INVESTIGATION OF THE FUNCTIONAL STATE OF ENDOTHELIA, STRUCTURAL DAMAGE OF MAIN BRAHIOCEPHAL ARTERIES, CARBOHYDRATE AND LIPID EXCHANGE IN OVERWEIGHT PATIENTS WITH DIABETES MELLITUS 2 TYPE
Keywords:diabetes mellitus type 2, obesity, metabolic syndrome, endothelial dysfunction, great vessels
The functional state of the endothelium and structural damage of the brachiocephalic vessels in diabetic patients with varying degrees of overweight were assessed. Materials and methods: 44 patients with type 2 diabetes mellitus, overweight and obesity were examined using ultrasound Doppler examination of the main vessels of the head and neck with determination of the thickness of the intima-media complex and presence of stenosing lesions. The functional vasomotor function of the endothelium was studied by compression flowdependent vasodilation of the brachial artery, the results were analyzed depending on the main parameters of the metabolic syndrome (BMI, indicators of the blood lipid spectrum, and compensation for diabetes mellitus by HBA1c). Results and discussion: Most patients with type 2 diabetes mellitus with increased body weight and obesity had compaction and thickening of the walls of brachiocephalic vessels. In 52.27 % of patients, hemodynamically significant stenosis was revealed due to the development of atherosclerotic plaques in the extracranial vascular section of the carotid pool. Most often (56.52 % of cases), atherosclerotic plaques were located in the bifurcation of the common carotid artery. In these patients, against the background of impaired carbohydrate and lipid metabolism, endothelial dysfunction was detected according to flow-dependent vasodilation, which may indicate a violation of the compensatory capabilities of regional blood flow. They observed an increase in the velocity parameters of blood flow through the vessels and in the diameter of a.car.com, an increase of intimamedia complex thickness in its distal departments. This can be regarded as a reaction of the vascular wall to hemodynamic loads with an increase in body weight. Thus, the presence of increased weight and obesity is one of the main risk factors for the occurrence of atherosclerotic lesions in patients with type 2 diabetes.
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