Features of prediabetes management in adolescents with excessive body weight and obesity

Background. The urgency of the problem of comorbidity of alcoholic steatohepatitis (ASH) and non-alcoholic steatohepatitis (NASH) with anaemic conditions and the need for their differentiated correction is determined by the significant frequency of these diseases in the world and Ukraine and the presence of the syndrome of the mutual burden. Anaemia is a marker for the progression of steatohepatitis to liver cirrhosis, in which anaemic conditions is often a manifestation of hypersplenism with the increased destruction of red blood cells in the spleen, as well as frequent complications of liver cirrhosis caused by posthemorrhagic anaemia, which occurs due to bleedings from the oesophageal and gastric varices, portal hypertension and decreased biosynthesis of coagulation factors by the liver. The purpose of the study was to find out metabolic prerequisites for the formation and progression of steatohepatitis of alcoholic, mixed and non-alcoholic aetiology and comorbid anaemic conditions. Materials and methods. One hundred and twenty-five patients with steatohepatitis of alcoholic, non-alcoholic and mixed aetiology were examined for comorbidities of anaemic conditions with lipid metabolism and glycemic regulation disorders. Results. The results of investigations demonstrate hyperlipidemia (by 1.35–1.5 times) in patients with steatohepatitis of mixed aetiology and ASH, although in anaemic conditions, the content of blood total cholesterol and low-density lipoprotein (LDL) cholesterol decreased (p < 0.05). Increased blood levels of triglycerides (in the range of 1.6–2.2 times) and decreased blood levels of high-density lipoprotein cholesterol (by 1.45–1.55 times) in all groups of patients with steatohepatitis and comorbidity with anaemic conditions deepened (p < 0.05). In NASH with anaemic conditions, there is an increase in the blood LDL cholesterol and total cholesterol levels, with the rise of the atherogenic index by 2.8 times (p < 0.05). Рatients with NASH and obesity have high values of glucose, insulin and degree of insulin resistance (by 2.6 times, p < 0.05), and with anaemic conditions, insulinemia and degree of insulin resistance are increased (by 2.9 and 3.0 times, respectively; p < 0.05). In patients with ASH and steatohepatitis of mixed aetiology associated with alcohol consumption, insulin deficiency is formed (by 1.4 and 1.2 times, p < 0.05), which develops in addition to anaemic conditions (blood insulin content is below the lower values by 1.8 and 1.6 times). Conclusions. The consequence of metabolic pathology (hyperlipidemia, hyperglycemia, insulin resistance), which developed under the comorbidity of steatohepatitis with anaemic conditions, was an increase in the degree of hepatocyte steatosis (p < 0.05).

Section: Discussionmentioning

confidence: 99%

Metabolic preconditions for the formation andprogression of steatohepatitis of alcoholic,mixed, non-alcoholic aetiology and their comorbidity withobesity and anaemic conditions

Antofiichuk

ХУХЛІНА

Антофійчук

et al. 2023

“…Припускають, що тип добового профілю оver-dipper є фактором ризику ішемічного інсульту [21]. Водночас циркадні ритми non-dipper та night-peaker асоціюються з підвищеним ризиком ураження органів-мішеней (гіпертрофії лівого шлуночка, мікроальбумінурії, геморагічного інсульту) [22,23].…”

Section: обговоренняunclassified

The course of arterial hypertension in patients with type 2 diabetes after surgical treatment of carotid artery stenotic lesions

O.Z.,

I.I.,

R.Ya.

