{"title":"2型糖尿病对高血压、肥胖和左室舒张功能不全女性临床和实验室状况的影响","authors":"N. Kyrychenko, N. Opolonska, O. Stepanets","doi":"10.21272/eumj.2019;7(4):358-364","DOIUrl":null,"url":null,"abstract":"Patients with type 2 diabetes mellitus (DM) may develop cardiomyopathy independently of such risk factors as arterial hypertension and coronary heart disease. Myocardial dysfunction in diabetes mellitus may vary from subclinical forms of left ventricular dysfunction to heart failure. It was suggested that diastolic left ventricular dysfunction is one of the earliest signs of myocardial injury in diabetes mellitus and plays a key role in the formation of diabetic cardiomyopathy.\nThe aim of our study was to evaluate the effect of diabetes on the clinical and laboratory status of women with hypertension, obesity, and left ventricular diastolic dysfunction (LVDD).\nMaterials and methods. We examined 80 patients aged 40 to 60 years with stage 2, grade II and grade III hypertension, class I–III obesity, grade 1 LVDD and preserved ejection fraction. Depending on the presence or absence of diabetes, the cohort of patients was divided into two groups: patients with diabetes were assigned to group 1 and non-diabetes patients – to group 2. Statistical processing was performed using Statistica for Windows version 6.0.\nResults. Patients had tendency to increased body mass index (BMI) in the DM group, but without significant differences. The results of the 6-minute walk test showed a tendency to decreased distance in the group of patients with diabetes. There was an increase in leptin levels and a decrease in adiponectin in patients with diabetes without significant differences. Levels of IL-6, glycosylated hemoglobin, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index were significantly higher in the cohort of patients with diabetes (p <0.05).\nConclusions. Women aged 40–60 years with LVDD with hypertension, class I–III obesity and type 2 diabetes mellitus differ from similar cohorts of patients without diabetes with a tendency to increased BMI levels, leptinemia, and decrease in distance of 6-minute walk test, LV ejection fraction and blood adiponectin level; they have significantly higher blood levels of interleukin-6, glycosylated hemoglobin (HbA1c) and HOMA-IR; indicators of diastolic function in the group of patients with diabetes tend to worsen the parameters of diastolic filling of the LV even in grade 1 DD.","PeriodicalId":315243,"journal":{"name":"Eastern Ukrainian Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2019-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"EFFECTS OF TYPE 2 DIABETES MELLITUS ON CLINICAL AND LABORATORY STATUS OF WOMEN WITH ARTERIAL HYPERTENSION, OBESITY, AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION\",\"authors\":\"N. Kyrychenko, N. Opolonska, O. Stepanets\",\"doi\":\"10.21272/eumj.2019;7(4):358-364\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Patients with type 2 diabetes mellitus (DM) may develop cardiomyopathy independently of such risk factors as arterial hypertension and coronary heart disease. Myocardial dysfunction in diabetes mellitus may vary from subclinical forms of left ventricular dysfunction to heart failure. It was suggested that diastolic left ventricular dysfunction is one of the earliest signs of myocardial injury in diabetes mellitus and plays a key role in the formation of diabetic cardiomyopathy.\\nThe aim of our study was to evaluate the effect of diabetes on the clinical and laboratory status of women with hypertension, obesity, and left ventricular diastolic dysfunction (LVDD).\\nMaterials and methods. We examined 80 patients aged 40 to 60 years with stage 2, grade II and grade III hypertension, class I–III obesity, grade 1 LVDD and preserved ejection fraction. Depending on the presence or absence of diabetes, the cohort of patients was divided into two groups: patients with diabetes were assigned to group 1 and non-diabetes patients – to group 2. Statistical processing was performed using Statistica for Windows version 6.0.\\nResults. Patients had tendency to increased body mass index (BMI) in the DM group, but without significant differences. The results of the 6-minute walk test showed a tendency to decreased distance in the group of patients with diabetes. There was an increase in leptin levels and a decrease in adiponectin in patients with diabetes without significant differences. Levels of IL-6, glycosylated hemoglobin, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index were significantly higher in the cohort of patients with diabetes (p <0.05).