Insulin Resistance Hypertension Research Articles

Коморбидный неврологический пациент: в фокусе метаболический синдром

INTRODUCTION. The article discusses the problem of managing patients suffering from metabolic syndrome and chronic cerebrovascular disorders. Metabolic syndrome is an important interdisciplinary problem. Metabolic syndrome significantly increases the incidence of strokes. Systemic metabolic disorders, insulin resistance and oxidative stress, as well as large vessel damage and microangiopathy play an important role. In addition, special attention is paid to low-grade chronic inflammation, which may be associated with the patient’s age. The most important risk factor for the development of acute cerebral ischemia is the combination of components of the metabolic syndrome, in particular, the combination of insulin resistance and arterial hypertension, which increase the likelihood of developing atrial fibrillation and increase the risk of an unfavorable outcome. CONCLUSION. Cognitive impairment is quite common in metabolic syndrome. When treating cognitive impairment as part of metabolic syndrome, it is advisable to use neuroprotectors. The use of citicoline (the drug “Ronocit”) has a clinically significant effect in restoring cognitive functions and reducing the risk of developing post-infarction and post-stroke dementia in patients with metabolic syndrome. The use of various approaches to the treatment of cognitive impairment in metabolic syndrome increases the likelihood of a favorable outcome. It is recommended to use the drugs “Ronocit” and “Cocarnit®” together in the treatment of patients with a predominance of cognitive and asthenic impairments and a clinical symptom complex of diabetic polyneuropathy. KEYWORDS: comorbidity, cognitive disorders, metabolic syndrome

Additive interactions between obesity and insulin resistance on hypertension in a Chinese rural population

BackgroundAdiposity and insulin resistance (IR) are closely associated with hypertension; however, the role of interactions between obesity phenotypes and IR in hypertension is unclear. This study aimed to evaluate the interactions of body mass index (BMI), waist circumference (WC), and body fat percentage (BF%) with IR on hypertension risk.MethodsWe analyzed data from 4888 participants (mean age 57 years, 41.2% men) in the China Northwest Natural Population Cohort, Ningxia Project. BMI, WC, and BF% were determined using bioelectrical impedance analysis devices. IR was estimated using a homeostasis model assessment index (HOMA-IR). Multivariable-adjusted logistic regression was used to evaluate the association between HOMA-IR and hypertension risk. We calculated the relative excess risk and attributable proportion with their 95% confidence intervals (CIs) to assess whether adiposity phenotypes modified the effect of HOMA-IR on hypertension risk.ResultsThe crude prevalence of hypertension was 52.2%. The multivariable-adjusted odds ratio of HOMA-IR was 1.80 (95% CI: 1.23–2.65) for the risk of hypertension in the highest versus the lowest quartiles, but this association became marginal in models further adjusting for BMI, WC, and BF% (P for trend = 0.056). Relative excess risk and attributable proportion for interaction between high HOMA-IR and high BF% were 0.32 (0.04–0.59) and 0.33 (0.06–0.60), respectively. Additionally, high truncal and leg BF% and high HOMA-IR accounted for the hypertension risk in women, but not in men. We did not observe any significant interactions between BMI or WC and HOMA-IR on hypertension.ConclusionBF% modified the association between IR and increased risk of hypertension in women with high truncal and leg BF%, but not in men.

Association between insulin resistance and uncontrolled hypertension and arterial stiffness among US adults: a population-based study

