Dunaieva I. Adiponectinemia and associated factors of cardiovascular risk in type 2 diabetes mellitus patients with non-alcoholic fatty liver disease and their nutrient correction

Object of the research: type 2 DM with liver disease. Purpose of the research: to determine adiponectin circulating level and associated cardiovascular risk factors in type 2 DM patients with non-alcohol fatty liver disease (NAFLD), and to identify the role of nutrient (food) therapy in correction of the revealed disorders. Methods of research and equipment: clinical, anthropometric, questionnaires, ultrasound, immunoassay, biochemical, molecular genetic, statistic methods; ALOKA-SSD-3500 USD unit; RADMIR (Ultima PRO 30) Echo-CG unit; Fluorat-02-ABLF-T unit and for blood lipid profile determination. Theoretical and practical results: based on the complex study of adiponectin, carbohydrate and lipid metabolic parameters in type 2 DM patients, interrelation of their levels with NAFLD course progressing was demonstrated. New findings which were obtained in the research expand the current concepts concerning disordered adiponectin secretion in type 2 DM patients with NAFLD, that will allow to predict the development of cardiovascular complications. The treatment algorithms were improved with nutrient therapy for the type 2 DM patients with liver comorbidity, and preventive measures concerning the development of cardiovascular complications were formulated in the above mentioned cohort of patients. Novelty: for the first time the changes of circulating adiponectin level in type 2 DM patients were proved taking into account NAFLD progressing. Adiponectinemia, focused on the NAFLD stage progressing, was revealed to correlate with parameters of carbohydrate, lipid metabolism in type 2 DM patients with NAFLD. For the first time positive effect of nutrient correction on circulatory adiponectin level, lipid peroxidation parameters, cardiohemodynamics in type 2 DM patients with NAFLD was proved considering the stage progressing of liver involvement. It was shown that genetic analysis of frequency of single nucleotide polymorphism +276G>Т genotypes in the adiponectin gene ADIPOQ allows to consider increased homozygosity as a factor of NAFLD development increased risk against the background of type 2 DM. Degree of introduction: the results obtained in the research are introduced into the clinical practice of SI “V. Danilevskiy Institute for Endocrine Pathology Problems of National Academy of Medical Sciences of Ukraine” (Kharkiv), endocrinology departments in other regions of Ukraine, and to the academic and medical activities of the Department of endocrinology and children’s endocrinology of Kharkiv Medical Academy of Postgraduate Education. The patent № 115846 was received. Sphere of application: endocrinology.