The role of obesity for target organs damage in patients with type 2 diabetes mellitus
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.
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