BackgroundPrior research has established the correlation between insulin resistance (IR) and hypertension. While the association between triglyceride-glucose (TyG) index, a reliable surrogate marker of IR, and uncontrolled hypertension as well as arterial stiffness among individuals with hypertension remains undisclosed.MethodsIn this study, a total of 8513 adults diagnosed with hypertension from the National Health and Nutrition Examination Survey 1999–2018 were included. The primary outcome of the study are arterial stiffness (represented with estimated pulse wave velocity, ePWV) and uncontrolled hypertension. Logistic regression model, subgroup analysis, restricted cubic spine, and smooth curve fitting curve were conducted to evaluate the association between the IR indicators and uncontrolled hypertension and arterial stiffness in individuals with hypertension.ResultsAmong included participants, the overall prevalence of uncontrolled hypertension was 54.3%. After adjusting for all potential covariates, compared with the first quartile of TyG index, the risk of uncontrolled hypertension increased about 28% and 49% for participants in the third quartile (OR, 1.28; 95% CI 1.06–1.52) and the fourth quartile (OR, 1.49; 95% CI 1.21–1.89) of TyG index, respectively. The higher OR of TyG index was observed in participants taking antihypertensive medication [fourth quartile versus first quartile (OR, 2.03; 95% CI 1.37–3.11)]. Meanwhile, we explored the potential association between TyG index and arterial stiffness and found that TyG index was significantly associated with increased arterial stiffness (β for ePWV, 0.04; 95% CI 0.00–0.08; P = 0.039). However, traditional IR indicator HOMA-IR showed no significant positive correlation to uncontrolled hypertension as well as arterial stiffness in US adults with hypertension.ConclusionElevated levels of the TyG index were positive associated with prevalence of uncontrolled hypertension and arterial stiffness among US adults with hypertension.

FRI099 Advanced Lipoprotein Analysis In Patients With Cushing’s Syndrome

Abstract Disclosure: R.T. Varghese: None. R. McGlotten: None. M. Sampson: None. A. Prakash: None. R. Shamburek: None. A.T. Remaley: None. R. Muniyappa: None. L.K. Nieman: None. Introduction: Cushing syndrome (CS) patients have a higher mortality rate due to increased cardiovascular disease (CVD). Analysis of lipoprotein particles with nuclear magnetic resonance (NMR) spectroscopy provides additional insights into CVD risk beyond the standard lipid panel. The goal of the study was to better characterize the lipid abnormalities in patients with CS by using high-resolution separation of lipoprotein particles. Methods: We measured plasma lipids (Cholesterol, TC; calculated low density lipoprotein, LDL; triglycerides, TG; high density lipoprotein, HDL) by the traditional enzymatic assay and lipoprotein particles by NMR spectroscopy. Measures of inflammation and insulin resistance were also derived from NMR spectra. Values are shown as mean ± SEM or median [IQR]. Results: After initial evaluation, 42 subjects (mean age 47.4 ± 2.5 years; 28 females; weight 85.0 ± 3.1 kg) had Cushing's disease (n=23), ectopic ACTH secretion (n=17), or adrenal adenoma (n=2). Ten patients were on chronic statin therapy, and 14 subjects had type 2 diabetes mellitus (T2DM). The control group comprised 45 subjects without T2DM [mean age 45.4 ± 2.1 years and weight (83.5 ± 2.7) kg]. None in the control group were on statin therapy. Compared to controls, CS patients had significantly higher systolic (135 ±2 vs. 119 ±2 mm Hg, p<0.001) and diastolic blood pressure (79 ±2 vs. 71 ±1 mm Hg, p<0.001), HbA1c (6.1 [5.4-7.5] vs. 5.4 [5.0-5.7], p<0.001), plasma glucose (103 [90-137] vs 94 [89-100] mg/dL, p=0.003), and insulin (17[12-26] vs 11[7-15] uU/mL, p=0.01) levels. Compared to controls, patients with CS had significantly higher triglyceride concentration (116 [84 -146] vs 87 [62-120] mg/dL, p=0.02) and lower LDL concentration (90 [69 -113] vs 108 [90 -125] mg/dL, p=0.04). However, total cholesterol and HDL cholesterol concentrations were not different. LDL particle size in CS was smaller (20.5[20.0-21.0] vs 21.0 [20.7-21.2] nm, p=0.01) and VLDL particle size was larger (49.8 ± 0.9 vs 45.7 ± 1.0 nm, p=0.002) than in controls. No difference was noted between groups in HDL particle number or size or in LDL and VLDL particle number. In the group with CS, a marker of inflammation, GlycA (Glycan N-acetylglucosamine) (494.5 ± 18.2 vs. 382.5 ± 9.0 µmol/L, p<0.001) and Lipoprotein Insulin Resistance score (LPIR) (46.4 ± 3.1 vs. 36.2 ± 3.1, p=0.02) were significantly higher. There were no group differences in branch-chained amino acids (BCCA) levels. These differences remained even when patients with type 2 diabetes and those on statin therapy were excluded. Conclusions: These data suggest that the higher inflammatory and insulin resistance state, dysglycemia, hypertension, and altered lipoprotein profiles may contribute to the increased CV risk in patients with Cushing’s syndrome. Early detection and treatment for these abnormalities may attenuate CV risk. Presentation: Friday, June 16, 2023

