic Syndrome.
 Materials and Methods. Research design. The first stage - formation of groups (the experimental group and the comparison group). The experimental group consisting of 27 patients (13 men and 14 women), taking Telmisartan 80 mg/day as a part of complex therapy (Metformin, Amlodipine, Rosuvastatin, Acetylsalicylic acid, and Nitroglycerin as needed). The comparison group consisting of 24 patients (12 men and 12 women) taking Ramipril, 5 mg/day in addition to the standard therapy, mentioned above. At the second stage, the patients were examined for carbohydrate metabolism and Thyroid-stimulating hormone and free Thyroxine. At the third stage, patients were prescribed the treatment for 1 month. The dose of metformin did not change during the study. Re-examination of hormones and carbohydrate metabolism parameters one month after the start of therapy was carried out at the fourth stage. The control group consisted of 40 practically healthy people (17 men and 23 women). The work involved researching the carbohydrate spectrum parameters as well as the followings hormones: free Thyroxine and Thyroid-stimulating hormone, control of blood pressure parameters. The Patients were examined twice, on the day of admission to inpatient treatment and after 1 month. According to the results of the obtained data, the studied groups were compared with each other, as well as with a group of healthy individuals.
 Results and Discussion. The study compared the dynamics of blood pressure parameters, indicators of carbohydrate metabolism, Thyroid-stimulating hormone and Free thyroxine in patients with Coronary Artery Disease and compensated type 2 Diabetes Mellitus on the basis of Metabolic Syndrome, depending on their intake of Telmisartan or Ramipril against the background of standard therapy, which included: Metformin, Amlodipine, Acetylsalicylic acid. In the group taking Telmisartan as part of complex treatment, a decrease in clinical manifestations of syntropic pathology was found, and the presence of positive dynamics of diastolic blood pressure indicators was noted even after 1 month of treatment. Patients experienced a decrease in the frequency of angina attacks, reduced shortness of breath, palpitations during exercise, headaches, dizziness, anxiety, improved attention and memory. The results of our study show taking Telmisartan as a part of complex therapy contributed to changes in the parameters of carbohydrate metabolism such as fasting blood glucose, insulin level, HOMA-IR index decreased significantly, which can be explained by a decrease in insulin resistance at addition Telmisartan to the complex treatment. In contrast to the mentioned above parameters, indicators of glycosylated hemoglobin after 1 month treatment did not change significantly, which can be explained by the insufficient duration of treatment. In the patients of the experimental group, it was found that the level of Thyroid-stimulating hormone significantly decreased during treatment with Telmisartan as part of complex therapy, in contrast to the comparison group, taking Ramipril at the same time. The level of free Thyroxine in patients with experimental group increased a month after start of therapy, while it remained unchanged in patients with comparison group.
 Conclusions. The effectiveness of correction of diastolic blood pressure parameters, the presence of peculiarities of changes in carbohydrate metabolism and thyroid functional state when Telmisartan is used as part of the complex therapy of patients with Coronary Artery Disease and compensated type 2 Diabetes Mellitus on the basis of Metabolic Syndrome. The use of Telmisartan as part of complex treatment reduces insulin resistance; helps to reduce the level of fasting blood glucose, values of the HOMA-IR index, as well as the amount of insulin in the blood. The use of Telmisartan in patients with Coronary Artery Disease and type 2 Diabetes Mellitus on the basis of Metabolic Syndrome aids in reducing the level of Thyroid-stimulating hormone and increase in free Thyroxine (within the reference values), confirming participation in the correction of metabolic changes.

