Aim. To study dynamics of stiffness parameters in various type arteries, renal function and renal circulation in arterial hypertension (AH) and ischemic heart disease (CHD ) with decompensated 2 type diabetes mellitus (DM2) on the sitagliptin therapy during 24 weeks.Material and methods. Totally 30 patients included, with decompensated DM2 (HbA1c >7%) and AH, most having also CHD. The dynamics of carbohydrate and lipid metabolisms were assessed, arterial wall stiffness in various structural and functional types, renal function and renal circulation at the background of sitagliptine therapy during 24 weeks.Results. There was no dynamics by the parameters of arterial wall stiffness in various types of arteries, as in renal function and renal circulation among the patients in sitagliptin (n=15) and comparison (n=15) groups. However in those achieved compensation of DM2 on sitagliptin (n=8) we found a decrease of stiffnes index β of brachial artery (muscular type) by 37% from baseline (p<0,01). There was no dynamics of stiffness in muscle-elastic or muscular types of arteries.Conclusion. In patients with hipertension disease and ischemic heart disease with DM2 on glucoselowering therapy there was no dynamics by the parameters of aortic, common caritid artery stiffness and renal circulation during 6 months followup. However on the therapy by dipeptidilpeptidase-4 inhibitor (sitagliptin) during 6 months and compensation of DM2 (HbA1c <7%) there was a decrease of brachial artery stiffness (muscular type).
Цель. Изучить взаимосвязь изменений показателей жесткости артерий различного типа, пульсационности гемодинамики, функции почек и почечного кровотока у больных ишемической болезнью сердца (ИБС) и гипертонической болезнью (ГБ) при наличии или отсутствии сахарного диабета 2 типа (СД2). Материалы и методы. В исследование было включено 96 пациентов с ИБС и ГБ, в том числе 54 пациента с СД2 и 42 пациента без СД2. Определяли показатели углеводного и липидного обменов, функции почек, а также показатели жесткости артерий различного типа, параметры пульсационности гемодинамики и почечного кровотока. Результаты. При наличии СД2 отмечено повышение показателей жесткости артерий различных типов: скорости пульсовой волны в аорте на каротидно-феморальном участке (сосуд эластического типа) на 16% (р Заключение. Полученные результаты могут свидетельствовать об общности и взаимосвязи патогенетических механизмов, лежащих в основе развития повышенной жесткости магистральных сосудов и дисфункции почек у больных ИБС и ГБ с сопутствующим СД2.
Aim. To investigate the relationship between changes in indicators of arterial stiffness of various types of vessels, hemodynamic pulsatility, renal function and renal blood flow in patients with coronary artery disease (CAD) and arterial hypertension in the presence or absence of type 2 diabetes mellitus (T2DM). Materials and Methods. The study included 96 patients with CAD and arterial hypertension; among them, 54 subjects had T2DM and 42 did not. Сarbohydrate and lipid metabolism, renal function, stiffness of various types of arteries, parameters of hemodynamic pulsatility and renal blood flow were investigated. Results. Arterial stiffness of various types of vessels was increased in the T2DM group: carotid?femoral pulse wave velocity as a marker of aortic stiffness (a vessel of the elastic type) was increased by 16% (p