Lipidemic Profile Research Articles

Screening and Risk Assessment of Coronary Artery Disease in Patients With Type 2 Diabetes: An Updated Review.

Current literature indicates that there is a strong correlation between coronary artery disease (CAD) and type 2 diabetes. The arteriosclerotic progression occurs earlier and in a greater extent in the diabetic than in the non-diabetic population. In diabetic subjects, the detection of arterial disease does not always precede the development of an acute arterial incident. Herein, we reviewed studies published within the last 5 years in order to reveal the risk factors for coronary artery disease in patients with type 2 diabetes. In addition, we aimed to discuss how to diagnose in an early stage or even screen the presence of coronary artery disease in asymptomatic diabetic patients. Possible blood markers as predictors of CAD, which are mostly related to the lipidemic profile of subjects, are included in this review. Less invasive imaging methods than conventional coronary angiography, included in the article, are gradually used more in the diagnosis of CAD and show high effectiveness. Data from 23 articles with 22,350 patients having type 2 diabetes were summarized and presented descriptively.

Single bout of low-intensity exercise produces modestly favorable changes in glycemic and lipidemic profiles after ingestion of non-isoglucidic breakfasts.

The aim of this study was to investigate the acute effects of low-intensity exercise on the postprandial hormonal and metabolic milieu induced by breakfast consumption. Exercise began 100 min after the initiation of breakfast consumption and consisted of cycling at 40% of maximum oxygen uptake for 20 min. Three different breakfasts were used to elicit the postprandial state: B1 = skimmed milk (125 mL) and 30g corn flakes; B2 = skimmed milk (220 mL), 200 g apple, 30 g cocoa cream-filled sponge cake; B3 = skimmed milk (125 mL), 50 g bread, 150 g apple, and 15 g hazelnut and cocoa spread. Nineteen young healthy participants (8 M/11 F; body mass index 22.7 ± 0.5 kg/m2; age 31 ± 0.7 y) consumed the three breakfasts, as well as an oral glucose load (50-g oral glucose tolerance test), under either resting or exercise conditions, in a randomized-crossover fashion. Blood glucose, insulinemia, ghrelinemia, lipidemia, and satiety were measured throughout the studies. To evaluate the metabolic effects of exercise, the changes that glucose, insulin, ghrelin, free fatty acid exhibited in the interval 90 to 120 min were analyzed with a two-way repeated measures analysis of variance (factor 1: type of oral test; factor 2: resting/exercise condition). No interaction between the two factors was found for any of the examined variables. Light exercise produced a modest, significant decrease in blood glucose levels (P = 0.004) and a modest, significant increase in free fatty acid levels (P = 0.002) with respect to the resting condition. These findings suggest that short, mild exercise has beneficial effects on postprandial metabolism and this may have direct bearing on the issue of counteracting the epidemic rising of sedentary lifestyle of the general population.

A Pharmacological Update of Ellagic Acid.

Ellagic acid is a common metabolite present in many medicinal plants and vegetables. It is present either in free form or as part of more complex molecules (ellagitannins), which can be metabolized to liberate ellagic acid and several of its metabolites, including urolithins. While ellagic acid's antioxidant properties are doubtless responsible for many of its pharmacological activities, other mechanisms have also been implicated in its various effects, including its ability to reduce the lipidemic profile and lipid metabolism, alter pro-inflammatory mediators (tumor necrosis factor-α, interleukin-1β, interleukin-6), and decrease the activity of nuclear factor-κB while increasing nuclear factor erythroid 2-related factor 2 expression. These events play an important role in ellagic acid's anti-atherogenic, anti-inflammatory, and neuroprotective effects. Several of these activities, together with the effect of ellagic acid on insulin, glycogen, phosphatases, aldose reductase, sorbitol accumulation, advanced glycation end-product formation, and resistin secretion, may explain its effects on metabolic syndrome and diabetes. In addition, results from recent research have increased the interest in ellagic acid, both as a potential protective agent of the liver and skin and as a potential anticancer agent, due to the specific mechanisms affecting cell proliferation, apoptosis, DNA damage, and angiogenesis and its aforementioned anti-inflammatory properties. Taken together, these effects make ellagic acid a highly interesting compound that may contribute to different aspects of health; however, more studies are needed, especially on the compound's pharmacokinetic profile. In this review, we selected papers published from 2005 to the present.