Analysis of parameters of purine metabolism in patients with diabetes mellitus type 2

The aim of this research is to comprehensively analyze the current state of purine metabolism as well as assess its features in patients with diabetes mellitus type 2, taking into account the clinical and metabolic polymorphism of the disease. The authors examined 327 patients with diabetes mellitus type 2 (144 men and 183 women), a group of individuals with an average age of 57.8±10.1 years. The average duration of the disease was (9.3±7.3) years. All subjects received oral hypoglycemic therapy. The researchers determined anthropometric indicators, indicators of carbohydrate metabolism, concentration of creatinine, uric acid, parameters of the blood lipid spectrum, purine bases, activity of xanthine oxidase and hypoxanthine-guanine-phosphoribosyltransferase in the blood. In the course of the study the authors verified excretion of uric acid and creatinine renal uric acid, fractional clearance of uric acid, total tubular reabsorption of uric acid and coefficient of complete degradation of purine bases. Using the software complex "Statgraphics Centurion 18.0", we statistically analyzed the obtained data. The research showed that a decrease in assimilation, increased oxidation of purine bases due to the activation of xanthine oxidase, and a decrease in their reutilization by inhibiting the activity of hypoxanthine-guanine-phospho­ribo­syltransferase cause the high intensity of purine catabolism in patients with diabetes mellitus type 2. Hyperuricemia (28.0%), increased creatinine renal uric acid (62.3%), increased coefficient of complete degradation of purine bases (41.6%), activity of xanthine oxidase (38.8%) and inhibition of hypoxanthine-guanine-phosphoribosyltransferase activity (50.3%) dominate in the structure of disorders of purine bases in patients with diabetes mellitus type 2. We found that more than 50% of the subjects had high concentrations of purine bases in the blood. Purine bases concentrations in the blood of patients with diabetes mellitus type 2 closely correlate with each other and with the activity of xanthine oxidase and do not correlate with the level of uricemia, the level of uricemia does not correlate with the level of uric acid excretion. That is, the concentration of uric acid in the blood of patients with diabetes mellitus type 2 does not objectively reflect its production in the body. Patients with diabetes mellitus type 2 with obesity associate hyperuricemia with significantly lower creatinine renal uric acid and fractional clearance of uric acid as well as activation of the anabolic pathway of purine bases deposition.

IMPACT OF MELATONIN ON SOME INDICATORS OF CARBOHYDRATE METABOLISM IN LIVER OF RATS WITH DEXAMETHASONE-INDUCED DIABETES

One frequently employed experimental model, particularly in pre-clinical studies examining the hypoglycemic effects of potential antidiabetic medications, is the metasteroid diabetes model induced by the prolonged administration of glucocorticoids to animals. This experimental study aimed to elucidate the effects of exogenous melatonin (10 mg/kg) on glycogen content and the activity of key enzymes—pyruvate kinase (PK) [EC 2.7.1.40], lactate dehydrogenase (LDH) [EC 1.1.1.27], glucose-6-phosphate dehydrogenase (G-6-PDH) [EC 1.1.1.49], and glucose-6-phosphatase (G-6-P-ase) [EC 3.1.3.9]—in the livers of rats with dexamethasone-induced diabetes. Materials and Methods. The experiments were performed on 44 male 18-month-old white non-linear rats, divided into three groups: 1) control (intact rats), 2) rats with dexamethasone-induced diabetes, 3) rats that amid the progression of dexamethasone-induced diabetes, underwent daily oral administration of melatonin (Sigma, USA) in a dose of 10 mg/kg. Dexamethasone diabetes was modeled by subcutaneous injection of dexamethasone (injection solution 4 mg/ml, KRKA, Slovenia) at a dose of 0.125 mg/kg body weight daily for 13 days (O.V. Stefanov, 2001). Decapitation of animals was carried out in accordance with the norms of the "European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes" (Strasbourg, 1986). Glucose content in blood from the tail vein of rats, taken on the 14th day of fasting before decapitation of the animals, was determined using a portable glucometer (One Touch Ultra Easy, Life Scan, USA). The content of glycogen and the activity of the studied enzymes of carbohydrate metabolism in the liver were determined according to the generally accepted, previously described methods. A 5% homogenate was prepared from the cold-isolated rat liver in a chilled 50 mM Tris-HCI buffer (pH=7.4) to study the activities of pyruvate kinase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase and glucose-6-phosphatase in the cytosolic fraction. The reliability of the difference between the obtained indicators was assessed using the parametric Student's t-test (for normal distribution) and the non-parametric Mann-Whitney U-test (for non-normal distribution). Differences were considered probable at p≤0.05. Results and discussion. According to our results, in the liver of diabetic rats that did not receive any means of correction of carbohydrate metabolism disorders, the glycogen content was 33% lower than in intact animals. The activities of enzymes such as pyruvate kinase and glucose-6-phosphate dehydrogenase were also reduced in the liver of rats with impaired glucose tolerance by 31.6 and 21.5%, respectively, compared to intact animals, indicating inhibition of glucose oxidation pathways, both at the level glycolysis (decrease of pyruvate kinase), as well as at the level of the oxidative stage of the pentose-phosphate pathway of glucose-6-phosphate oxidation. At the same time, the activity of lactate dehydrogenase and especially glucose-6-phosphatase in the liver of rats with diabetes by 19.5 and 56%, respectively, exceeded the indicators of animals of the control group, which demonstrates the increased activity, intensity of glycogenolysis and gluconeogenesis under conditions of insulin resistance, because glucose-6-phosphatase is the terminal enzyme of these processes. Regarding the investigated parameters of carbohydrate metabolism, both the glucose content in the blood of rats, as well as the glycogen content and the activity of all studied enzymes in the liver of rats that were injected with melatonin against the background of the development of diabetes, did not reliably differ from the parameters of intact animals, which confirms the assumption of the probable hypoglycemic effect of melatonin against the background of the development of diabetes. Conclusions: The daily two-week use of melatonin (10 mg/kg), against the background of the development of dexamethasone diabetes in rats, contributes to the normalization of certain indicators of carbohydrate metabolism in the liver of animals.