Insulin Resistance in relation to Hypertension and Dyslipidaemia among Men Clinically Diagnosed with Type 2 Diabetes.

Pathophysiologically, type 2 diabetes can result from insulin resistance or insulin insufficiency alone. It is unclear whether relative insulin shortage or pronounced insulin resistance is linked to poor cardiometabolic problems like obesity. Therefore, the objective of this study was to evaluate the relationship between insulin resistance (IR), hypertension, and dyslipidaemia, in men with type 2 diabetes mellitus. One hundred and twenty-one (121) type 2 diabetic men participated in this cross-sectional study, which was conducted between September 2018 and September 2019. Sociodemographic information was collected using a self-designed questionnaire. Anthropometric data were also taken and blood samples collected for estimation of insulin, glucose, and lipid concentrations. HOMA-IR was calculated from the fasting insulin and glucose values, and a HOMA - IR ≥ 2 was considered to indicate insulin resistance. Of the 121 participants, 39.7% were classified as insulin-resistant. Levels of total cholesterol (4.82 ± 1.2 mmol/L; p = 0.007 vs. 4.25 ± 1.1 mmol/L), LDL cholesterol (3.17 ± 0.9 mmol/L; p = 0.001 vs. 2.52 ± 0.8 mmol/L), and TC/HDL-C ratio (3.93 ± 0.9; p = 0.042 vs. 3.58 ± 0.9) and the prevalence of abnormal LDL-C (14.6%; p = 0.015 vs. 2.7%) and elevated BP (83.3%; p = 0.048 vs. 67.1%) were higher in the insulin-resistant group. LDL cholesterol (AUC = 0.670; p = 0.001) better classified subjects as being insulin-resistant compared to other lipid markers. The odds of insulin resistance in dyslipidaemia were not statistically significant after adjusting for obesity. The link between insulin resistance and dyslipidaemia and hypertension in male diabetics may thus be mediated by obesity.

Association of three insulin resistance indices with hypertension and body weight among Uyghur adults in rural areas of Xinjiang, China.

Obesity and insulin resistance are significant contributors to hypertension. There is a high prevalence of obesity among Uyghurs in the rural areas of Xinjiang, China. Therefore, this study aimed to explore the association between insulin resistance indices and hypertension according to different body weights in rural Uyghur residents of Xinjiang, China. A total of 12 813 local Uyghur residents were recruited for the study. Excluding those with incomplete data and those using antihypertensive, lipid-lowering, or glycemic drugs, 9577 permanent residents were eligible for the study. Three insulin resistance indicators were calculated: triglyceride to high-density lipoprotein cholesterol ratio, product of fasting triglyceride and glucose (TYG), and metabolic score for insulin resistance. Multivariate logistic regression analysis was performed to estimate the association between the three non-insulin-based insulin resistance indices and the risk of hypertension for different body weights. TYG was significantly associated with hypertension in the normal-weight group, particularly in women. In the obese group that was obese, all three indicators were associated with hypertension. Since TYG was associated with hypertension in the groups with normal weight and obesity, it may be useful as a reference indicator for insulin resistance. This indicator may provide a basis for the identification and management of hypertension risk among adults in the Uyghur population.