Effect of Saffron on Metabolic Profile and Retina in Apolipoprotein E–Knockout Mice Fed a High-Fat Diet

ABSTRACTSaffron is a spice that has been traditionally used as a regimen for a variety of diseases due to its potent antioxidant attributes. It is well documented that impaired systemic oxidative status is firmly associated with diverse adverse effects including retinal damage. The aim of this study was to investigate the role of saffron administration against the retinal damage in apoE −/− mice fed a high-fat diet, since they constitute a designated experimental model susceptible to oxidative stress. Twenty-one mice were allocated into three groups: Group A (control, n = 7 c57bl/6 mice) received standard chow diet; Group B (high-fat, n = 7 apoE −/− mice) received a high-fat diet; and Group C (high-fat and saffron, n = 7 apoE −/− mice) received a high-fat diet and saffron (25 mg/kg/d) through their drinking water. The duration of the study was 20 weeks. Lipidemic profile, glucose, C-reactive protein (CRP), and total oxidative capacity (PerOX) were measured in blood serum. Histological analysis of retina was also conducted. Administration of saffron resulted in enhanced glycemic control and preservation of retinal thickness when compared with apoE −/− mice fed a high-fat diet. The outcomes of the study suggest the potential protective role of saffron against retinal damage induced by oxidative stress. Nevertheless, verification of these results in humans is required before any definite conclusions can be drawn.

Thyroid hormones: a potential ally to LDL-cholesterol-lowering agents.

L-thyroxine (LT4) treatment of hypothyroidism, particularly in patients with thyroid- stimulating hormone (TSH) >10mU/L, results in improved lipid profile, as LT4 stimulates low-density lipoprotein cholesterol (LDL-C) degradation and the conversion of cholesterol in bile acids by inducing LDL-receptor and 7 alpha hydroxylase expression, respectively. Statins decrease total cholesterol (TC) and LDL-C mainly by suppressing 3-hydroxy-3-methylglutaryl coenzyme A activity. Therefore, the addition of statins to LT4 treatment, following the reversal of hypothyroidism, acts synergistically and forms a powerful treatment modality in patients with this condition whose serum lipids have not achieved the target. Statin add-on therapies, such as ezetimibe (EZE) and the recently approved proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, in conjunction with LT4 therapy, produce an even more favorable profile. Ezetimibe blocks the intestinal absorption of cholesterol, while in patients with heterozygous familiar hyperlipidemia, PCSK9 inhibitors suppress PCSK9, thereby promoting LDL-C degradation. The synergy of these drugs results in a far better lipidemic profile than when each drug is administered alone, with LT4 treatment clearly enhancing, in many respects, the efficacy of therapy.

Relationship between endothelial function and platelet hemostasis in patients with a good compensation of type 2 diabetes mellitus and hypertension.

Background. Disorders of hemostasis in patients with arterial hypertension and diabetes mellitus type 2 are complex: growing aggregative activity of platelets and red blood cells, activation and degranulation of platelet antiaggregatory potential endothelium; reduced anticoagulant and fibrinolytic activity of blood. Objective. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with good compensation of type 2 diabetes mellitus and arterial hypertension.. Methods. In 69 patients with good glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. Results. Results of correlation analysis showed the presence of credible negative relation between the content of unactivated platelets and concentrations of endothelin-1 (r=-0.53; p<0.05), von Willebrand factor (r=-0.68; p<0.05) and thrombomodulin (r=-0.55; p<0.05). The largest number and strength of correlations between morphological indicators of intravascular platelet activation and studied clinical and laboratory parameters were observed with admiration to the activated and aggregated forms of cells. In particular, elevated levels of activated platelets in patients of this contingent had reliable high degree of direct correlation with the content of glycated hemoglobin (r=+0.79), systolic blood pressure (r=+0.63), the concentration of endothelial dysfunction markers, including the level of albuminuria (r=+0.73), as well as with the values of total cholesterol (r=+0.64) and low density lipoprotein cholesterol (r=+0.79). On the level of endothelin-1 and thrombomodulin concentration was found positive linear correlation, but alpha-granules located in shut inverse correlation not only with endothelin-1 (r=-0.57; p<0.05), as well as with the concentration of glycated hemoglobin (r=-0.76; p<0.05) and with dyslipidemic changes. Increased platelet aggregation activity in patients with good glycemic compensation, which was manifested in a twofold increase in the content of circulating small units was significantly correlated with the level of glycated hemoglobin (r=+0.66) and the values of systolic blood pressure (r=+0.58), as well as concentrations of markers of endothelial dysfunction and renal function, but did not have any significant relationships with blood lipids in patients of this contingent. Conclusion. It has been established that in the good glycemic control morphological criteria of platelet hemostasis damage clearly correlated with markers of endothelial dysfunction, but did not show significant relationships with indicators of renal function and blood lipid profile.

