ABSTRACT
The purpose of study was to develop and test the method of determination of destruction of endotheliocytes in blood-vascular system. The level of circulating endothelial cells was determined by enumeration of CD32+CD40+ micro particles by means of flow cytofluorometry. During the application of the modified method it is demonstrated that in patients with metabolic syndrome the amount of CD32+CD40+ micro particles is twice higher than in the control group (p < 0.05). The research data revealed the increase of content of big endothelin and atherogenic lipoproteids. The method of determination of the level of circulating CD32+CD40+ micro particles can be applied to assess the desquamationed endotheliocytes.
Subject(s)
CD40 Antigens/blood , Cell-Derived Microparticles/metabolism , Endothelial Cells/metabolism , Receptors, IgG/blood , Aged , Endothelial Cells/immunology , Endothelin-1/blood , Endothelium, Vascular/cytology , Endothelium, Vascular/physiopathology , Flow Cytometry/methods , Humans , Male , Metabolic Syndrome/pathology , Middle AgedABSTRACT
The use of metformin during the first month of treatment of patients with coronary artery disease and diabetes type 2 led to the decrease of insulin resistance and reduced activity of systemic inflammation (significant decrease in the concentrations of IL-1, IL-6, IL-8 and TNF-alpha). Reduced activity of systemic inflammation had a beneficial effect on the course of coronary artery disease (significant decrease in the functional class of stable angina). Type 2 diabetes appears to be quite successfully modifiable risk factor for coronary artery disease by the adequate controls.
Subject(s)
Angina Pectoris/drug therapy , Coronary Artery Disease/drug therapy , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use , Aged , Angina Pectoris/blood , Angina Pectoris/complications , Angina Pectoris/physiopathology , Antihypertensive Agents/administration & dosage , Blood Glucose/analysis , Body Mass Index , C-Reactive Protein/analysis , Coronary Artery Disease/blood , Coronary Artery Disease/complications , Coronary Artery Disease/physiopathology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/physiopathology , Electrocardiography , Female , Humans , Hypoglycemic Agents/administration & dosage , Inflammation/blood , Insulin/blood , Insulin Resistance , Interleukin-1/analysis , Interleukin-6/analysis , Interleukin-8/analysis , Lipid Metabolism/drug effects , Male , Metformin/administration & dosage , Middle Aged , Risk Factors , Treatment Outcome , Tumor Necrosis Factor-alpha/analysisABSTRACT
We investigated the effectiveness of pioglitazone in the treatment of patients with coronary heart disease in combination with MS. In the conduct of research revealed that the addition to standard therapy in patients with coronary heart disease on the background of metabolic syndrome pioglitazone led to a reliable slight decrease in body weight, BMI, hip circumference, waist their relationship. Receiving pioglitazone also significantly reduces the concentration of immunoreactive insulin and blood glucose levels, significantly altered lipid metabolism, which generally leads to a lower level of systemic inflammation, metabolism and reduces the severity of insulin resistance. This allows you to recommend the inclusion of pioglitazone in complex coronary heart disease and metabolic syndrome.
Subject(s)
Coronary Disease/drug therapy , Hypoglycemic Agents/administration & dosage , Metabolic Syndrome/drug therapy , Thiazolidinediones/administration & dosage , Aged , Amlodipine/administration & dosage , Amlodipine/therapeutic use , Aspirin/administration & dosage , Aspirin/therapeutic use , Atorvastatin , Bisoprolol/administration & dosage , Bisoprolol/therapeutic use , Blood Glucose/analysis , Body Mass Index , Body Weight/drug effects , C-Reactive Protein/analysis , C-Reactive Protein/immunology , Coronary Disease/blood , Coronary Disease/complications , Coronary Disease/immunology , Coronary Disease/physiopathology , Heptanoic Acids/administration & dosage , Heptanoic Acids/therapeutic use , Humans , Hypoglycemic Agents/therapeutic use , Insulin/blood , Insulin Resistance , Isosorbide Dinitrate/administration & dosage , Isosorbide Dinitrate/therapeutic use , Lipid Metabolism/drug effects , Lipid Peroxidation/drug effects , Metabolic Syndrome/blood , Metabolic Syndrome/complications , Metabolic Syndrome/immunology , Metabolic Syndrome/physiopathology , Middle Aged , Pioglitazone , Pyrroles/administration & dosage , Pyrroles/therapeutic use , Thiazolidinediones/therapeutic use , Waist-Hip RatioABSTRACT
The inclusion of a short course of metformin in complex therapy of coronary artery disease with metabolic syndrome does not alter the clinical features of disease. It had a positive effect on weight loss and the activity of systemic inflammation. The lipid metabolism and insulin resistance were not significantly altered. This results suggest that the treatment with metformin during 1 month in patients with coronary artery disease and metabolic syndrome is sufficient for the manifestation of systemic anti-inflammatory effect of the drug, but not enough to implement a reliable effect of insulin resistance and to improve the clinical features of coronary artery disease.
Subject(s)
Coronary Disease/drug therapy , Hypoglycemic Agents/therapeutic use , Metabolic Syndrome/drug therapy , Metformin/therapeutic use , Aged , Body Mass Index , Body Weight/drug effects , Carbohydrate Metabolism/drug effects , Coronary Disease/complications , Coronary Disease/metabolism , Cytokines/blood , Dose-Response Relationship, Drug , Drug Administration Schedule , Drug Therapy, Combination , Humans , Hypoglycemic Agents/administration & dosage , Lipid Metabolism/drug effects , Male , Metabolic Syndrome/complications , Metabolic Syndrome/metabolism , Metformin/administration & dosage , Middle Aged , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
We have studied efficiency of a complex therapy with metformin and ramipril combination (1000 mg and 5 mg per day) respectively in patients with metabolic syndrome (MS). The group of patients with MS which answered the basic criteria IDF (2005) was determined. Carbohydrate and Lipidic metabolism were studied. Patients were characterized with raised weight index (WI), arterial hypertension, increased concentration of triglycerides in blood serum, of glucose, of HbAlc level and S-peptide, and also high level of endotelin (1-38) and CD32+CD40+circulating particles of endothelium. Three months treatment lead to decrease in WI, arterial pressure, triglycerides concentration, HbAlc, glucose, except CD32+CD40+. Six months treatment lead to more expressed positive dynamics. Thus, metformin and ramipril combination in patients with MS leads to decrease in insulin resistancy, carbohydrate and lipid metabolism normalization, to restoration of endothelium functions that is possible to consider as prophylaxis of the development of type 2 diabetes melitus and its cardiovascular complications.
