RESUMO
Cerebral perfusion was studied in patients with arterial hypertension combined with metabolic syndrome and diabetes mellitus type II. The data is compared to the results obtained for patients with a single disorder--metabolic syndrome, diabetes mellitus type II and arterial hypertension without metabolic alterations. It is shown that patients with disregulation of carbohydrate and lipid metabolism are more vulnerable to cerebral blood supply alterations. A level of perfusion was the same in patients with metabolic syndrome and diabetes mellitus type II. Besides, an acetazolamide application revealed that patients with metabolic syndrome had reduced cerebral vascular autoregulation.
Assuntos
Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/fisiopatologia , Doenças Metabólicas/complicações , Acetazolamida/farmacocinética , Adulto , Encéfalo/irrigação sanguínea , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Inibidores da Anidrase Carbônica/farmacocinética , Circulação Cerebrovascular/fisiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Teste de Tolerância a Glucose , Humanos , Hiperlipidemias/complicações , Hiperlipidemias/fisiopatologia , Hipertensão/complicações , Hipertensão/fisiopatologia , Resistência à Insulina , Masculino , Doenças Metabólicas/diagnóstico , SíndromeRESUMO
AIM: To study effects of body mass loss due to orlistat on carbohydrate and lipid metabolism, insulin resistance, 24-h profile of arterial pressure (AP), left ventricular myocardial hypertrophy, brain perfusion in patients with metabolic syndrome (MS). MATERIAL AND METHODS: Thirty middle-aged patients with MS entered the trial. They received orlistat in a dose 120 mg twice a day for 24 weeks. Before and after the treatment the patients' carbohydrate and lipid metabolism, insulin resistance were studied, 24-h monitoring of arterial pressure, echo-cardiography were made. Brain perfusion was studied with single-photon emission computed tomography in 18 patients. Results. All the patients lost much weight. This was accompanied with improved indices of AP profile, metabolism of carbohydrates and lipids, insulin resistance, left ventricular hypertrophy, brain perfusion. Conclusion. Orlistat treatment weakens basic factors of cardiovascular risk.
Assuntos
Fármacos Antiobesidade/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Lactonas/uso terapêutico , Síndrome Metabólica/tratamento farmacológico , Redução de Peso , Adulto , Fármacos Antiobesidade/efeitos adversos , Fármacos Antiobesidade/farmacologia , Glicemia/metabolismo , Doenças Cardiovasculares/etiologia , Angiografia Cerebral , Feminino , Humanos , Insulina/sangue , Insulina/metabolismo , Resistência à Insulina , Lactonas/efeitos adversos , Lactonas/farmacologia , Metabolismo dos Lipídeos , Lipídeos/sangue , Masculino , Síndrome Metabólica/complicações , Orlistate , Fatores de RiscoRESUMO
AIM: To compare brain perfusion in hypertensive patients with diabetes mellitus type 2 (DM2) or metabolic (MS) syndrome and hypertensive patients without clinicobiochemical signs of DM2 or MS; to study enoxaparin effects on brain perfusion in DM2 and arterial hypertension (AH). MATERIAL AND METHODS: Seventy patients included in the study were divided into three groups: 30 patients with DM2 and AH (group 1), 30 patients with MS and AH (group 2) and 10 AH patients without manifestations of MS or DM2 (group 3). All the patients have undergone single-photon emission computed tomography (SPECT) of the brain, carbohydrate and lipid metabolism were examined. RESULTS: Deterioration of brain perfusion was more prominent in DM2 and MS patients with AH than in hypertensive patients with normal metabolism. Stress test with acetasolamide revealed defective autoregulation of cerebral blood flow in hypertensive patients with DM2. A 6-week therapy with enoxaparin significantly improved brain perfusion in hypertensive patients with DM2. CONCLUSION: Enoxaparin treatment of hypertensive DM2 and MS patients with abnormal perfusion of the brain can be used for prevention of cerebrovascular complications.