Lipoprotein redox status evaluation as a marker of cardiovascular disease risk in patients with inflammatory disease.

Patients with chronic inflammatory disorders (ID) have an increased risk of developing cardiovascular disease, and routinely determined parameters do not reveal the real metabolic status of specific subgroups, such as patients with rheumatoid arthritis (RA). In this study, in order to evaluate state of the art markers for the assessment of cardiometabolic risk, abnormalities in lipoprotein levels in patients with a low-grade inflammatory status [diabetes mellitus (DM) subgroup] and in patients with a high systemic inflammatory burden (RA subgroup) was determined. The study group comprised patients with ID [DM (n=20) and RA (n=20)], with an aged-matched control group (n=17). Patient serum was used to determine routine biochemical parameters and to isolate low-density lipoprotein (LDL) and high-density lipoprotein (HDL). The heparin-citrate method was used for LDL precipitation and the phosphotungstic acid-MgCl2 technique for the isolation of HDL. Further, Amplex Red and advanced oxidation protein product (AOPP) assays were applied to determine lipid peroxides and protein oxidation, respectively, while the levels of serum advanced glycation end products (AGEs) were also determined. Although the differences in the routinely determined lipidemic profile were notable between the DM and RA subgroups, markers of lipid peroxidation and of advanced protein oxidation/glycation did not differ significantly, indicating possible similar oxidative damage of serum lipoproteins. On the whole, as alterations in lipoprotein functionality can occur long before any changes in routinely measured biochemical parameters are observed, more sensitive markers for the assessment of cardiovascular risk are required. As AOPPs, AGEs, oxidized LDL (oxLDL) and especially oxidized HDL (oxHDL) are affected during the early stages of inflammatory disease, and due to their known link to coronary artery disease, it would be wise to include these markers in the routine cardiovascular evaluation of patients with chronic inflammatory disease, such as those with RA.

Heterozygous connexin 50 mutation affects metabolic syndrome attributes in spontaneously hypertensive rat.

BackgroundSeveral members of connexin family of transmembrane proteins were previously implicated in distinct metabolic conditions. In this study we aimed to determine the effects of complete and heterozygous form of connexin50 gene (Gja8) mutation L7Q on metabolic profile and oxidative stress parameters in spontaneously hypertensive inbred rat strain (SHR).MethodsAdult, standard chow-fed male rats of SHR, heterozygous SHR-Dca+/− and SHR-Dca−/− coisogenic strains were used. At the age of 4 months, dexamethasone (2.6 μg/ml) was administered in the drinking water for three days. The lipidemic profile (cholesterol and triacylglycerol concentration in 20 lipoprotein fractions, chylomicron, VLDL, LDL and HDL particle sizes) together with 33 cytokines and hormones in serum and several oxidative stress parameters in plasma, liver, kidney and heart were assessed.ResultsSHR and SHR-Dca−/− rats had similar concentrations of triacylglycerols and cholesterol in all major lipoprotein fractions. The heterozygotes reached significantly highest levels of total (SHR-Dca+/−: 51.3 ± 7.2 vs. SHR: 34.5 ± 2.4 and SHR-Dca−/−: 34.4 ± 2.5 mg/dl, p = 0.026), chylomicron and VLDL triacylglycerols. The heterozygotes showed significantly lowest values of HDL cholesterol (40.9 ± 2.3 mg/dl) compared both to SHR (51.8 ± 2.2 mg/dl) and SHR-Dca−/− (48.6 ± 2.7 mg/dl). Total and LDL cholesterol in SHR-Dca+/− was lower compared to SHR. Glucose tolerance was improved and insulin concentrations were lowest in SHR-Dca−/− (1.11 ± 0.20 pg/ml) in comparison with both SHR (2.32 ± 0.49 pg/ml) and SHR-Dca+/− (3.04 ± 0.21 pg/ml). The heterozygous rats showed profile suggestive of increased oxidative stress as well as highest serum concentrations of several pro-inflammatory cytokines including interleukins 6, 12, 17, 18 and tumor necrosis factor alpha.ConclusionsOur results demonstrate that connexin50 mutation in heterozygous state affects significantly the lipid profile and the oxidative stress parameters in the spontaneously hypertensive rat strain.Electronic supplementary materialThe online version of this article (doi:10.1186/s12944-016-0376-3) contains supplementary material, which is available to authorized users.

