Dynamics of endothelial dysfunction, nephropathic and dyslipidemic disorders in patients with insufficient glycemic compensation of type 2 diabetes mellitus during 1 year of application of angiotensin II receptor antagonists for hypertension correction.
DOI:
https://doi.org/10.26641/2307-0404.2014.4.35802Keywords:
diabetes mellitus type 2, insufficient compensation, arterial hypertension, endothelial dysfunction, renal function, lipidemic profile, angiotensin II receptor antagonistsAbstract
The purpose of this study was to determine the dynamics of endothelial dysfunction, nephropathic and dyslipidemic disorders in patients with an insufficient compensation of type 2 diabetes mellitus and hypertension in the correction of blood pressure using angiotensin II receptor antagonists for 1 year. In patients with type 2 diabetes mellitus with insufficient compensation of hyperglycemia on the background of the standard treatment of hypertension in the normalization of glycated hemoglobin in 61.9% of patients, partial reduction of markers of endothelial dysfunction, regression of microalbuminuria in 32.3% of patients, as well as the normalization of concentrations of low density lipoproteins cholesterol and triglycerides occur after 1 year of treatment. Antihypertensive treatment of patients with insufficient compensation of hyperglycemia using angiotensin II receptor antagonists significantly more effective than standard treatment rule tactics by the influence on development of endothelial dysfunction on the background of normalization of nephropathic and dyslipidemic disorders. Within one year of treatment of hypertension with angiotensin II receptor antagonists concentrations of endothelin-1 and thrombomodulin reduced more than doubled relative to the initial values, the level of von Willebrand factor decreases by 67.4% (p<0,05). In this group, the level of glycated hemoglobin returns to the norm in 73.3% of patients, regression of microalbuminuria is achieved in 54.7% of patients.References
Алексеев В.В. Медицинские лабораторные технологии. Руководство по клинической лабора¬торной диагностике. В 2-х т. / В.В. Алексеев, А.И. Кар¬пищенко. – М.: ГЭОТАР-Медиа, 2012. – 472 с.
Аметов А.С. Сахарный диабет 2 типа. Про¬бле¬мы и решения / А.С. Аметов. – М.: ГЭОТАР-Медиа, 2012. – 704 с.
Зимин Ю.В. Артериальная гипертония при са¬харном диабете: особенности патогенеза и лечения (обзор) / Ю.В. Зимин // Терапевт. архив. – 1999. - № 10. – С. 15-20.
Лакин Г.Ф. Биометрия: учеб. пособие для биол. спец. вузов / Г. Ф. Лакин. – 4-е изд., перераб. и доп. – М.: Высшая школа, 1990. – 352 с.
Сахарный диабет: острые и хронические ос¬ложнения / под ред. И.И. Дедова, М.В. Шестаковой. – М.: Мед. информ. агентство, 2011. – 480 с.
Biomarkers of diabetes-associated oxidative stress and antioxidant status in young diabetic patients with or without subclinical complications / P. Martin-Gallan, A. Carrascosa, M. Gussinye, C. Dominguez // Free Rad. Biol. Med. – 2003. – Vol. 34, N 12. – P. 1563-1574.
Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephro¬pathy / B.M. Brenner, M.E. Cooper, D. Zeeuw [et al.] // N. Engl. J. Med. – 2001. – Vol. 345. – P. 861-869.
Epstein M. Diabetes and hypertension: the bad companions / M. Epstein // J. Hypertension. – 1997. – Vol. 15, Suppl. 2. – P. 55-62.
Mathewkutty S. Platelet perturbations in diabetes: implications for cardiovascular disease risk and treatment / S. Mathewkutty, D.K. McGuire // Expert. Rev. Cardio¬vasc. Ther. – 2009. – Vol. 7, N 5. – P. 541-549.
Relationship between fluctuations in glucose levels measured by continuous glucose monito¬ring and vascular endothelial dysfunction in type 2 diabe¬tes mellitus / K. Torimoto, Y. Okada, H. Mori, Y. Tanaka // Cardiovasc. Diabetol. – 2013. – Vol. 13. – P. 18-24.
Xu J. Molecular insights and therapeutic targets for diabetic endothelial dysfunction / J. Xu, M. N. Zou // Circulation. – 2009. – Vol. 13. – P. 1266-1286.
REFERENCES
Alekseev VV, Karpishchenko AI. [Medical labo¬ratory technology. Manual of Clinical Laboratory Diag¬nostics]. Moscow: GEOTAR-Media, 2012;472. Russian.
Ametov AS. [Type 2 diabetes mellitus. Problems and Solutions]. Moscow: GEOTAR-Media, 2012;704. Russian.
Zimin Y. [Arterial hypertension in diabetes mel¬litus: pathogenesis and treatment characteristics (review)]. Ter. archive. 1999;10:15-20. Russian.
Lakin GF. [Biometrics: 4th ed.]. Moscow: Vys¬shaya shkola, 1990;352. Russian.
Dedov II, Shestakova MV, editors. [Diabetes: acute and chronic complications]. Moscow: "Publishing house "Medical Information Agency", 2011;480. Russian.
Martin-Gallan P, Carrascosa A, Gussinye M, Dominguez C. Biomarkers of diabetes-associated oxida¬tive stress and antioxidant status in young diabetic pa¬tients with or without subclinical complications. Free Rad. Biol. Med. 2003;34(12):1563-74.
Brenner BM, Cooper ME, Zeeuw D. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N. Engl. J. Med. 2001;345:861-9.
Epstein M. Diabetes and hypertension: the bad companions. Hypertension. 1997;15(2):55-62.
Mathewkutty S, McGuire DK. Platelet perturba¬tions in diabetes: implications for cardiovascular disease risk and treatment. Expert. Rev. Cardiovasc. Ther. 2009;7(5):541-9.
Torimoto K, Okada Y, Mori H, Tanaka Y. Re¬lationship between fluctuations in glucose levels mea¬sured by continuous glucose monitoring and vascular endothelial dysfunction in type 2 diabetes mel¬litus. Cardiovasc. Diabetol. 2013;13:18-24.
Xu J, Zou MN. Molecular insights and thera¬peutic targets for diabetic endothelial dysfunction. Circu¬lation. 2009;13:1266-86.
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