The objective of this study is to explore changes in microvascular tone during a contralateral cold pressor test and to compare the results obtained in healthy subjects and in patients with impaired glucose tolerance (IGT) and type 2 diabetes. Low-amplitude fluctuations of skin temperature in the appropriate frequency ranges were used as a characteristic for the mechanism for vascular tone regulation. In total, 13 adults with type 2 diabetes aged 40-67 years and 18 adults with IGT aged 31-60 years participated in this pilot study. The control group included 12 healthy men and women aged 39-60 years. The response to the cold pressor test in patients with type 2 diabetes and with IGT differs essentially from that of healthy subjects in the endothelial frequency range. Endothelial dysfunction occurs in the preclinical stage of diabetes and manifests, in particular, as a disturbance of the endothelial part of vascular tone regulation.
Obesity is a multifactorial disease. The aim of this study was to investigate the etiological factors contributing to the formation of obesity in children and adolescents. Study included two groups of children. Main group: 101 children with obesity aged 10 to 17 years, body mass index (BMI) 31,27±0,51 kg/m 2. Comparison group: of 14 children aged 10 to 17 years, without obesity, BMI 18,54±0,11 kg/m 2. In all children we evaluated perinatal and family history, lifestyle and diet, anthropometric parameters, assessed the progress of sexual development. We found that the manifestation of the disease occurred in the early school years, and in boys significantly earlier than in girls. Mothers of obese children had complications during pregnancy (such as toxaemia, the risk of miscarriage, hypertension, previous medical abortions). The children in the majority of cases were early nursed on milk formula, had violations in feeding regime, and hypokinesia. The disease was shown to run in families.
According to experts of the World Health Organization (WHO), metabolic syndrome (MS) can be considered as pandemy of the XXI century, because its prevalence among the population of developed countries is about 25-35%. In this study with the purpose of complex investigation of the autonomic nervous system and endothelial function we included 66 patients with MS between the ages of 25 and 61 (46.9±9.9 years). A comparison group of apparently healthy individuals (16 individuals, average age of 45.3±2.3 years; P>0.05) was studied. To evaluate the response of microvascular tone, we used the method of wavelet analysis of skin temperature oscillations during cooling of the limb. All patients underwent the study of heart rate variability. The levels of insulin, endothelin-1, and vascular endothelial growth factor were determined using enzyme immunoassay. Patients with MS had significant differences in all metabolic parameters. Our study showed that in the group of MS there is a decrease of the variability of heart rhythm compared with the healthy group. Conducting cold test revealed signs of endothelial dysfunction in the MS group, which was manifested by the decrease of the index of vasodilation in the endothelial and neurogenic frequency range. In the study group we determined the increase in biochemical markers of endothelial dysfunction, which correlated with parameters of vasodilation. Also, the presence of endothelial dysfunction significantly correlated with signs of reduction of the variability of the heart rhythm.
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