Object of the research: cardiocerebral disorders in patients with cerebral atherosclerosis (CA) stage 1-3, depending on the presence of diabetes mellitus (DM). Objective: to determine the relationships and clinical and diagnostic features of cardiocerebral disorders in patients with DM with CA, to improve the diagnosis, treatment methods and to identify possible probable pathogenic factors of CA progression in patients depending on the presence of carbohydrate metabolism disorders based on comprehensive analysis of structural and functional heart condition , extra- and intracranial arteries, systemic and cerebral hemodynamics, heart rate variability (HRV), neuropsychological status, telomere length, telomerase activity, lipid spectrum and oxidative stress markers. Methods of the investigation and equipment: general clinical, anthropometric, biochemical, instrumental, neuropsychological, spectrophotometric, multiplex quantitative polymerase chain reaction in real time, statistical -parametric and nonparametric; Siemens tomograph (Germany), Philips EnVisor device, Aplio 300 ultrasound machine (Toshiba, Japan). Theoretical and practical results: for the first time proved the feasibility of a comprehensive study of patients with DM at different stages of CA, namely echocardiography, ultrasound of the head and neck vessels, HRV and telomere length, telomerase activity and markers of oxidative stress. Based on the obtained results, the idea of the peculiarities of the formation of cardiocerebral disorders was expanded, diagnosis and treatment were improved, predictors of the progression of CA of the 1st-3rd stages in patients with DM were established. Understanding the features of cardiocerebral relationships in patients with DM will improve the quality and objectivity of their diagnosis and treatment, as well as prevent cardiovascular complications. Proven positive effect of citicoline on clinical and neurological status, neuropsychological functions, cerebral circulation and HRV of the heart gives reason to recommend the inclusion of this drug in the treatment of patients with CA 1-2 stages and diabetes mellitus at a dose of 500 mg 2 times a day for 3 months. Novelty: for the first time a comprehensive study of the structural and functional state of the heart, extra- and intracranial arteries, systemic and cerebral hemodynamics, HRV, telomere length and telomerase activity, markers of oxidative stress, cognitive status in patients with CA 1-3 -th stages, depending on the presence of disorders of carbohydrate metabolism of varying degrees. Stage 3 CA in patients with diabetes mellitus has been shown to be accompanied by a significant decrease in antioxidant defenses and the development of atherogenic dyslipidemia due to shortened telomere length and lower levels of physical activity compared with patients with stage 3 CA without DM. The presence of morphofunctional changes of the heart and cerebral vessels, as well as HRV in patients with DM and without DM with stage 3 CA depending on the hemispherical location of the ischemic focus. It was found that the level of physical activity was three times lower in patients with prediabetes and CA compared to patients without carbohydrate metabolism disorders. It has been proven that patients with DM with CA with moderate cognitive impairment are characterized by short telomeres, more pronounced situational anxiety and thickening of the intima-media complex of the carotid arteries. The need to determine the structural and functional state of the heart and blood vessels, HRV, markers of oxidative stress, lipid profile and neuropsychological testing to predict the development of cardiocerebral relationships in patients with DM with CA 1-3 stages. The degree of implementation; the obtained results of the research are implemented in the practice of the health care system of Ukraine. Areas of application: endocrinology.