Impairment of auditory function in persons with type 2 diabetes mellitus depending on the level of peripheral myelin protein 22

Background. One of the priority tasks of modern medicine is early diagnosis and treatment of micro- and macrovascular complications of diabetes mellitus (DM) which cause a decrease in the quality of life of working age people and an increase in mortali­ty. Variability of carbohydrate metabolism indicators, metabolic dysfunction are leading factors in the development and progression of disabling complications of type 2 DM with hearing loss due to degenerative changes in nerve fibers. An important aspect of diagnostic and treatment algorithms of sensorineural hearing disorders in patients with type 2 DM is early detection of demyelinating processes to prevent damage to neuronal structures. The purpose of the study is to determine the relationship between the level of peripheral myelin protein 22 (PMP 22) and the condition of the auditory analyzer according to the data of instrumental examination in patients with type 2 DM combined with hearing impairment. Materials and methods. There were examined 30 patients with type 2 DM (15 men and 15 women aged 56.28 ± 4.54 years) associated with degree I–II sensorineural disorders of the auditory function; 15 people with signs of sensorineural hearing loss (SNHL) (8 men, 7 women aged 59.33 ± 2.65 years) without diabetes and 15 controls. During the examination, the patients with type 2 DM and SNHL, depending on the severity of the underlying disease, were divided into groups: the first group (n = 15) with or without isolated microvascular complications of type 2 DM, the second group (n = 15) with neuro-, nephro- and retinopathy. All patients underwent a set of laboratory tests to determine the content of PMP 22 in the blood serum, clinical and instrumental diagnosis of the auditory function. The obtained data were processed statistically, and correlations were identified. Results. The analysis of the results revealed that in patients with type 2 DM and SNHL (groups 1 and 2), the level of peripheral myelin protein 22 significantly increased compared to both controls and the comparison group, and more significantly in those with microangiopathies. The correlations were found bet­ween the most informative indicators reflecting the state of various structures of the hearing analyzer and the content of PMP 22 in the blood serum. Conclusions. A significant increase was revealed in the content of PMP 22 and manifestations of sensorineural hearing loss in patients with type 2 diabetes mellitus associated with microangiopathies that indicate demyelinating processes in the neural structures of the auditory analyzer.