Prevalence and risk factors associated with different comorbidities in obese children and adolescents

IntroductionDifferent obesity-related comorbidities already present in childhood, such as: vitamin D deficiency, impaired carbohydrate metabolism, dyslipidaemia, arterial hypertension and non-alcoholic steatohepatitis. In this study, we aim to analyse the prevalence of comorbidities and to determine the predictive factors that affect these comorbidities. Material and methodsAnthropometric, demographic and biochemical variables were collected from obese patients between six and 18 years of age. Subsequently, a statistical analysis was performed to describe the characteristics of the patients and the prevalence of comorbidities, as well as their predictive factors. ResultsA total of 158 obese children (76 boys and 82 girls) with a mean age at diagnosis of 12.48 years and a BMI Z-score of +3.24 SDS were included. The most prevalent comorbidities were vitamin D deficiency (64.2%), insulin resistance (45.1%), dyslipidaemia (32.2%), hyperuricaemia (18.5%) and arterial hypertension (15%). Age, BMI Z-score, percentage of fat mass and male sex have been found to be predictors of these comorbidities. ConclusionObese children and adolescents have a high prevalence of comorbidities. Once the diagnosis of obesity has been established, it would be very useful to identify early those patients with a higher risk of comorbidities, knowing their relationship with sex, age, BMI Z-score, percentage of fat mass and pubertal stage.

Nutrition and the state of the intestinal microflora in the formation of the metabolic syndrome

The literature review presents the results of modern studies of the relationship between diet and intestinal microbiota in the regulation of metabolic disorders. Metabolic syndrome, which is a symptom complex that combines abdominal obesity, insulin resistance, hyperglycemia, dyslipidemia and arterial hypertension, remains an important problem, being a risk factor for cardiovascular, neurodegenerative, oncological diseases and the development of type 2 diabetes mellitus. Although the pathogenesis of the metabolic syndrome has not yet been fully elucidated, it is known that visceral obesity and its associated complications, such as dyslipidemia and increased levels of pro-inflammatory cytokines, play a central role. The article presents data on the impact of the consumption of certain food products, the inclusion of plant biologically active substances (flavonoids, polyphenols, etc.) in the diet, as well as the use of elimination diets with the exclusion of carbohydrates or fats from the diet, on reducing the risk of cardiovascular accidents, levels of fasting glucose, total cholesterol, LDL, triglycerides, C-reactive protein, leptin, insulin, reduction in body weight and waist circumference, reduction in the level of circulating endotoxins and changes in the activity of immunocompetent cells. Data are presented on the possible influence of the intestinal microbiota in maintaining inflammation and the formation of degenerative changes in the body. The role of changes in the ratio of the levels of pathogenic microflora, bifidobacteria and lactobacilli in the formation of a pathological condition is shown.

Effects of Metformin on Body Weight Management and Markers of the Metabolic Syndrome in Persons with Normal Glucose Tolerance

Treatment of the metabolic syndrome (MS) is essential for prevention of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). The purpose of this open-label prospective one year observational clinical study was to examine the effects of metformin 2.55 ± 0.3 g/d on body weight management and markers of the MS in normal glucose tolerant persons with hyperinsulinaemia. Body weight was reduced by 6.8% at 6 months and by 11.1% at 1 year. The body weight reduction was 7.2 ± 3.4 kg at 6 months and 11.7 ± 4.7 kg (mean ± SD) at 1 year. We found a significant correlation of reduction of body weight at 1 year with initial body weight, body mass index, waist circumference and homeostasis model assessment of insulin resistance (HOMA-IR), all p < 0:001. At 1 year of metformin treatment HOMA-IR, total cholesterol, low-density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure were significantly reduced, all p < 0:001 and high-density lipoprotein cholesterol was significantly increased, p = 0:004. Our study shows that treatment with metformin alone, without intensive diet and physical activity, could reduce visceral obesity, insulin resistance, dyslipidaemia and arterial hypertension and supports the hypothesis that it could be applied for prevention of T2DM and CVD.

