Zhuravleva Y. Complex ultrasound evaluation of changes in vascularization of target organs in case of carbohydrate metabolism disorder

The purpose of the dissertation is to increase the efficiency and optimization of the target organs vascularization diagnosis in case of carbohydrate metabolism disorder on the basis of complex ultrasound research use. In the dissertation work the quantitative characteristics of the blood flow, the state of the vessel wall and the features of the atherosclerotic lesion of the extracranial part of the brachiocephalic arteries, the state of arterial and venous orbital blood flow, renal and hepatic blood flow, the degree of vascular endothelial dysfunction depending on age and type of violation of carbohydrate metabolism have been studied. The correlation interconnections of intraorganic and peripheral blood flow, as well as the relation between lipid, carbohydrate metabolism and blood flow parameters in target organs and endothelial function in patients of different age upon occurrence and progression of carbohydrate disorders are determined. For the first time a comprehensive assessment of nature, severity and distribution of hemodynamic changes in various target organs was made: the extracranial section of the brachiocephalic arteries, kidneys, eyes, liver and endothelium state in patients of all ages, depending on the presence and type of carbohydrate metabolism disorder. The interconnection of hemodynamic changes in different organs was established at occurrence and progression of carbohydrate metabolism. The necessity in state target organ vascularization diagnosis is determined at the stage of early carbohydrate metabolism disorder. For the first time a method of early diagnosis of the preclinical stage nephropathy in patients with insulin resistance was developed. It was shown that carbohydrate metabolism disorder is a factor that causes the deterioration of cerebral hemodynamics as well as among middle age (in the internal carotid arteries) and among elderly (in common and in the internal carotid arteries). We determined the dependence of endothelial function on the state of carbohydrate metabolism in middle-age, as in old age. The flow-dependent vasodilation was significantly lower in all patients with type 2 diabetes (p> 0.05), and in the middle- age, a significant reduction in vasodilation was observed in comparison with the control group from the pre-diabetes group, but the average percentages of vascular diameter increase in response to compression in the examined middle ages, were noted within the normal values in all groups (> 10%). Thus, the necessity of a screening examination of patients with various types of carbohydrate metabolism disorder is shown for the purpose of assessing the state of hemodynamics in target organs for the purpose of early detection of hemodynamic disorders. The introduction into clinical practice of the definition of endothelial dysfunction in patients of different ages, depending on the degree of disorder to the carbohydrate metabolism for further timely medical treatment. The value of ultrasound duplex scanning for evaluation of vascularization of target organs in people of different ages with different types of carbohydrate metabolism disorder is shown.