A clinical case of hypothalamic syndrome combined with Klinefelter syndrome

the article describes a clinical case of a hypothalamic syndrome associated with a congenital disease - Klinefelter syndrome in a 21-year-old patient. Dysmetabolic complications were studied against the background of endocrine and genetic pathologies. Klinefelter syndrome was diagnosed in the patient at the age of 10, mosaic variant of karyotype 47XXY/46XY was detected. Against the background of a rare genetic pathology, signs of a hypothalamic puberty syndrome began to appear at the age of 15: acne, pink stretch marks on the lateral areas of the abdomen and breasts, gynecomastia, and excess weight. General clinical laboratory studies, carbohydrate metabolism indicators, sexual and thyroid hormones did not differ from reference values. The cortisol level in the blood was 23.4 mcg/dL, slightly exceeding the upper limit of the reference values (4.30-22.4 mcg/dL), indicating a state of mild hypercorticism. Manifestations of dysmetabolic cardiomyopathy were noted in the cardiovascular system, complicated by stable stage II arterial hypertension. The peculiarity of the clinical case is the combination of endocrine pathology with genetic pathology, which determines the specific appearance of the patient, and the presence of dysmetabolic complications without disturbances of carbohydrate metabolism in stage III obesity. The acceleration of puberty, which often occurs with the hypothalamic syndrome, did not occur due to the concomitant hypoandrogenic effect of Klinefelter syndrome. In the presence of hypothalamic syndrome in the patient, the late development of secondary sexual characteristics was noted, which is more characteristic of Klinefelter syndrome, but normal mental activity was preserved, which is rarely observed with the mosaic form of this genetic pathology. Another clinical feature is the absence of typical manifestations of hypogonadism in the post-pubertal period, which is confirmed by a normal level of male and female sex hormones in the blood, which is atypical. Due to the peculiarity of this clinical case, the patient's fertility can be preserved. In addition to the existing dysmetabolic complications in the patient and metabolic syndrome, there is a high risk of developing type 2 diabetes, atherosclerosis, osteoporosis, and breast cancer, because Klinefelter syndrome andhypothalamic syndrome complicate each other. Therefore, it is important to study the issue of the combination of these two pathologies, possible consequences, and ways to overcome them to improve thepatient's clinical prognosis and quality of life.

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

Features of the course of superficial candidiasis of the skin against the background of changes in carbohydrate metabolism

Objective — to investigate the pattern of the relationship between carbohydrate metabolism and superficial candidiasis for further development of rational therapeutic approaches to the treatment of candidiasis associated with initial disorders of carbohydrate metabolism. Materials and methods. In order to determine the indicators of carbohydrate metabolism and their influence on the course of superficial candidiasis, 93 patients with different severity of this disease were examined. The study of carbohydrate metabolism included the determination of fasting blood sugar level to detect the overt diabetes and glucose tolerance test (with the load of 75 g of glucose). The impaired glucose tolerance was detected in 32 patients, so their levels of glycosylated hemoglobin and fructosamine were additionally determined. HbA1c level was determined in whole blood by ion exchange chromatography. Fructosamine was measured by kinetic colorimetric method in both serum and plasma. Blood sampling was performed on an empty stomach from the cubital vein. The studies were carried out immediately after sampling. The Sentinel CH test system from Intero (Italy) and a spectrophotometer with a 405—425 nm filter were used for the research. Results and discussion. The research showed that in the group of patients with candidal lesions, there was a direct dependence of HbA1c and fructosamine levels on the severity of the disease. In patients with minimal and moderate candidal lesions, an increase in HbA1c and fructosamine indicators (by 1.54 and 1.21 times, respectively) was observed compared to similar indicators in the control group. In patients with significant candidal lesions and relapses, the concentration of HbA1c increased by 2.59 times and the concentration of fructosamine — by 2.26 times compared to the indicators of the control group. Conclusions. As shown by the results of our research, we have proven a direct correlation between the severity of candidiasis and the levels of НbA1с and fructosamine. The identification of correlation patterns is important for the development of a multimodal pathogenetically justified treatment of patients with candidal lesions of the skin and mucous membranes.