PP.30.22] DYSLIPIDEMIA AND AGGRAVATED QUALITY OF LIFE IN HYPERTENSIVES

Objective: Essential hypertension (EH) has a negative impact on health-related quality of life (H-rQoL) while dyslipidemia very often accompanies the hypertensive sequelae. We assesed the hypothesis that the combination of EH and dyslipidemia may have an additive effect on H-rQoL. Design and method: We studied 145 subjects with newly diagnosed stage I-II untreated EH (aged 56 ± 7 years, 47 = dyslipidemic, office blood pressure = 156/92 mmHg). Venous sampling was performed for estimation of lipidemic profile. The validated Greek version of Short Form 36 (SF-36) General Health Survey questionnaire was administered. The 8 subscales of SF-36 were further grouped into two summary scales: the physical component summary scale (PCS) and the mental component summary scale (MCS). Non-parametric Mann-Whitney and Spearmann rho tests were performed. Results: Dyslipidemic hypertensives demonstrated significantly lower scores in all SF-36 dimensions compared to non dyslipidemic (Table). There was a negative correlation between scores in general health and the total SF-36 score with serum triglycerides level (r = -0.284 p = 0.009, r = -0.287 p = 0.014, respectively).Conclusions: Dyslipidemia exerts an additive detrimental effect on quality of life in the setting of essential hypertension. Whether the above mentioned association contributes to the high cardiovascular risk observed in those patients remains to be determined in future studies.

Relationship of morphological changes of blood cells with endothelial function, renal function and lipidemic profile in patients with type 2 diabetes mellitus with suboptimal glycemic control and hypertension.

Background. Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. Objective. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with type 2 diabetes mellitus with suboptimal glycemic control and hypertension. Methods. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. Results. Against the background of insufficient glycemic compensation glycated hemoglobin concentration tightly correlated with the share of activated platelets (r=+0.77; p<0.05), with the level of aggregated forms (r=+0.82; p<0.05) and the concentration of small blood platelet aggregates (r=+0.76; p<0.05), established a positive relationship with the share degranulated platelets (r=+0.60; p<0.05). Signs of atherogenic dyslipidemia triad that this contingent of patients indicated significant deviation from that of the control group not only had a correlation with the share of activated platelets and content of alpha and delta granules, but also formed a new moderate strength correlations with other observable parameters of platelet morphology. In particular, amid insufficient glycemic compensation formed reliable values of the coefficients of linear correlation in pairs: total cholesterol and activated platelets (r=-0.54), low density lipoprotein cholesterol and activated platelets (r=-0.51), low density lipoprotein cholesterol and aggregated forms (r=+0.59), low density lipoprotein cholesterol and degranulated platelets (r=+0.48). Also triglycerides level in these patients established statistically significant correlation with all studied parameters of intravascular platelet activation. Conclusion. It has been established that in the insufficient glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathy and dyslipidemic changes.

The Impact of Continuous Subcutaneous Insulin Infusion Therapy on Efficacy and Safety in a Cohort of Type 1 Diabetes Patients: A 3-Year Prospective Study.

