Varicose vein disease and comorbid diabetes mellitus. Report 1. The changes in the parameters of carbohydrate metabolism in the blood from cubital and affected veins of the lower extremities
Background. In some regions, up to 1/4 of the adult population suffer from varicose vein disease (VVD) of the lower limbs, and its incidence increases every year. A risk factor for the prevalence and severe course of VVD is type 2 diabetes mellitus (DM2). It is believed that every fifth patient with trophic ulcers of the skin of the lower legs suffers from DM2 due to VVD. Such comorbid pathology causes significant medical, social and economic damage to sick people and the society as a whole. The purpose was to study the nature of the course of VVD and comorbid diabetes, to assess the clinical and pathogenetic significance of the changes in carbohydrate metabolism. Materials and methods. Under the survey, there were 162 patients with VVD (19 % of men and 81 % of women with the average age of 50 years) among whom the ratio of classes II, III, IV, V and VI of venous insufficiency was 1 : 1 :3 : 1 : 2. DM2 occurred in 14 % of cases while the distribution of mild, moderate and severe forms of the disease was 1 : 2 : 4 and the ratio of the phases of compensation, subcompensation and decompensation was 1 : 4 : 6. In the blood from the cubital vein and the affected vein of the lower extremities, the levels of glucose, glycosylated hemoglobuin, insulin, Cpeptide, fructosamine were studied by biochemical and enzyme immunoassays (devices OlympusAU640, Japan, SF46, Russia, PR2100, Sanofi Diagnostics Pasteur, France, BIORADD10, USA). Results. VVD is accompanied by the changes in carbohydrate metabolism that has gender characteristics and is associated with the severity and clinical manifestations of comorbid DM2 (angiopathy, neuropathy, arthropathy), local production of fructosamine by the affected vein, at the same time determining the severity of venous insufficiency, it depends on the state of the varicose vein (trunk lumen, previous phlebothrombosis) and arterial vascular system. Conclusions. VVD and DM2 aggravate the course of each other, and local changes in carbohydrate metabolism are involved in pathogenetic constructions of venous pathology.
Full Text:PDF (Русский)
Sutzko DC, Obi AT, Kimball AS, Smith ME, Wakefield TW, Osborne NH. Clinical outcomes after varicose vein procedures in octogenarians within the vascular quality initiative varicose vein registry. J Vasc Surg Venous Lymphat Disord. 2018 Jul;6(4):464-470. doi: 10.1016/j.jvsv.2018.02.008.
Robertson LA, Evans CJ, Lee AJ, Allan PL, Ruckley CV, Fowkes FG. Incidence and risk factors for venous reflux in the general population: Edinburgh Vein Study. Eur J Vasc Endovasc Surg. 2014 Aug;48(2):208-14. doi: 10.1016/j.ejvs.2014.05.017.
Smith D, Team V, Barber G, et al. Factors associated with physical activity levels in people with venous leg ulcers: A multicentre, prospective, cohort study. Int Wound J. 2018 Apr;15(2):291-296. doi: 10.1111/iwj.12868.
Vemulapalli S, Parikh K, Coeytaux R, et al. Systematic review and meta-analysis of endovascular and surgical revascularization for patients with chronic lower extremity venous insufficiency and varicose veins. Am Heart J. 2018 Feb;196:131-143. doi: 10.1016/j.ahj.2017.09.017.
Shao M, Hussain Z, Thu HE, et al. Emerging trends in therapeutic algorithm of chronic wound healers: recent advances in drug delivery systems, concepts-to-clinical application and future prospects. Crit Rev Ther Drug Carrier Syst. 2017;34(5):387-452. doi: 10.1615/CritRevTherDrugCarrierSyst.2017016957.
Tavares DMDS, Bolina AF, Dias FA, Ferreira PCDS, Santos NMF. Overweight in rural elderly: association with health conditions and quality of life. Cien Saude Colet. 2018 Mar;23(3):913-922. doi: 10.1590/1413-81232018233.25492015.
McInnes RL, Cullen BM, Hill KE, et al. Contrasting host immuno-inflammatory responses to bacterial challenge within venous and diabetic ulcers. Wound Repair Regen. 2014 Jan-Feb;22(1):58-69. doi: 10.1111/wrr.12133.
Balasubramanya B, Nisha C, Ramesh N, Joseph B. Staff working in ancillary departments at a tertiary care hospital in Bengaluru, Karnataka, India: How healthy are they? Indian J Occup Environ Med. 2016 Jan-Apr;20(1):44-7. doi: 10.4103/0019-5278.183844.
Lundgren F, Edén E, Arfvidsson B, Lundholm K. Insulin time-dependent effects on the leg exchange of glucose and amino acids in man. Eur J Clin Invest. 1991 Aug;21(4):421-9. doi: 10.1111/j.1365-2362.1991.tb01390.x.
Zaidi H, Byrkjeland R, Njerve IU, et al. Effects of exercise training on inflammasome-related mediators and their associations to glucometabolic variables in patients with combined coronary artery disease and type 2 diabetes mellitus: Sub-study of a randomized control trial. Diab Vasc Dis Res. 2019 Jul;16(4):360-368. doi: 10.1177/1479164119836922.
Neelofar K, Ahmad J. A comparative analysis of fructosamine with other risk factors for kidney dysfunction in diabetic patients with or without chronic kidney disease. Diabetes Metab Syndr. 2019 Jan - Feb;13(1):240-244. doi: 10.1016/j.dsx.2018.08.007.
Thorsen IK, Johansen MY, Pilmark NS, et al. The effect of frequency of activity interruptions in prolonged sitting on postprandial glucose metabolism: a randomized crossover trial. Metabolism. 2019 Jul;96:1-7. doi: 10.1016/j.metabol.2019.04.003.
Zhong X, Zhang D, Yang L, Du Y, Pan T. The relationship between serum uric acid within the normal range and β-cell function in Chinese patients with type 2 diabetes: differences by body mass index and gender. PeerJ. 2019 Mar 26;7:e6666. doi: 10.7717/peerj.6666.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2019