Log-Linear Model and Multistate Model to Assess the Rate of Fibrosis in Patients With NAFLD

In this paper, the deleterious effects of obesity, type II diabetes, and insulin resistance, systolic and diastolic hypertension on the rate of progression of fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) are illustrated using a new approach utilizing the Poisson regression to model the transition rate matrix. The observed counts in the transition count matrix are used as the response variables and the covariates are the risk factors for fatty liver. Then, the estimated counts from running the Poisson regression are used to estimate the transition rates using the continuous-time Markov chains (CTMCs) followed by exponentiation of the estimated rate matrix to obtain the transition probability matrix at specific time points. A depicted, hypothetical, observational, prospective longitudinal study of 150 participants followed up every year for a total of 29 years recording their demographic characteristics and their timeline follow-up is demonstrated. The findings revealed that insulin resistance expressed by HOMA2-IR had the most deleterious effects among other factors on increasing the rate of fibrosis progression from state 1 to state 2, from state 2 to state 3, and from state 3 to state 4. The higher the level of HOMA2-IR is, the more rapid the rate of progression is. This analysis helps the health policymakers and medical insurance managers to allocate the financial and human resources for investigating and treating high-risk patients with NAFLD. In addition, this analysis can be used by pharmaceutical companies to conduct longitudinal studies to assess the effectiveness of the newly emerging anti-fibrotic drugs.

Study on association of possible link of ions and insulin resistance in hypertension and diabetes mellitus

To authenticate doubts relating to influence of altered state of some ions in insulin resistance and hypertension we analysed some biomolecules; glucose, insulin, glycated hemoglobin, magnesium, zinc, sodium, potassium and copper from diabetics, non-diabetics and hypertensives. Adopting spectroscopic and immunoassay methods values obtained were statistically evaluated by Anova (Analysis of variance). We observed identical pattern in glucose concentration, glycated hemoglobin and insulin levels among hypertensive and non-hypertensive subjects. However, an aggregated insulin response to glucose was elevated significantly (34.5+3.2 vs 20+2.3 µIU/mL, P<0.05). Zinc and magnesium levels were inversely correlated with HbAIc in insulin dependent diabetics and Non-insulin dependent diabetic (P<0.05). We observed Values increasing in tandem relationship with hypertension. We conclude that while hypertension and insulin resistance may have differential biochemical precursor, a nexus could be established for the place of ionic interferences in these disorders.

Study on association of possible link of ions and insulin resistance in hypertension and diabetes mellitus

Study on association of possible link of ions and insulin resistance in hypertension and diabetes mellitus

Nanomedicine of Plant Origin for the Treatment of Metabolic Disorders.

Metabolic disorders are major clinical challenges of health that are progressing globally. A concurrence of metabolic disorders such as obesity, insulin resistance, atherogenic dyslipidemia, and systematic hypertension leads to metabolic syndrome. Over the past years, the metabolic syndrome leads to a five- and two-fold rise in diabetes mellitus type II and cardiovascular diseases. Natural products specifically plant extracts have insulin-sensitizing, anti-inflammatory, and antioxidant properties and are also considered as an alternative option due to few adverse effects. Nanotechnology is one of the promising strategies, which improves the effectiveness of treatment and limits side effects. This review mainly focuses on plant extract-based nanosystems in the management of the metabolic syndrome. Numerous nano-drug delivery systems, i.e., liposomes, hydrogel nanocomposites, nanoemulsions, micelles, solid lipid, and core–shell nanoparticles, have been designed using plant extracts. It has been found that most of the nano-formulations successfully reduced oxidative stress, insulin resistance, chronic inflammation, and lipid profile in in vitro and in vivo studies as plant extracts interfere with the pathways of metabolic syndrome. Thus, these novel plant-based nanosystems could act as a promising candidate for clinical applications.