ОЦЕНКА РАСПРОСТРАНЕННОСТИ И СТРУКТУРЫ ХРОНИЧЕСКОЙ БОЛЕЗНИ ПОЧЕК ПРИ САХАРНОМ ДИАБЕТЕ

The incidence of diabetes mellitus has more than doubled over the past ten years. The prevalence of chronic kidney disease is comparable to the prevalence of diabetes mellitus. Chronic kidney disease occurs in diabetes mellitus in 20-40% of cases. The aim of the study was to analyze the prevalence and structure of chronic kidney disease in diabetes mellitus according to the diabetes registry «Polyclinic № 4», Saransk. According to the diabetes registry data, the structure and prevalence of chronic kidney disease in patients with type 1 and type 2 diabetes mellitus, anthropometric indicators, the duration of diabetes mellitus and chronic kidney disease, and indicators of metabolic control of diabetes were analyzed. In the present study, the prevalence of chronic kidney disease was 17% in type 1 diabetes mellitus and 19% in type 2 diabetes mellitus. At the same time, in both types of diabetes mellitus, chronic kidney disease of stage C2 (50% in type 1 and 52% in type 2) and C3 stage (39% in type 2 and 28% in type 1) predominated. type of diabetes). Glycosylated hemoglobin was within the target range in 78% of type 1 diabetic patients and in 83% of type 2 diabetic patients. In patients with diabetes mellitus and chronic kidney disease, it is necessary to intensify hypoglycemic therapy, achieving target indicators of carbohydrate metabolism. The only indicator of the lipid spectrum, which is presented in the registry, was total cholesterol, it is necessary to study the full lipid spectrum.

Correlated interdependences of characteristics of carbohydrate metabolism and lipid profile and batokines levels in patients with coronary heart disease and obesity

Research of comorbid coronary heart disease (CHD) and obesity in recent years often rely on the study of inflammatory mediators, among which the first and foremost are batokines, in particular on fibroblast growth factor (FGF-21) and vascular endothelial growth factor A (VEGFa). The aim of our study was to determine the correlational interdependencies of indicators of carbohydrate metabolism and lipid profile and levels of batokines in the comorbidity of CHD and obesity. 70 people aged from 25 to 85 were examined with CHD on the background of obesity. The average age was (63.6±8.8) years. The research do not violate the principles of bioethics, which is confirmed by the conclusion of the Bioethics Committee of the Kharkiv National Medical University. All patients who participated in the study signed an informed voluntary consent. Based on the results of research probable direct strong correlations of total cholesterol (TC) with low-density lipoprotein (LDL) were determined (ρ=0.889; p=0.000); triglycerides (TG) with very low-density lipoprotein (VLDL) (ρ=0.810; p=0.000). The average strength of correlation was determined: glycosylated hemoglobin (HbA1c) with vascular endothelial growth factor A (VEGFA) (ρ=0.374; p=0.001); TC and LDL and AI (respectively ρ=0.615; p=0.000, and ρ=0.648; p=0.000); VLDL with atherogenic index (AI) (ρ=0.367; p=0.002). Probable direct weak correlations of blood glucose levels with TG (ρ=0.253; p=0.034) and VLDL (ρ=0.277; p=0.020) and VEGFA (ρ=0.225; p=0.061) were found; TG and VLDL with VEGFA (ρ=0.256; p=0.032 and ρ = 0.273; p = 0.022, respectively). Inverse interdependencies were recorded: medium strength – high-density lipoprotein (HDL) and AI (ρ=-0.583; p=0.000) and weak – hemoglobin levels with HDL (ρ=-0.251; p=0.036); HbA1c with LDL (ρ=-0.241; p=0.044); HDL with VLDL (ρ=-0.293; p=0.014). Keywords: comorbidity of coronary heart disease and obesity, batokines, FGF21, VEGFA.