et al. 2023

Background. Arterial hypertension (AH) is the cause of 70–75 % of strokes. Atherosclerotic lesion of the carotid artery (CA) is a classic example of a vascular lesion in individuals with hypertension. The risk of stroke increases twice when hypertension and diabetes are combined. Carotid endarterectomy (CA), which has both a curative and preventive nature, is the main method of surgical treatment of CA stenoses. The purpose was to study the course of blood pressure in patients with type 2 diabetes and without it after CE. Materials and methods. 138 patients with arterial hypertension and CA stenosis were selected for the purpose of CE under local anesthesia. Patients were divided into two groups: 68 patients with type 2 diabetes (group I) and 70 patients without diabetes (group II). The median age of patients in group I was 64 [50–71] years, group II — 63.5 [47–68] years. Daily blood pressure monitoring (BPD) was performed 2 days before surgery (1 examination), 5–7 days after surgery (2 examinations) and 3–6 months after CE (3 examinations). The average indicators of systolic blood pressure (SBP) and diastolic blood pressure (DBP) per day, day, and night were evaluated; average pulse blood pressure (BP); variability of SBP and DBP per day, day, night. Results. Before the operation, group I, in contrast to group II, recorded significantly higher indicators: SATdb (p = 0.02), SATd (p = 0.03), SATn (p = 0.01), DBTn (p < 0, 05), PAT (p = 0.03), varDATdb (p = 0.03), varSATd (p = 0.03), varDATn (p = 0.04). During the second examination in group II, significantly more significant dynamics of DMAT indicators were noted: SATdb (p = 0.002), SATd (p = 0.02), DAPdb (p = 0.002), DAPd (p = 0.01), DAPn (p = 0.03), varSATn (p < 0.04), varDATn (p < 0.05), varSATdb (p = 0.0002), varDATdb (p = 0.0001). The dynamics of PAT and midnight SAT were insignificant. 3 months after KE, all mean values of SBP and DBP, as well as PAT, decreased significantly in patients of group II. The expressiveness of changes in SBP indicators during the day, day and night, as well as indicators of SBP variability in group II was more significant. During the third examination, the proportion of patients with a "dipper" circadian rhythm increased in the two groups (p < 0.05). In group II, the proportion of patients with an unfavorable type of daily profile "over-dipper" significantly decreased (p < 0.001), which did not occur in group I. Conclusions. Surgical treatment of carotid stenoses in patients with and without type 2 diabetes is associated with a decrease in blood pressure in the early postoperative period and is observed for several months after the operation.

Relationship between vitamin D deficiency and metabolic disorders

Tsyryuk

Tseyslyer

Strubchevska

et al. 2023

The relationship between vitamin D deficiency and the metabolic syndrome has recently been revealed. Vitamin D deficiency was hypothesized to cause increased insulin resistance and decreased insulin secretion, which can result in the development of diabetes mellitus and obesity. Cardiovascular diseases are also closely related to the metabolic syndrome. Vitamin D has been shown to have complex multistep metabolism and act as a hormone at many extraskeletal targets. In this literature review, a comprehensive analysis of publications from Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health databases, as well as scientific libraries of Ukraine, European Union, Great Britain, USA and other countries was performed. Our goal is to identify and analyze scientific publications discussing various biological effects of vitamin D and its use in the comprehensive treatment of various diseases. In addition to the previously known role of vitamin D in calcium metabolism and the musculoskeletal system functionality, a wide range of its pleiotropic effects has been discovered recently. Modern studies have shown a relationship between low levels of vitamin D and development of neurocognitive dysfunction, mental and neurological disorders, infertility, immune reactivity and autoimmune disorders, various types of cancer, and cardiovascular pathologies. More recent data also revealed a relationship of vitamin D deficiency with practically all aspects of metabolic syndrome, namely diabetes mellitus type 2 and type 1, hyperglycemia, dyslipidemia, obesity, hypertension, and insulin resistance. It was concluded that the data of the modern literature regarding the effectiveness of vitamin D in the treatment and prevention of metabolic disorders and structural and functional changes of the liver in diabetes and non-alcoholic fatty liver disease are quite contradictory: at the same level as the numerous publications on the effective use of vitamin D, there are studies with unconfirmed effectiveness of therapy and even its toxicity for the indicated pathologies.