Tashkent Pediatric Medical Institute, Tashkent, the Republic of Uzbekistan Tashkent Pediatric Medical Institute, Tashkent, the Republic of Uzbekistan

S.U. Ahmedova, Z.S. Kadyrova

Abstract


Background. The article describes the results of the studies of diabetic nephropathy in obese patients with type 2 diabetes mellitus (DM). The aim of the study is to investigate the combination of obesity and renal pathology in patients with type 2 diabetes mellitus. Materials and methods. The study included 50 patients with type 2 DM (17 men and 33 women), mean age 58.5 ± 7.0 years treated at the Republican Specialized Scientific and Practical Centre of Endocrinology in 2014–2016. The patients were randomized into 2 groups: with obesity (BMI > 30 kg/m2; n = 38) and without it (BMI < 30 kg/m2; n = 12). Exclusion criteria included manifested diabetic nephropathy (DN) (glomerular filtration rate (GFR) below 60 ml/min/m2, albuminuria over 2 g/24 hr), hematuria, acute cardiovascular events less than last 6 month ago, age over 70 years. Anthropometric parameters included body mass index, waist and hips circumference, waist-to-height ratio. Serum creatinine, uric acid, triglycerides levels, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glycosylated hemoglobin were determined. Severity of renal pathology was estimated by GFR and albumin excretion in urine. Results. Prevalence of hyperfiltration, microalbuminuria and proteinuria increased in patients with obesity (15, 26.6, 50 %, respectively) compared to the patients without obesity (8, 11, 11 %, respectively) when the DM duration over 5 years. Patients with BMI > 30 kg/m2 more frequently presented higher blood pressure levels (arterial hypertension stage 3 in 13 %), enhanced uric acid and reduced low-density lipoprotein cholesterol level (55.1 %) than the patients with BMI < 30 kg/m2. Conclusions. The obese patients with type 2 DM and obesity (BMI > 30 kg/m2) more frequently had renal pathology than non- obese patients. It suggests an independent role of obesity in the development of DN in addition to specific mechanisms of renal pathology in diabetic patients. This effect of obesity is mediated through the enhancement of hemodynamic and metabolic disorders.

Keywords


obesity; type 2 diabetes mellitus; diabetic nephropathy

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DOI: https://doi.org/10.22141/2224-0721.13.2.2017.100609

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