Гістеректомія в період менопаузального переходу як предиктор метаболічних порушень

Although data on the decrease in ovarian function after hysterectomy (GE) are found in literature sources, the nature of changes in the hormonal and metabolic profile, its chronological sequence, the issue of the relationship with the development of metabolic syndrome (MS), even in the case of preservation of ovarian tissue, remain controversial and fragmented, which served as an impetus for conducting this study. Purpose - to assess the risk of metabolic disorders after GE during the menopausal transition. Materials and methods. A comprehensive assessment of the long-term consequences of GE was carried out in 160 women of the menopausal transition age. Metabolic homeostasis parameters were evaluated before surgery and in dynamics after surgical intervention (after 12 months). Risk factors were identified during a general clinical examination, based on anamnestic data. Indicators of carbohydrate and lipid metabolism were evaluated in the examined women. Inclusion criteria: the age of the menopausal transition, GE due to benign uterine pathology, the patient's consent to participate in the research. Results. Analysis of carbohydrate metabolism indicators showed an increase in the HOMA-IR index and postprandial glucose level, changes in the lipid profile. When comparing clinical symptoms and laboratory research methods, in 34.37% of cases, the formation of MS was noted one year after GE. Based on multivariate analysis using binary logistic regression, the following risk factors for metabolic disorders were found to be statistically significant: high body mass index, waist circumference above 80 cm, age older than 45, climacteric syndrome, GE. Conclusions. A high body mass index, a waist circumference greater than 80 cm, the presence of signs of the climacteric syndrome, GE and age older than 45 years show the association with the development of metabolic disorders in the distant postoperative period, and their combined effect increases the risk of their development. These factors at the preoperative stage can serve as prognostic markers of metabolic disorders in the distant postoperative period. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Comparative assessment of the state of main arteries in workers of the pivotal occupations in the coal and aluminum industries

Introduction. To prevent cardiovascular accidents and preserve the employability in workers in the pivotal occupations of the coal and aluminum industries it is required timely identification of risk groups for long-term asymptomatic damage to the atherosclerotic process of the arteries.
 Material and methods. The study included two hundred twenty two miners and 109 workers in the aluminum industry aged of 40–55 years (average age of miners – 47.1 ± 0.36 years, metallurgists – 47.64 ± 0.43 years, р = 0.367). All subjects underwent ultrasound investigation of the carotid and femoral arteries. Also anamnestic, anthropometric data, the presence of arterial hypertension, indices of lipid and carbohydrate metabolism were evaluated.
 Results. Miners were more often diagnosed with intimal thickening (41.9% vs. 27.5%, p = 0.011), in contrast to aluminum production workers, who were significantly more likely to have atherosclerotic plaques (57.8% vs. 43.2%, p = 0.0127). The frequency of generally accepted risk factors for atherosclerosis in both occupational cohorts (arterial hypertension, smoking, carbohydrate metabolism disorders, physical inactivity, obesity) was detected without significant differences. Miners with atherosclerosis were diagnosed with significantly higher average values of total cholesterol and low-density lipoprotein cholesterol, metallurgists with atherosclerosis showed hypertriglyceridemia.
 Limitations. The study was limited by the number of the examined persons undergoing periodic medical examination at the Research Institute for Complex Problems of Hygiene and Occupational Diseases.
 Conclusion. A more significant lesion of the main arteries in the form of atherosclerotic plaques with varying degrees of stenosis was found in aluminum production workers compared to miners, which was probably due to the more aggressive influence of harmful production factors in metallurgists. In this regard, it is recommended to conduct a screening ultrasound investigation of the main arteries at a periodic medical examination, which will identify a risk group for the timely prevention of cardiovascular complications.