Several studies have found improved glycemic control with continuous subcutaneous insulin infusion compared with multiple daily insulin injections for patients with type 1 diabetes, albeit for a relatively short-period of follow-up. This prospective study presents for the first time the optimization of glycemic control with insulin pumps in a cohort of Greek patients with type 1 diabetes for a 3-year follow-up period during the socioeconomic crisis in Greece. Ninety-four patients, previously on intensified basal-bolus insulin therapy with poor glycemic control, were initially recruited. Glycosylated hemoglobin (HbA1c), hypoglycemic and diabetic ketoacidosis episodes, pump-related side effects, lipidemic profile, 24-h urine albumin excretion, body mass index, blood pressure, and total daily insulin requirements (bolus and basal) were recorded during the 3-year follow-up. Statistical analysis was initially conducted for the entire study population and after body mass index and gender stratification. Seventy-nine patients completed the study. A statistically significant decrease of HbA1c level (P < 0.0001) was observed at the end of Year 1 and was retained for the following years for the whole population. Similarly, significantly fewer hypoglycemic episodes occurred during the follow-up period (P < 0.0001) compared with study entry. Insulin pump treatment was not accompanied with weight changes across all body mass index strata. Continuous subcutaneous insulin infusion achieved almost optimal glycemic control, reduced the number of hypoglycemic episodes without weight gain, and was well tolerated for the whole study period. Finally, this therapeutic approach was accompanied with lower daily insulin requirements.

Effets of &lt;i&gt;Pistacia lentiscus&lt;/i&gt; Virgin Fatty Oil on Lipidemic Profile and Carcass Characteristics in Hyperlipidemic &lt;i&gt;Oryctolagus cuniculus&lt;/i&gt; Rabbits

The study aimed to evaluate Pistacia Lentiscus Virgin Fatty Oil (PLVFO) effects on lipidemic profile and carcass characteristics in rabbits. 15 male adult rabbits were allocated in three groups of 5 each. The first was not treated and served as control (CRL), the second was gavaged by Egg Yolk (EY) at a dose of 7 mL kg-1 BW (6/7 days), the third was treated as EY and then PLVFO was applied at a dose of 1 mL kg-1 BW (6/7 days). At 28th day of experiment, the biochemical profiles were determined and then animals were sacrified for anatomo-pathological studies and carcass characteristics investigation. PLVFO has resulted in non significant decrease of total cholesterol, a significant decrease of LDL-C (PLVFO Vs EY, ANOVA, p<0.01) and a significant increase of HDL-C (PLVFO Vs EY, ANOVA, p<0.001) with a significant amelioration of atherogenic index (PLVFO Vs EY, ANOVA, p<0.01). This oil has also increased non significantly ALT with a significant increase of AST (PLVFO Vs EY, ANOVA, p<0.01). Anatomo pathological investigations have not shown significant disturbances by PLVFO, this later has reduced significantly dissectible fat (PLVFO Vs EY, ANOVA, p<0.05). The study concludes that PLVFO prevent hyperlipidemia and obesity at tested dose. However, its prolonged use may increase transaminases enzymes activities.

PP.19.16

Objective: Insulin resistance has been found to be higher in hypertensive subjects. Whether this is also true in prehypertension is controversial. We examined both insulin resistance and lipidemic profile in subjects with prehypertension Design and method: 214 outpatients (119 men and 97 women) of Greek origin were divided into 2 groups: a) prehypertensive and b) control group. These groups were tested for insulin resistance using the HOMA index, as well as lipids values. All participants were matched for age and BMI. Prehypertension is defined as BP = 120–139/80–89 mmHg and normal BP < 120/80 mmHg. Ambulatory blood pressure were measured in both groups. Categorical and numeric values were analyzed with x2 and t-test or Mann-Whitney test were appropriate. Results: HOMA index was higher in the prehypertensive versus the control group (p = 0,013), and similar results were shown for the measurement of insulin (p = 0,001). Additionally, a statistically significant difference was found between the control versus the prehypertensive group for cholesterol (p = 0,017) and triglycerides (p = 0,003). No significant differences were found for all the other parameters. Conclusions: Our study revealed a significantly higher Insulin resistance, total cholesterol and triglyceride the prehypertensives. These are parameters of the metabolic syndrome, which is associated with the high cardiovascular risk. Thus, measuring these factors might be useful people with non-optimal values of BP