Prevalencia y factores de riesgo asociados a distintas comorbilidades en niños y adolescentes obesos

IntroductionDifferent obesity-related comorbidities are already present in childhood, such as: vitamin D deficiency, impaired carbohydrate metabolism, dyslipidaemia, arterial hypertension and non-alcoholic steatohepatitis. In this study, we aim to analyse the prevalence of comorbidities and to determine the predictive factors that affect these comorbidities. Material and methodsAnthropometric, demographic and biochemical variables were collected from obese patients between 6 and 18 years of age. Subsequently, a statistical analysis was performed to describe the characteristics of the patients and the prevalence of comorbidities, as well as their predictive factors. ResultsA total of 158 obese children (76 boys and 82 girls) with a mean age at diagnosis of 12.48 years and a BMI Z-score of +3.24 SDS were included. The most prevalent comorbidities were vitamin D deficiency (64.2%), insulin resistance (45.1%), dyslipidaemia (32.2%), hyperuricaemia (18.5%) and arterial hypertension (15%). Age, BMI Z-score, percentage of fat mass, male sex and higher pubertal stage have been found to be predictors of these comorbidities. ConclusionObese children and adolescents have a high prevalence of comorbidities. Once the diagnosis of obesity has been established, it would be very useful to identify early those patients with a higher risk of comorbidities, knowing their relationship with sex, age, BMI Z-score, percentage of fat mass and pubertal stage.

Potentially Probiotic Limosilactobacillus fermentum Fruit-Derived Strains Alleviate Cardiometabolic Disorders and Gut Microbiota Impairment in Male Rats Fed a High-Fat Diet.

High-fat diet (HFD) consumption is a risk factor for dyslipidemias, insulin resistance, and arterial hypertension linked with gut dysbiosis. Probiotic administration has been suggested as a safe therapeutic strategy for gut microbiota modulation and treatment and/or prevention of cardiometabolic disorders. Here, we assessed the effects of a potentially probiotic formulation containing strains of the Limosilactobacillus (L.) fermentum 139, 263, and 296 on the cardiometabolic disorders and gut microbiota derangements provoked by the HFD consumption. Male Wistar rats were allocated into control diet (CTL, n = 6), HFD (n = 6), and HFD receiving L. fermentum formulation (HFD-LF, n = 6) groups for 4weeks. L. fermentum formulation (109 colony-forming unit (CFU)/ml of each strain) was daily administered by oral gavage. After 4-week follow-up, biochemical measurements, blood pressure (BP), heart rate (HR), sympathetic tone, and gut microbiota composition were evaluated. HFD consumption for 4weeks increased lipid profile, insulin resistance, sympathetic tone, and blood pressure and impaired gut microbiota composition in male rats. Administration of L. fermentum formulation improved the gut microbiota composition, lipid profile, insulin resistance, autonomic dysfunction, and BP in rats fed with a HFD. Administration of a potentially fruit-derived probiotic formulation of L. fermentum strains improved gut microbiota composition and alleviated hyperlipidemia, insulin resistance, and sympathetic hyperactivity and increased BP in rats fed a HFD. Our findings may encourage the development of randomized controlled trials to assess the effects of L. fermentum treatment in subjects with cardiometabolic disorders.

