Pathogenetic and clinical correlation of type 2 diabetes mellitus with metabolic syndrome and chronic coronary artery disease
Background. Increase of morbidity of diabetes mellitus (DM) associated with coronary artery disease (CAD) on the background of metabolic syndrome (MS) is worrisome. It is very important to improve the diagnosis of this associated pathology and also to develop pathogenetic therapy, taking into account the specific stage of disease. The purpose of our work was to study the correlation of compensated and decompensated type 2 DM on the background of MS with chronic CAD. Materials and methods. 231 patients with MS and with or without type 2 DM and chronic CAD were examined. MS was characterized by the II–IIІ degree of obesity in all studied groups. The levels of cortisol, prolactin, free thyroxine, thyroidstimulating hormone (TSH), lipids were evaluated in all patients, ultrasonography of the heart was performed. Results. Increase of cortisol levels, prolactin in women, TSH, change of lipids as high levels of triglycerides, very lowdensity lipoprotein cholesterol, at the control value of highdensity lipoprotein cholesterol, lowdensity lipoprotein cholesterol and total cholesterol was detected in patients with metabolic syndrome, and also patients with compensated type 2 DM on the background of MS. Increase of interventricular septal thickness and left atrium anteroposterior dimension was observed in patients of this group. Increased levels of cortisol and prolactin as well as the control level of TSH were detected in patients with MS and decompensated type 2 DM as well as with or without chronic CAD. Increase of interventricular septal thickness, left ventricular posterior wall thickness, left atrium anteroposterior dimension was observed in patients of both groups according to results of ultrasonography. High level of total cholesterol, lowdensity lipoprotein cholesterol, triglycerides, very lowdensity lipoprotein cholesterol and low level of highdensity lipoprotein cholesterol were observed in patients with MS and decompensated type 2 DM associated with chronic CAD compared to patients with MS and type 2 DM without chronic CAD. Conclusions. The pathogenetic and clinical relation of type 2 DM was established in MS and chronic CAD.
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