Sokolova L. Risk factors, clinical and diagnostic aspects of cardiovascular disease in patients with diabetes mellitus type 1 and type 2

The object of study: cardiovascular system in patients with diabetes mellitus (DM) type 1 and 2. Objective: to study major risk factors, mechanisms of development and peculiarities of cardiovascular disease in patients with type 1 and type 2 to determine the main clinical diagnostic criteria for the formation of cardiac pathology in this category of patients. Methods and equipment: general clinical, biochemical, instrumental, radioimmunological and statistical; angiograph Allura Clarity FD-10 ultrasound machine «Aloka 5000", analyzer "Eksan." Theoretical and practical results: based on the study of major risk factors, mechanisms of development and peculiarities of cardiovascular disease (CVD) in patients with DM type 1 and type 2 the pathogenetic relationship between traditional risk factors for CVD and indicators of chronic systemic inflammation, endothelial dysfunction, lipid metabolism were established. This is allowing to define a category of patients with DM of very high cardiovascular risk. Novelty: comprehensive study performed in patients with diabetes type 1 revealed early signs of metabolic cardiomyopathy and describe the role of metabolic and immunological abnormalities in its development. For the first time based on in vivo intravascular ultrasound (IVUS) morphological structural features atherosclerotic plaque in patients with DM was established. It was proved that the presence of silent myocardial ischemia in patients with DM2 is an unfavorable prognostic factor determining burdened course of cardiovascular disease. The most pronounced changes in the adipokines production and in the degree of insulin resistance in patients with DM 2 with more severe course of coronary heart disease (CHD) are established. It was proved that in patients with DM2 complicated course of CAD and adverse consequence of disease are associated with proinflammatory cytokines and CRP overexpression. Degree of implementation: proposed for use in the educational process at the Department of Endocrinology, Diabetology and Cardiology NMAPGE after P.L. Shupik, Department of Endocrinology NMU after O.O.Bogomolets. 3 patents of Ukraine were done, practical recommendations were implemented into clinical practice of the departments of SI “V. P. Komisarenko Institute of Endocrinology and Metabolism NAMS of Ukraine and regional endocrinology clinics. Area of application: endocrinology, cardiology.