Bulak O. Changes in pituitary-adrenal axis in patients with acute coronary syndrome combined with diabetes mellitus type 2

The object of investigation - hormones of pituitary-adrenal system and sex hormones, parameters of oxidative stress, antioxidant system, lipid and carbohydrate metabolism in patients with acute coronary, combined with diabetes mellitus type 2. The aim of research was to investigate activity of hormones of pituitary-adrenal system and sex hormones, parameters of oxidative stress, antioxidant system, lipid and carbohydrate metabolism in patients with acute coronary, combined with diabetes mellitus type 2 and to define the prognostic criteria of complicated course of acute coronary syndrome and fatal ending after myocardial infarction in patients with diabetes mellitus type 2. Established that patients with ACS and diabetes mellitus type 2 compared with patients with ACS without diabetes have more pronounced changes in pituitary- adrenal axis and sex hormones appear reduced activity of cortisol and DHEAs, increased levels of growth hormone and increased in men free androgen index and testosterone. Definitely the 4 most significant predictor of the risk of complications in ACS patients with diabetes mellitus type 2 during the hospital phase: the index of cortisol/GH <= 165,39, gama-GTP levels >= 132,08 units., level of HbA1c >= 8,21% and the level of DHEAs <= 0,92 mg/ml. Established 6 independent predictors of risk of the fatal myocardial infarction with diabetes mellitus type 2 during the hospital phase: the presence of сongestive рeart failure (Killip class III-IV), index cortisol/GH <= 58,4, gama-GTP levels >= 212,32 units., level of HbA1c >= 9,12%, level of DHEAs <= 0.62 mg/ml and cortisol levels >= 901,26 nmol /l. The results were inserted in the hospital practice, scientific and teaching-metodological process.The branch of science in medicine.