pm mfvt1
    • Main page
      • About journal
      • Articles. Working with contents
      • Editor-in-chief
      • Editorial Council
      • Editorial Board


      • For authors
      • Standards for formatting information
      • Reviewing
      • Politics editorial board
      • Ethics of journal publications


      • For advertisers
      • Subscription
      • About the Publishing House
      • Contact us
  • The role of obesity for target organs damage in patients with type 2 diabetes mellitus

    Редактор | 2016, Articles based on dissertstions, Practical medicine 08 (16) Pediatrics | 30 ноября, 2016

    M.G. EVSINA1, E.M. VISHNEVA2, E.M. FUTERMAN2

    1City Clinical Hospital №14, 15A 22 Partsezd Str., Ekaterinburg, Russian Federation, 620039

    2Ural State Medical University, 3 Repin Str., Ekaterinburg, Russian Federation, 620028 

     Evsina M.G. ― Doctor of functional diagnostics, tel. +7-908-631-39-08, e-mail: evsinam@mail.ru

    Vishneva E.M. ― D. Med. Sc, Associate Professor of the Department, tel. +7-912-241-86-52, e-mail: e.m.vishneva@mail.ru

    Futerman E.M. ― Cand. Med. Sc., Assistant of the Department, tel. +7-912-030-42-16, e-mail: efuterman@mail.ru

    The article presents the results of a one-time survey of 92 patients with cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Three groups of patients have been studied: group 1 (control) ― 10 men and 22 women with a history of CVD, body mass index (BMI) <25 kg/m2 and without T2DM, average age 65,50±6,98 years; group of 2 ― 14 men and 16 women with T2DM and CVD, with a BMI <25 kg/m2, average age 62,13±8,30 years; group of 3 ― 12 men and 18 women with T2DM, CV, with IMT ≥30 kg/m2, average age 63,00±6,99 years. Height, weight, BMI, blood pressure and heart rate have been evaluated, laboratory test of renal function, carbohydrate metabolism have been assessed. Transthoracic echocardiography and renal ultrasound examination with Doppler of the renal arteries have been performed. In groups 2 and 3 as compared to group 1 is revealed high evidence of hypertrophy of a left ventricle in the form of an increase of LVMM I (р1-2 and 2-3 <0,05). More pronounced diastolic dysfunction of a LV is revealed in groups 2 and 3: an increase of sphericity index (p<0.05) and reduced integral systolic remodeling index (p<0.05). A higher value of end-diastolic wall stress (p<0.05) is in group 3. The early predictor of left ventricular systolic dysfunction ― decrease of integral systolic remodeling index ― is identified in the groups 2 and 3, more pronounced in the group 3 (p<0.05). The adverse types of LV remodeling are more common in group 3. In group 3 manifestations of nephroangiopathy are more pronounced: PI at the level of interlobar arteries and at the level of the main renal arteries is significantly higher (p for all <0.05), than in group 2. The findings lead to the conclusion that obesity makes an additional damage to target organs in patients with T2DM and CVD.

    Key words: type 2 diabetes mellitus, obesity, cardiovascular disease.