Glycemic control and cardiovascular complications of type 2 diabetes mellitus

Over the past few decades, the prevalence of diabetes in developed and developing countries has increased dramatically, making diabetes a key health priority worldwide. It can be assumed that an increase in the life expectancy of patients with diabetes significantly affects the prevalence of diabetes, maintaining the trend of its increase. Patients with type 2 diabetes mellitus (DM2) are at higher risk for cardiovascular disease and its adverse outcomes compared to the general population. The pathophysiological relationship between hyperglycemia and cardiovascular disease is beyond doubt. Glycemic control per se remains essential for the successful management of diabetes, prevention of chronic complications of the disease and death. Diabetes control involves, first of all, the achievement of target indicators of carbohydrate metabolism. The use of glycated hemoglobin (HbA1c), despite known sensitivity limitations, has become the standard for assessing glycemic control in diabetic patients. Early achievement of the target HbA1c level reduces the risk of diabetic complications, increases the likelihood of long-term sustainable disease control. Numerous clinical studies have demonstrated that higher HbA1c and greater HbA1c variability are manageable risk factors for adverse cardiovascular events. Optimal hypoglycemic therapy for diabetes in order to reduce cardiovascular risks should ensure the achievement of the target level of glycemic control as soon as possible (the first 3 months of therapy), maintaining the target level of glycemia with the lowest possible HbA1c variability in subsequent years and therapy should be safe. Timely intensification of therapy, including the use of insulin, can prevent the negative consequences of prolonged hyperglycemia. Glar-100 has a high efficacy and safety in comparison with other insulin preparations at the initiation and intensification of DM2 therapy. RingGlar® and Lantus® are equivalent drugs.

The effect of feeding the feed additive "Prinarovskaya" on the body of laying hens

The aim of the conducted studies was a comprehensive assessment of the clinical and physiological state of laying hens, which included a fish feed additive (DCR) in the main diet. The composition of the new Prinarovskaya DKR includes chilled river fish, its processed products and grain products (wheat bran). The additive preparation process goes through several stages: grinding, cavitation heating and subsequent drying of the resulting mixture. The investigated additive is a homogeneous dry mass and contains a number of amino acids, vitamins and minerals in its composition. DKR "Prinarovskaya" was fed to laying hens of the Lohmann Lsn-Classic breed of 130 days of age. All chickens participating in the experiment were divided into 4 groups. Chickens of the 1st experimental group included 8 g of "Prinarovskaya" additives per 100 g of the main diet; chickens of the 2nd experimental group - 6 g of additives to OR; chickens of the 3rd experimental group – 4 g of additives to OR; 4-control group of chickens were fed only OR – compound feed PK1-1G-1227, prepared in accordance with GOST R 51851-2001. The usefulness of poultry feeding is reflected in the morphological and biochemical parameters of blood, which served as the basis for using them in an experiment to characterize metabolic processes and assess the state of the body of laying hens. An important indicator of the effect of the new feed additive "Prinarovskaya" on metabolic processes was the determination of the concentration of total protein and the main protein fractions (albumins, globulins). The state of lipid metabolism in terms of cholesterol and triglycerides was analyzed. Indicators of carbohydrate metabolism and the functional state of the liver were also studied. To characterize the mineral metabolism, the level of calcium and phosphorus in the blood serum was determined. The conducted study with a comprehensive assessment of morphological and biochemical parameters of blood confirmed the expediency of including Prinarovskaya DCR in the diet of laying hens, which generally has a positive effect on the state of their body.

