Pkhakadze O. Indicators of endothelial function among patients with type 1 diabetes mellitus complicated by diabetic nephropathy

Subject of the study: pathogenesis and treatment of vascular events in patients with type 1 diabetes mellitus. Objective of the study: to characterize the functional state of endothelium in patients with type 1 diabetes mellitus complicated by various stages of diabetic nephropathy (DN) and to optimize the treatment of this category of patients. Methods of the study and facilities: biochemical, statistic methods, solid-phase competitive ELISA using Griss reagent and zinc dust, spectrofotometr SF-26. Theoretical and practical results: The complex comparative study of the state of endothelium in patients with type 1 diabetes mellitus (DM) with various stages of DN was carried by evels in blood plasma of vasoactive endothelial markers endothelin 1 (E1), nitric oxide (NO) and von Willebrand factor (vWf) and analyzed it’s role in DN’ pathogenesis. Expanded understanding of possibility of iACE influence on DN by ED correction. Novelty: The complex comparative study of the state of endothelium in patients with type 1 diabetes mellitus (DM) without diabetic nephropathy (DN) and in patients with various stages of DN and healthy persons was carried out for the first time. In order to correct ED in patients with different stages of DN under type 1 DM there was suggested ACE inhibitor perindopril for the first time. The use of Е1 level, NO and vWf as the criteria of efficacy of treatment by ACE inhibitor, perindopril, is grounded. Perindopril is proven to be effective at the initial stage of DN, microalbuminuria. The opportunity to slow down DN progression during proteinuria under influence of an ACE inhibitor is demonstrated. The use of E1, NO and vWf levels in blood plasma of patients with type 1 DM as markers of early pre-clinical stage of DN is well-grounded. It is proved that correction of ED is the important aspect of effect of an ACE inhibitor, perindopril.Implementation stage: the results of the study were included into the educational program of the diabetology department of the National Shchupik P. L. Medical Academy of Postgraduate Education, and are used in the clinical practice of the clinical base of the department. Field of application: endocrinology, nephrology.