    REFERENCES

    1. World Health Organization. Obesity and overweight. Informatsionnyy byulleten’, no. 311, January, 2015 (in Russ.), available at: http://www.who.int/mediacentre/factsheets/fs311/ru/
    2. Diagnosis and treatment of metabolic syndrome. Recommendations GFCF. Kardiovaskulyarnaya terapiya i profilaktika, 2009, 6 (6), appl. 2 (in Russ.).
    3. Van Gaal L.F., Mertens I.L., De Block C.E. Mechanisms linking obesity with cardiovascular disease. Nature, 2006, no. 444, rr. 875-880.
    4. Adam R., Abel W. Lipotoxicity in the Heart. Biochim. Biophys. Acta, 2010, 1801 (3), pp. 311-319.
    5. Fedorova E.Yu., Krasnova E.A., Shestakova M.V. Obesity and the Kidney: mechanisms of renal damage in obesity. Ozhirenie i metabolizm, 2006, no. 1, pp. 22-28 (in Russ.).
    6. Recommendations for the treatment of hypertension. ESH. Rossiyskiy kardiologicheskiy zhurnal, 2014, no. 1, pp. 7-94 (in Russ.).
    7. Diagnostika i lechenie ishemicheskoy bolezni serdtsa. Natsional’nye klinicheskie rekomendatsii. Sbornik, pod red. R.G. Oganova. 2-e izdanie [The diagnosis and treatment of coronary heart disease. National clinical guidelines. Collection. Ed. by R.G. Oganov. 2nd edition]. Moscow: Silitseya-Poligraf, 2009. Pp. 1-98.
    8. Diagnostika i lechenie serdechnoy nedostatochnosti. Natsional’nye klinicheskie rekomendatsii. Sbornik, pod. red. R.G. Oganova. 2-e izdanie [The diagnosis and treatment of coronary heart disease. National clinical guidelines. Collection. Ed. by R.G. Oganov. 2nd edition]. Moscow: Silitseya-Poligraf, 2009. Pp. 150-207.
    9. Diagnostika i lechenie metabolicheskogo sindroma. Natsional’nye klinicheskie rekomendatsii. Sbornik, pod. red. R.G. Oganova. 2-e izdanie [The diagnosis and treatment of coronary heart disease. National clinical guidelines. Collection. Ed. by R.G. Oganov. 2nd edition]. Moscow: Silitseya-Poligraf, 2009. Pp. 106-148.
    10. Dedov I.I., Shestakova M.V., Aleksandrov A.A. et al. The algorithms of specialized medical care to patients with diabetes mellitus. Sakharnyy diabet, 2013, no. 1 (in Russ.).
    11. WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization, 1995.
    12. Lang R.M., Bierig M., Devereux R.B. et al. Recommendations for chamber quantifi cation. Guidelines. Eur. J. Echocardiography, 2006, vol. 7, no. 2, pp. 79-108.
    13. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISATICA [Statistical analysis of medical data. Application package STATISATICA]. Moscow: MediaSfera, 2003. 312 p.
    14. Svistunov A.A., Golovacheva T.V., Skvortsov K.Yu. et al. Heart rate as a risk factor for cardiovascular diseases. Arterial’naya gipertenziya, 2008, vol. 14, no. 4, pp. 324-331 (in Russ.).
    15. Tkacheva O.N., Vertkin A.L. Diabeticheskaya avtonomnaya neyropatiya [Diabetic autonomic neuropathy]. Moscow: Geotar-Media, 2009. 76 p.
    16. Karpov R.S., Koshel’skaya O.A., Efimova E.V. et al. Features intrarenal kovotoka in patients with type 2 diabetes and hypertension in the preclinical stage nefroangiopatii. Sakharnyy diabet, 2001, no. 3, pp. 37-40 (in Russ.).
    17. Saginova E.A., Fedorova E.Yu., Fomin V.V. et al. Formation of kidney disease in patients with obesity. Terapevticheskiy arkhiv, 2006, no. 5, pp. 36-41 (in Russ.).
    18. Smalcelj A., Puljevic D., Buljeevic B., Brida V. Left ventricular hypertrophy in obese hypertensives: is it really eccentric? (An echocardiographic study). Coll. Antropol., 2002, vol. 24, no. 1, rr. 167-183.
    19. Sundstrum J., Lind L., Nystrum N. et al. Left ventricular concentric remodeling rather than left ventricular hypertrophy is related to insulin resistance syndrome in the elderly. Circulation, 2000, vol. 101, no. 22, pp. 2595-2600.
    20. Jean-Pierre Despres. Optimal prevention of coronary risk in patients with visceral obesity, and dyslipidemia. 10th European Congress on Obesity, May 2000. Ozhirenie. Aktual’nye voprosy, 2001, no. 5, pp. 6-8 (in Russ.).
    21. Ganau A., Devereux R.B., Roman M.J. et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J. Am. Coll Cardiol, 1992, vol. 19, rr. 1550-1558.

    Метки: 2016, cardiovascular disease, E.M. FUTERMAN, E.M. VISHNEVA, M.G. EVSINA, Obesity, Practical medicine 08 (16) Pediatrics, type 2 diabetes mellitus

    ‹ Pathogenetic rationale for the use of antioxidant, immunomodulator and hyperbaric oxygenation in complex treatment of nonpsychotic hysterical disorders To a question of the organization of the monitoring center behind the infections connected with delivery of health care in the Republic of Tatarstan ›
    • rus Версия на русском языке


      usa English version site


      Find loupe

      

    • PARTNERS

      пов  logonew
    «Для
    Practical medicine. Scientific and practical reviewed medical journal
    All rights reserved ©