A safe approach to the treatment of type 2 diabetes in elderly patients

Introduction. Type 2 diabetes is a significant medical problem. The solution to this problem lies not only in lowering the patient’s blood glucose level, but also in preventing the complications of diabetes, influencing insulin resistance and normalizing body weight.Aim. To develop an effective and safe treatment regimen for elderly women with type 2 diabetes, which is aimed at compensating carbohydrate metabolism, improving lipid metabolism and anthropometric parameters.Materials and methods. The study involved 80 women with type 2 diabetes aged 60 to 74 years, who were divided into 2 groups of 40 people. Group 1 included patients with type 2 diabetes receiving traditional therapy for type 2 diabetes. Patients of the group 2 received the method of treatment developed by us, including, in addition to the traditional regimen, the drug Subetta®, cholecalciferol drops. All women collected complaints and anamnesis, assessed anthropometric parameters, glucose, glycated hemoglobin, vitamin D, lipid profile.Results. All patients with type 2 diabetes initially were not compensated for carbohydrate metabolism, had abdominal obesity, atherogenic dyslipidemia, and vitamin D deficiency. Anthropometric parameters significantly improved, glucose and HbA1c levels decreased to target values in patients of group 2 after 6 months against the background of the use of Subetta® and cholecalciferol. Also in this group, the indicators of lipid metabolism improved: the levels of cholesterol, LDL, triglycerides decreased, and the levels of HDL increased. Vitamin D levels reached target range. No episodes of hypoglycemia were recorded.Conclusions. The addition of Subetta® and cholecalciferol to the treatment of patients with type 2 diabetes contributed to the achievement of target indicators of carbohydrate metabolism, improved lipid profile, and weight loss. This method of treatment is well tolerated and has a low risk of hypoglycemia, which is especially important for elderly patients.

Self-assessment of health status in patients with complicated type 2 diabetes mellitus is one of quality of life components

Objective. To identify the characteristics of the subjective health status in patients with complicated type 2 diabetes mellitus (DM) based on the survey data.
 Materials and methods. 387 women with type 2 DM having microvascular complications were examined; the control group patients without DM (118 persons).
 Results. The study showed that for women with complicated type 2 diabetes, physical activity restrictions were more significant than mental ones. They were 18 times more likely (95 % CI [3.25; 99.65], p 0.05) to have physical problems than mental health problems. Subjective assessment of deterioration in physical condition depended on the duration of the disease, and not on age. There was no relationship between the components of the quality of life and indicators of carbohydrate metabolism, body mass index, waist circumference. Patients with type 2 DM are worse adapted in the society, there is observed a reduced level of "social activity" (58.11.8 versus 63.22.3; p=0.05, respectively).
 Conclusions. The low quality of life, from the point of view of patients with complicated type 2 diabetes, is associated with physical and mental components. Limited physical activity in comparison with mental is more significant for patients. The lack of relationship between the quality of life indicators and objective data makes it possible to assert that their improvement does not influence the subjective assessment of a patient that is important for physicians to consider.

Exercise-Induced Alternations of Adiponectin, Interleukin-8 and Indicators of Carbohydrate Metabolism in Males with Metabolic Syndrome.

Adiponectin (ADIPO) and interleukin-8 (IL-8) are proteins that play a significant, albeit opposing, role in metabolic syndrome (MetS). The reported data on the effect of physical activity on the levels of these hormones in the population of people with MetS are conflicting. The aim of the study was to evaluate the changes in hormone concentrations, insulin-resistance indices and body composition after two types of training. The study included 62 men with MetS (age 36.6 ± 6.9 years, body fat [BF] = 37.53 ± 4.5%), randomly assigned to: an experimental group EG1 (n = 21) with aerobic exercise intervention, an experimental group EG2 (n = 21) with combined aerobic and resistance exercise intervention, both for 12 weeks, and a control group CG (n = 20) without interventions. Anthropometric measurements and body composition (fat-free mass [FFM], gynoid body fat [GYNOID]), as well as a biochemical blood analysis (adiponectin [ADIPO], interleukin-8 [IL-8], homeostatic model assessment-adiponectin (HOMA-AD) and homeostatic model assessment-triglycerides (HOMA-TG) were performed at baseline, and at 6 and 12 weeks of intervention and 4 weeks after the intervention (follow-up). Intergroup (between groups) and intragroup (within each group) changes were statistically evaluated. In the experimental groups EG1 and EG2, no significant changes were observed in the ADIPO concentration, but a decrease of GYNOID and insulin-resistance indices was confirmed. The aerobic training led to favorable changes in IL-8 concentration. The use of combined resistance and aerobic training led to improved body composition, decreased waist circumference and better insulin-resistance indices in men with MetS.