A case-control study to assess the association of obesity and insulin resistance in hypertension at a tertiary care hospital in North Kerala

A case-control study to assess the association of obesity and insulin resistance in hypertension at a tertiary care hospital in North Kerala

Vascular stiffness in children born after frozen or fresh embryo transfer. A cardiac magnetic resonance imaging study of 8 to 9 year old children

Abstract Background Vascular stiffness increases during childhood, and increased vascular stiffness is associated with symptomatic cardiovascular disease in adults with metabolic syndrome. In comparison with naturally conceived children (NC), children conceived after in-vitro fertilization by frozen (FET) or fresh embryo transfer (Fresh ET) are at risk of being large- and small-for-gestational-age, respectively. Epigenetic modulation during assisted reproductive technologies (ART) is suggested to influence cardiovascular risk factors, and recent literature suggests that children conceived after ART are at increased risk of insulin resistance, endothelial dysfunction and arterial hypertension. Such changes may be associated with increased vascular stiffness, but it is not yet been examined directly. Purpose We investigated if ART children are at increased risk of aortic distensibility and pulse-wave velocity. Methods 150 children aged 8–9 years conceived after FET (n=50), Fresh ET (n=50) or by natural conception (NC, n=50) were studied with magnetic resonance imaging. Conductance artery stiffness was determined from aortic distensibility and aortic pulse-wave velocity (PWV). Data were analyzed with blinding according to treatment group. Based on a conservative estimate for the common SD for the difference between groups of 1.5 mm2/mmHg, 36 children were required in each group to detect a difference in aortic distensibility of 10%, which corresponds to a 5 year age difference, with an alpha of 0.05 (double-sided) and a beta of 0.80. We aimed for 50 children in each group to allow for dropouts and non-analyzable scans, and to allow for further determinations. The effects of potential confounders on the effect of conception method on ascending aorta distensibility and total aortic PWV were tested stepwise in four linear regression models (Figure 1). Results Child groups were comparable with respect to anthropometric measures (Table 1). No differences were observed in systolic or diastolic blood pressure, cardiac output, total peripheral resistance, or in aortic distensibility (Ascending aorta distensibility: FET, ascending aorta 11.12±3.55 10–3 mm2/mmHg; Fresh ET 11.77±2.97 10–3 mm2/mmHg; NC 11.43±2.82 10–3 mm2/mmHg) (ANOVA-p=0.58) or aortic PWV (PWV of total aorta: FET, 3.69±0.75 m/s; Fresh ET, 3.49±0.31 m/s; NC, 3.59±0.61 m/s) (ANOVA-p=0.26). The effect of ART remained non-significant after adjustment for child sex, maternal BMI at early pregnancy, and maternal educational level (Figure 1). Conclusion The effects of ART on aortic distensibility were not statistically significant, but in the direction of the hypothesis of stiffer conductance arteries from frozen embryo transfer. The confidence interval was relatively wide, and the results suggest that the difference between frozen and fresh embryo transfer may in fact correspond to an age difference of more than 5 years. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): The Novo Nordisk Foundation Table 1Figure 1

Влияние маркеров субклинического воспаления на развитие сердечно-сосудистой патологии у больных с метаболическим синдромом

Metabolic syndrome currently remains one of the most pressing problems in medicine, since it makes its decisive contribution to the development of cardiovascular diseases and cerebral complications. Another important problem of modern medicine is arterial hypertension, which is one of the constituent criteria of metabolic syndrome, whose mechanism of development is due to a disruption in the work of the renin-angiotensin-aldosterone system, the sympathoadrenal system, an increased content of pro-inflammatory cytokines, as well as an imbalance in the adipokine system. Adipose tissue now acts not just as a structure that provides our body with energy only, but now it acts as an organ of the endocrine system, producing a large number of metabolically active substances. Patients with metabolic syndrome have been found to have elevated levels of proinflammatory cytokines were increased: monocytic chemotactic protein-1 (MCP-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). These cytokines are thought to be synthesised by adipose tissue macrophages and are involved in the pathogenesis of the metabolic syndrome. Oxidative stress can induce insulin resistance in adipocytes. The pathogenesis of oxidative stress in adipocytes in MS is still a mystery. This knowledge would be very useful in developing new approaches to MS therapy. Given the significant effect of chemokines in MS on the development of systemic inflammation, insulin resistance, and arterial hypertension, scientists have an important task not only to describe the actions of individual chemokines in hypertension, but also to characterize how the effect on one chemokine modulates the expression and/or function of other chemokines and their related receptors.

