Kobrinchuk Y. The relationship of insulin resistance, leptinemia and changes in lipid profile of blood and their possible correction in patients with coronary heart disease associated with type 2 diabetes mellitus

Object of study: coronary heart disease in patients with diabetes type two. Aim to improve diagnosis of ischemic heart disease and improve the treatment strategy of coronary artery disease , combined with diabetes mellitus type II, by comparing levels of leptin and insulin resistance with the clinical course of coronary artery disease , changes in blood lipid parameters and inflammatory response indicator - C- reactive protein. Found that diabetes significantly affect the course of coronary artery disease increases the duration of daily myocardial ischemia with prevalence of silent form, increases the incidence of cardiac arrhythmias and early CHD , especially in women , and often eccentric LVH and significant diastolic impairment . Absence of manifest clinical coronary heart disease combined with diabetes leads to its late detection , often under severe complications. It is shown that as a diagnostic and prognostic test in patients with coronary artery disease associated and associated with diabetes , it is recommended to use parameters that characterize insulin resistance and leptynemiyu . To assess the possible effect of treatment on initiation of therapy recommended prognostic scale that includes metrics that are available for clinical practice: the patient's age , waist circumference , PAT, duration of myocardial ischemia during the day, atherogenic index , the level of CRP, leptin , HOMA index . Due to the relationship between the degree of insulin resistance and blood pressure value is recommended for the determination of antihypertensive therapy in patients with coronary artery disease combined with diabetes antyhipertenezyvnyh consider the effects of drugs on insulin resistance . It is shown that due to the characteristics of dyslipidemia in patients with coronary artery disease combined with diabetes of the second type recommended a differentiated approach to lipid-lowering therapy with the appointment of adequate doses of statins , which affect both cholesterol and the triglycerides , HDL , or a combination statins with fibrates . The results put into practice medical institutions , scientific and educational process. The branch of sciences - medicine.