Российский кардиологический журнал (Mar 2014)

: инсулинорезистентность, метаболический и нормальный фенотип, макро- и микроангиопатии

  • N. V. Leonova,
  • G. A. Chumakova,
  • A. K. Vigel,
  • S. V. Pushkareva

DOI
https://doi.org/10.15829/1560-4071-2014-3-102-106
Journal volume & issue
Vol. 0, no. 3
pp. 102 – 106

Abstract

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Patients with Type 1 diabetes mellitus (DM-1) represent a heterogeneous group with different phenotypes, which might include some individuals with genetic predisposition towards insulin resistance (IR) and metabolic phenotype (MPH) development. At present, the IR effects on cardiovascular risk development in DM-1 patients remain an understudied area.Aim. To assess the prevalence of cardiometabolic risk factors (RF) and micro- and macrovascular complications by phenotype in patients with DM-1. Material and methods. The study included 3371 DM-1 patients from the Altay Region Diabetes Register. All participants were divided into two groups, by the waist circumference/hip circumference ratio: those with normal phenotype (NPH) and those with metabolic phenotype (MPH). Overall and separately in two age groups (under 50 and >50 years), the prevalence of the following characteristics was assessed: overweight, obesity, arterial hypertension, diabetic retinopathy, diabetic nephropathy, diabetic polyneuropathy, acute myocardial infarction, stroke (S), angina, and lipid metabolism disturbances.Results. MPH was registered in 46,5% of DM-1 patients. Overall, MPH patients were 7 years older than their NPH peers. The percentage of men was higher among MPH participants. Among DM-1 patients with MPH, the prevalence of all clinical conditions was significantly higher (p<0,05), with S as the only exception. The effect of MPH on macroangiopathy development was greater than that for microangiopathy development. MPH participants were characterised by a higher prevalence of hypercholesterolemia and hypertriglyceridemia (p<0,01); however, this difference was less obvious in older patients. In the age group of 50 years and older, the strength of the association between MPH and cardiovascular diabetic complications was different from that in younger patients.Conclusion. In DM-1 patients, MPH is an additional RF of cardiovascular disease development, which should be taken into account while choosing the appropriate therapeutic strategy

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