PP.30.22

Objective: Essential hypertension (EH) has a negative impact on health-related quality of life (H-rQoL) while dyslipidemia very often accompanies the hypertensive sequelae. We assesed the hypothesis that the combination of EH and dyslipidemia may have an additive effect on H-rQoL. Design and method: We studied 145 subjects with newly diagnosed stage I-II untreated EH (aged 56 ± 7 years, 47 = dyslipidemic, office blood pressure = 156/92 mmHg). Venous sampling was performed for estimation of lipidemic profile. The validated Greek version of Short Form 36 (SF-36) General Health Survey questionnaire was administered. The 8 subscales of SF-36 were further grouped into two summary scales: the physical component summary scale (PCS) and the mental component summary scale (MCS). Non-parametric Mann-Whitney and Spearmann rho tests were performed. Results: Dyslipidemic hypertensives demonstrated significantly lower scores in all SF-36 dimensions compared to non dyslipidemic (Table). There was a negative correlation between scores in general health and the total SF-36 score with serum triglycerides level (r = -0.284 p = 0.009, r = -0.287 p = 0.014, respectively).Conclusions: Dyslipidemia exerts an additive detrimental effect on quality of life in the setting of essential hypertension. Whether the above mentioned association contributes to the high cardiovascular risk observed in those patients remains to be determined in future studies.

PP.02.08

Objective: Much of the variance in hypertension-related sequelae across ethnic groups is highly related to differences in socioeconomic conditions, nutrition, attitudes and deficits in accurate health related data. East european countries exhibit higher morbidity and mortality from coronary disease than tha rest of Europe. We assessed the hypothesis that target organ damage in this vulnerable population may be different than the one of the native hypertensive patients. Design and method: The study population consisted of 128 hypertensives: 67 immigrants from Eastern Europe to Greece and 61 native inhabitants, matched for age, gender and office BP. Demographic characteristics were recorded, while echocardiography was performed and arterial stiffness was estimated by measuring carotid-femoral pulse wave velocity in all subjects. In addition, glomerular filtration rate (GFR) was evaluated and fundoscopy was performed in all study subjects. Results: Although immigrants exhibited lower body mass index (BMI) compared to natives, they had significantly increased arterial stiffness (p = 0.003), increased left atrial volume index (p < 0.05) and left ventricular mass index (p < 0.05), worse left ventricular diastolic dysfunction (p < 0.05), elevated levels of serum cholesterol (p = 0.046) and sodium urinary excretion (p < 0.05) and considerably lower GFR (p < 0.05). Finally, univariate analysis showed a positive correlation between LVMI and LAVI (r = 0.43, p < 0.0001), and a negative correlation between LAVI and GFR (r = -0.45, p = 0.001) as well as between PWV and GFR (r = -0.538, p < 0.0001) in both groups. Conclusions: Hypertensive immigrants appear to have lower BMI compared to native Greeks, but they are characterized by unfavourable lipidemic profile, increased aortic stiffness, structural and functional atrio-ventricular maladaptations and marked acceleration of the renal damage. Evidence indicate that dietary peculiarities like augmented salt intake might partially explain the increased target organ damage burden in this group.

Evaluation of relationship between endothelial function and vascular-platelet hemostasis in patients with a good compensation of type 2 diabetes mellitus and hypertension

The aim of research. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with good compensation of type 2 diabetes mellitus and arterial hypertension. Material s and m ethods . In 69 patients with good glycemic compensation using clinical, laboratory, morphological methods and correlational analysis association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis have been identified. Results. Results of correlation analysis showed the presence of credible negative relation between the content of inactivated platelets and concentrations of endothelin-1 (r=-0.53; p<0.05), von Willebrand factor (r=-0.68; p<0.05) and thrombomodulin (r=-0.55; p<0.05). The largest number and strength of correlations between morphological indicators of intravascular platelet activation and studied clinical and laboratory parameters were observed with admiration to the activated and aggregated forms of cells. In particular, elevated levels of activated platelets in patients of this contingent had reliable high degree of direct correlation with the content of glycated hemoglobin (r=+0.79), systolic blood pressure (r=+0.63), the concentration of endothelial dysfunction markers, including the level of albuminuria (r=+0.73), as well as with the values of total cholesterol (r=+0.64) and low density lipoprotein cholesterol (r=+0.79). Content of aggregated platelets statistically significantly positively correlated with the level of glycated hemoglobin (r=+0.73), all markers of endothelial dysfunction, urea concentration (r=+0.51) and creatinine (r=+0.58). In contrast, the relative content of degranulated platelet establish a reliable correlation only with the levels of endothelin-1 (r=+0.75) and thrombomodulin (r=+0.62). On the level of endothelin-1 and thrombomodulin concentration positive linear correlation was found, but alpha-granules located in shut inverse correlation not only with endothelin-1 (r=-0.57; p<0.05), as well as with the concentration of glycated hemoglobin (r=-0.76; p<0.05) and with dyslipidemic changes. Increased platelet aggregation activity in patients with good glycemic compensation, which was manifested in a twofold increase in the content of circulating small units was significantly correlated with the level of glycated hemoglobin (r=+0.66) and the values of systolic blood pressure (r=+0.58), as well as concentrations of markers of endothelial dysfunction and renal function, but did not have any significant relationships with blood lipids in patients of this contingent. Conclusion. It has been established that in the good glycemic control morphological criteria of platelet hemostasis damage clearly correlated with markers of endothelial dysfunction, but did not show significant relationships with indicators of renal function and blood lipid profile.