\\nConclusions. Women aged 40–60 years with LVDD with hypertension, class I–III obesity and type 2 diabetes mellitus differ from similar cohorts of patients without diabetes with a tendency to increased BMI levels, leptinemia, and decrease in distance of 6-minute walk test, LV ejection fraction and blood adiponectin level; they have significantly higher blood levels of interleukin-6, glycosylated hemoglobin (HbA1c) and HOMA-IR; indicators of diastolic function in the group of patients with diabetes tend to worsen the parameters of diastolic filling of the LV even in grade 1 DD.\",\"PeriodicalId\":315243,\"journal\":{\"name\":\"Eastern Ukrainian Medical Journal\",\"volume\":\"29 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-12-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eastern Ukrainian Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21272/eumj.2019;7(4):358-364\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eastern Ukrainian Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21272/eumj.2019;7(4):358-364","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
2型糖尿病(DM)患者可能独立于动脉高血压和冠心病等危险因素发生心肌病。糖尿病的心肌功能障碍可能从亚临床形式的左心室功能障碍到心力衰竭不等。提示舒张性左心室功能障碍是糖尿病心肌损伤的早期征象之一,在糖尿病性心肌病的形成中起关键作用。本研究的目的是评估糖尿病对合并高血压、肥胖和左心室舒张功能不全(LVDD)的女性临床和实验室状态的影响。材料和方法。我们研究了80例年龄在40 - 60岁的2期、II级和III级高血压、I-III级肥胖、1级LVDD和保留射血分数的患者。根据是否患有糖尿病,患者被分为两组:糖尿病患者被分配到第一组,非糖尿病患者被分配到第二组。统计处理使用Statistica for Windows version 6.0.Results。DM组患者体质指数(BMI)有升高的趋势,但差异无统计学意义。6分钟步行测试的结果显示,糖尿病患者组的步行距离有减少的趋势。糖尿病患者瘦素水平升高,脂联素水平降低,但无显著差异。糖尿病患者IL-6水平、糖化血红蛋白水平及胰岛素抵抗稳态模型评估(HOMA-IR)指数均显著升高(p <0.05)。40-60岁LVDD合并高血压、I-III级肥胖和2型糖尿病的女性与同类无糖尿病患者不同,BMI水平升高、瘦素血症、6分钟步行距离试验、左室射血分数和血脂联素水平降低;他们的白细胞介素-6、糖化血红蛋白(HbA1c)和HOMA-IR水平明显较高;糖尿病患者组的舒张功能指标甚至在1级DD时有使左室舒张充盈参数恶化的趋势。
EFFECTS OF TYPE 2 DIABETES MELLITUS ON CLINICAL AND LABORATORY STATUS OF WOMEN WITH ARTERIAL HYPERTENSION, OBESITY, AND LEFT VENTRICULAR DIASTOLIC DYSFUNCTION
Patients with type 2 diabetes mellitus (DM) may develop cardiomyopathy independently of such risk factors as arterial hypertension and coronary heart disease. Myocardial dysfunction in diabetes mellitus may vary from subclinical forms of left ventricular dysfunction to heart failure. It was suggested that diastolic left ventricular dysfunction is one of the earliest signs of myocardial injury in diabetes mellitus and plays a key role in the formation of diabetic cardiomyopathy.
The aim of our study was to evaluate the effect of diabetes on the clinical and laboratory status of women with hypertension, obesity, and left ventricular diastolic dysfunction (LVDD).
Materials and methods. We examined 80 patients aged 40 to 60 years with stage 2, grade II and grade III hypertension, class I–III obesity, grade 1 LVDD and preserved ejection fraction. Depending on the presence or absence of diabetes, the cohort of patients was divided into two groups: patients with diabetes were assigned to group 1 and non-diabetes patients – to group 2. Statistical processing was performed using Statistica for Windows version 6.0.
Results. Patients had tendency to increased body mass index (BMI) in the DM group, but without significant differences. The results of the 6-minute walk test showed a tendency to decreased distance in the group of patients with diabetes. There was an increase in leptin levels and a decrease in adiponectin in patients with diabetes without significant differences. Levels of IL-6, glycosylated hemoglobin, and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index were significantly higher in the cohort of patients with diabetes (p <0.05).
Conclusions. Women aged 40–60 years with LVDD with hypertension, class I–III obesity and type 2 diabetes mellitus differ from similar cohorts of patients without diabetes with a tendency to increased BMI levels, leptinemia, and decrease in distance of 6-minute walk test, LV ejection fraction and blood adiponectin level; they have significantly higher blood levels of interleukin-6, glycosylated hemoglobin (HbA1c) and HOMA-IR; indicators of diastolic function in the group of patients with diabetes tend to worsen the parameters of diastolic filling of the LV even in grade 1 DD.