DOI: https://doi.org/10.22141/2224-0721.14.3.2018.136418

Pathogenetic mechanisms and signs of cardiovascular disorders in type 2 diabetes mellitus

L.V. Shkala, G.I. Mishanich, O.V. Shkala, O.V. Cherpak, E.A. Karapetyan, T.G. Volkovskaya

Abstract


Background. A high morbidity and prevalence of diabetes mellitus (DM) cause early disability and mortality due to the development of chronic complications. The main cause of death in type 2 DM is associated with cardiovascular di­seases. The purpose of the study: to determine the incidence, mechanisms and manifestations of cardiovascular disorders in patients with type 2 DM. Materials and methods. Forty-nine individuals with type 2 DM aged over 50 years were exami­ned, including 25 men and 24 women. Metabolic parameters, changes in the electrocardiogram were determined. Results. In the observation group, 55.1 % of patients had coronary heart disease, 77.6 % — arterial hypertension and 28.6 % — cardiovascular events. An overweight and obesity were prevalent in 83.7 % of patients. In 57.1 %, disorders of lipid metabolism were detected, with the presence of diabetes decompensation in 61.2 %, confirmed by an increased level of glycosylated hemoglobin on average to 8.8 ± 0.3 %. Disorders of the automatism processes, excitability and cardiac conduction were detected: in 12.2 % of cases — sinus tachycardia, in 6.1 % — sinus bradycardia, in 4.1 % — sinus arrhythmia, in 10.2 % — atrial fibrillation, in 8.2 % — supraventricular and ventricular extrasystole, in 30.6 % — intraventricular blockades. 32.7 % of patients had hypoxia manifestations, 8.2 % — changes in the Q wave, 8.2 % — changes in the ST interval. Conclusions. Dysmetabolic disorders are the basis for the development of chronic diabetic complications forming, in particular, cardiac autonomic neuropathy, diabetic cardiomyopathy and atherosclerotic lesions of the cardiovascular system with manifestation of coronary heart disease, arterial hypertension, syndrome of rhythm and conduction disorders, hypoxia.


Keywords


diabetes mellitus type 2; diabetic neuropathy; diabetic cardiomyopathy; cardiovascular disorders

References


Bardenheier BH, Lin J, Zhuo X, et al. Compression of disability between two birth cohorts of US adults with diabetes, 1992-2012: a prospective longitudinal analysis. Lancet Diabetes Endocrinol. 2016 Aug;4(8):686-94. doi: 10.1016/S2213-8587(16)30090-0.

McEwen LN, Karter AJ, Curb JD, Marrero DG, Crosson JC, Herman WH. Temporal trends in recording of diabetes on death certificates: results from Translating Research Into Action for Diabetes (TRIAD). Diabetes Care. 2011 Jul;34(7):1529-33. doi: 10.2337/dc10-2312.

Lallukka T, Ervasti J, Mattendorfer-Ruz E, et al. The joint contribution of diabetes and work to premature death during working age: a population-based study in Sweden. Scand J Public Health. 2016 Aug;44(6):580-6. doi: 10.1177/1403494816655059.

Skrypnyk NV, Gryb VA, Didushko OM. Features of pathogenesis and treatment of diabetic autonomic neuropathy (literature review). Liky Ukrai'ny. 2012;(158):6-14. (in Ukrainian).

Serhiyenko VO. Pathogenesis of diabetic cardiovascular neuropathy (review of literature). Zhurnal NAMN Ukrai'ny. 2015;21(2):142-157. (in Ukrainian).

Рop-Busui R, Evans GW, Gerstein HC, et al. Effects of cardiac autonomic dysfunction on mortality risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Diabetes Care. 2010 Jul;33(7):1578-84. doi: 10.2337/dc10-0125.

Vlasenko MV. Complications of diabetes mellitus - diabetic distal polyneuropathy: pathophysiology and pathogenetic treatment option. Mìžnarodnij endokrinologìčnij žurnal. 2011;(39):44-49. (in Ukrainian).

Mankovsky BN. Diabetic polyneuropathy – epidemiology, pathogenesis, clinical features, diagnostics and treatment. In: Karachentsev IuI, Kazakov AV, Kravchun NA, Il'ina IM, editors. 100 izbrannykh lektsii po endokrinologii [100 select lectures on endocrinology]. 2nd ed. Kharkiv: SАМ; 2014. 164-171 pp. (in Russian).

Tkacheva ON, Vertkin AL. Diabeticheskaia avtonomnaia neiropatiia: rukovodstvo dlia vrachei [Diabetic autonomic neuropathy: a guide for doctors]. Мoscow: GEОТАR-Media; 2009. 176 p. (in Russian).

Obrezan AG, Bitsadze RM. Structure of cardiovascular pathology in patients with type 2 diabetes mellitus, diabetic cardiomyopathy as a special condition of myocardium. Mìžnarodnij endokrinologìčnij žurnal. 2010;(28):18-22. (in Russian).

Mankovsky BN. Clinical features and treatment of peripheral sensory and motoric diabetic neuropathy. Liky Ukrai'ny. 2009;(128):63-66. (in Russian).

Ziegler D, Movsesuan L, Mankovsky B, Gurieva I, Abylaiuly Z, Strokov I. Treatment with аctovegin in type 2 diabetic patients with symptomatic polyneuropathy. Diabetes Care. 2009 Aug;32(8):1479-84. doi: 10.2337/dc09-0545.

Kyyak YuH, Kyyak HYu, Barnett OYu. Specifics of Diabetic Cardiomyopathy in the Cases of Concomitant Cardiovascular Diseases: Clinical and Ultrastructural Examinations. Mìžnarodnij endokrinologìčnij žurnal. 2016;(77):33-38. doi: 10.22141/2224-0721.5.77.2016.78751. (in Ukrainian).

Jia G, DeMarco VG, Sowers JR. Insulin resistance and hyperinsulinaemia in diabetic cardiomyopathy. Nat Rev Endocrinol. 2016 Mar;12(3):144-53. doi: 10.1038/nrendo.2015.216.

Serhiyenko VO. Features of arterial pressure variability in patients with diabetic cardiomyopathy. Klinichna endokrynologiya ta endokrynna hirurgiya. 2009;2(27):24-31. (in Ukrainian).

Zhang EL, Wu YJ. Metabolic memory: mechanisms and implications for diabetic vasculopathies. Sci China Life Sci. 2014 Aug;57(8):845-51. doi: 10.1007/s11427-014-4710-6.

Biriukova EV. Diabetes mellitus and cardiovascular complications: is it possible to break the vicious circle? RMJ. 2010;18(14):904-906. (in Russian).

Huang YC, Chang PY, Hwang JS, Ning HC. Association of small dense low density lipoprotein cholesterol in type 2 diabetics with coronary artery disease. Biomed J. 2014 Nov-Dec;37(6):375-9. doi: 10.4103/2319-4170.132883.




Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© "Publishing House "Zaslavsky", 1997-2018

 

   Seo анализ сайта