Correlations between clinical, laboratory and morphological parameters of endothelial dysfunction and vascular-platelet hemostasis in patients with type 2 diabetes mellitus and hypertension with poor glycemic compensation

Aim. Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance.Methods and results. In 78 patients with poor glycemic compensation associations between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis were identified using clinical, laboratory, morphological methods and correlational analysis.Conclusion. It has been established that in the poor glycemic control against the background of significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis extremely dense correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes are formed.

Relationship of hyperglycemia with endothelial function, renal function, lipidemic profile, and morphological changes of blood cells in patients with insufficient compensation of type 2 diabetes mellitus with hypertension

Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. It has been established that in the insufficient glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis (up to r=+0.95) formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes.

Relationship of endothelial dysfunction with degree of renal function damage and lipidemic profile in patients with type 2 diabetes mellitus and hypertension.

In the article defining relationship between endothelial dysfunction, the degree of renal and lipidemic profile damage in 234 patients with type 2 diabetes mellitus with hypertension was carried depending on the quality of glycemic control. It is shown that the deepening of endothelial dysfunction in patients with insufficient and poor compensation tightly correlates with the degree of renal and lipidemic disorders. In these patients there was a significant increase in the level of albuminuria, reduction in glomerular filtration rate, increase of concentrations of urea and creatinine. Against the background of poor hyperglycemia, compensation total cholesterol, low density lipoprotein content increases by 73,3% (p<0.05), hype­rtriglyceridemia twice exceeds the control values. In patients with type 2 diabetes mellitus with poor compensation the most significant correlation links were observed between the concentration of endothelin-1 and the level of microalbuminuria (r=+0,79), as well as the content of low density lipoprotein cholesterol (r=+0.81). Thrombomodulin concentration is in direct correlation with microalbuminuria (r=+0.76), hypercholesterolemia (r=+0.80) and hypertriglyceridemia (r=+0.83), indicating to increasing interaction between the pathogenetic mechanisms which cause depression of endothelial dysfunction, renal and dyslipidemic disorders with increasing hyperglycemia.

The effect of physical exercise on postpartum fitness, hormone and lipid levels: a randomized controlled trial in primiparous, lactating women.

To evaluate the effect of an exercise training program combining low-impact dance aerobic, resistance and stretching exercise on physical fitness, hormone and lipid levels of postpartum, primiparous, lactating women. Thirty seven primiparous, lactating women were randomly assigned at 4-6 weeks postpartum to either follow an exercise training program of 50-60 min aerobic, strengthening and stretching exercise, 3 days a week, for 12 weeks (interventional group; n = 20) or no training program at all (control group; n = 17). The following parameters were measured at baseline and 12 weeks later: (1) for evaluation of physical fitness: VO2max, muscular endurance, joint mobility and body fat; (2) for evaluation of the lipidemic profile: triglyceride, total cholesterol, HDL and LDL levels, and (3) levels of hormones associated with lactation: prolactin, estradiol, cortisol, TSH, fT3 and fT4. After completion of the exercise training program, comparisons between the interventional and the control group showed statistically significant mean changes in VO2max (p = 0.003), muscular endurance of the upper extremities (p < 0.001), and the abdomen (p < 0.001), flexibility (p = 0.042), and body fat (p = 0.007). There were no significant differences between the two groups in mean changes of lipid and hormone levels. Implementation of a low-impact exercise training program appears to improve physical fitness of postpartum women, while it does not seem to affect lipid levels and lactation-associated hormone levels. Hence, implementation of an exercise training program combining low-impact dance aerobic, resistance and stretching exercise is feasible in postpartum, primiparous, lactating women.