Study of the Efficiency of Using Type 5 Phosphodiesterase Inhibitors in the Therapy of Ereсtile Dysfunction in Patients with Metabolic Syndrome

Metabolic syndrome is a symptom complex that combines abdominal obesity, insulin resistance, hyperglycemia, dyslipidemia and arterial hypertension. One of the complications of metabolic syndrome is sexual dysfunction in men. The objective: is to evaluate the efficacy and tolerability of udenafil 200 mg in the treatment of erectile dysfunction in patients with metabolic syndrome. Materials and methods. The clinical efficacy of the IV generation PDE-5 inhibitor medicine udenafil in 76 patients with erectile dysfunction of mixed origin and with metabolic syndrome in dynamics was studied. The average age was 51,6±8,2 years. The observation period was 12 weeks, but the control of metabolic syndrome parameters (anthropometry, review, biochemical blood tests) and the assessment of erectile function were carried out for 6 months. Results. After 12 weeks, patients achieved positive results in weight loss, BMI and waist circumference, although not significantly. It is necessary to note the positive changes in the indicators of the cardiovascular system. The downward trend was demonstrated by such indicators as heart. Diet therapy and taking statins have improved the indicators of fat metabolism. Correction of metabolic disorders in patients was accompanied by an increase in total and free testosterone. However, there was no statistically significant difference in the degree of increase in the concentration of androgens. Correction of metabolic disorders in patients was accompanied by an increase in total and free testosterone. During treatment, almost all integrative indices of IIEF increased. Specifically, the index «erectile function» improved 2,26 times (p<0,01), «satisfaction with intercourse» 2,59 times (p<0,001), «orgasm» 2,0 times (p<0,01), «libido» – 2,9 times (p<0,001), «general satisfaction» 2,3 times (p<0,01). According to various indicators, the sexual function of men with metabolic syndrome and erectile dysfunction improved 2–2,9 times. Changes in cavernous blood flow on Doppler ultrasonography showed an increase in peak systolic blood flow rate by 1,5 times, which is associated with the udenafil half-life. Our data indicate that the use of the medicine udenafil is perspective in men with erectile dysfunction and metabolic syndrome and in those who do not have stable family-sexual relations to ensure spontaneity of sexual relations. Conclusions. Udenafil can be considered as a first-line medecine in the treatment of erectile dysfunction in patients with metabolic syndrome.

CLINICAL COURSE, TREATMENT AND PROGNOSIS OF CEREBROVASCULAR DISORDERS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Type 2 diabetes mellitus (DM2) significantly increases the risk of stroke, dementia, and other cognitive and mental disorders. Atherosclerotic type of cardiovascular disorders (CVD) is the main cause of death in patients with DM2. Aim. In this review, we aimed to outline risk factors, clinical characteristics and outcomes of stroke in patients with DM2. The obtained information can be used to improve prevention, early diagnosis, and treatment of cerebral vascular disorders in DM2. Materials and Methods. We conducted a systematic review of prognostic and risk factors of cerebral vascular disorders in DM2. Our search included 50 articles from PUBMED published in the last few years. We compared statistical data from Azerbaijan with those from other countries. Results. Hyperglycemia, obesity, insulin resistance and arterial hypertension (AH) are all risk factors of brain microvascular dysfunctions in patients with diabetes mellitus. Furthermore, obesity, AH, dyslipidemias, smoking and genetic predisposition to CVD, chronic kidney disorders, and albuminuria are all risk factors of cardiovascular disorders in DM2. The possible outcomes can be a stroke, cognitive dysfunction, and depressive disorders. For Azerbaijan, main risk factors is an atherosclerotic type of CVD. Conclusion. Due to the high socio-economic burden of disease there is an urgent need in new approaches aimed at prevention, early diagnosis and treatment of cerebral vascular disorders in patients with DM2 in Azerbaijan.