Kuznetcova H. The role of endothelial dysfunction in the pathogenesis of diabetic kidney disease and the possibility of its correction in the treatment of diabetes

The dissertation is devoted to studying of endothelial state in patients with type 1 and 2 diabetes mellitus (DM), as well as to determine the impact of inpatient treatment and normalization of carbohydrate metabolism on diabetic kidney disease (DKD), and to predict the development and progression of diabetic angiopathy in patients with diabetes. 150 people were involved in the study. 130 patients with diabetes formed the main study group – 31 patients with type 1 diabetes and 99 patients with type 2 diabetes and 20 healthy individuals formed the control group. To determine the stability of the angioprotective effect, a 3-month study was conducted, which included 50 patients with type 1 and type 2 diabetes. The baseline CECs level was in average 2530 ± 204.8 cells/ml, 10 days after inpatient treatment – 1792 ± 117.9 cells/ml. And at the final visit in 3 months – 1706 ± 58.9 cells/ml. A statistically significant decrease in the degree of endotheliocythemia was observed in all groups of patients with diabetes with different GFR. As a result of our application of the multiple linear regression method, a prognostic model was built, which is able to predict the level of CECs in 3 months after the end of 10-day complex inpatient treatment depending on the type of diabetes. The coefficient of determination of this model was 83%, the adjusted coefficient of determination was 85%, which confirms the feasibility of the conduct of angioprotective and nephroprotective therapy in patients with DM. The study clarified the role of ED in the development of diabetic microangiopathies in patients with type 1 and type 2 diabetes, in particular, DKD, to determine the dynamics of ED and their prognostic significance against the background of comprehensive conservative treatment during pre- and post-hospital periods. Correction of endothelial dysfunction may become a new strategically important in terms of prevention of complications of the therapeutic target in the treatment and prevention of diabetic vascular complications in diabetes.