Endocrine Abstracts

Cardio-vascular disorders (CVD), ischemic heart disease (IHD) and myocardial infarction (MI) heading the line are the main cause of death among patients with diabetes mellitus (DM). DM has been proved to be an essential risk factor for IHD and MI to be instrumental in regarding all patients as belonging to the CVD high risk group. Dysfunction of adipocytes, insulin resistance, hyperinsulinemia, hyperglycemia and dyslipidemia seen in DM are the triggers for the cascade of hemodynamic and neuro-humoral responses underlying the atherosclerotic damages of vessels of various location with clinical manifestation in the form of IHD. The work was initiated to study lipid metabolism parameters in patients with the IHD- accompanied type 1 diabetes mellitus.

Materials and methods: We examined 10 patients with type 1 DM and 14 patients with type 1DM and IHD. 12 donors were included in the control group. Concentrations of lipids, triglycerides (TG), total cholesterol (TC) and high density lipoproteins (HDP) cholesterol were analyzed in all groups.

Results and discussion: Significant increase in concentrations of total lipids and TC could be seen in all patients being more pronounced in the IHD-accompanied type 1 DM. Concentrations of total lipids in patients with the accompanied pathology were the highest (11.42 ± 0.61 versus 5.2 ±.33 g/l in the controls). Total cholesterol concentrations were approximately equal in all groups of patients to be 226.0 ± 11.3 mg% in patients with type 1 DM and 223.0 ±11.8 mg% in those with DM and IHD (P < 0.05) while the concentrations of TG and HDL cholesterol changed by presence of IHD. The most pronounced changes in the serum TG concentrations could be seen in patients with IHD-accompanied type 1 DM (232.8 ± 26.0 mg%), as compared to those in patients with DM but not IHD (211.3 ± 14.3 mg%)(P < 0.05) and the controls (137.8 ± 1.9 mg%). The reduction in HDL cholesterol could be seen both in patients with type 1 DM (36.3 ± 2.26 mg%, P < 0.05) and those with the pathology-accompanied disease (33.9 ± 1.8 mg%, P < 0.001) to significantly differ from the parameters in the controls (59.7 ± 0.8 mg%). Thus, the increase in concentrations of total cholesterol, TC, TG paralleling reduction in HDL cholesterol could be seen characteristic of patients with type 1 DM. IHD was demonstrated to be the confounding factor for DM course due to metabolic and pro-atherogenic changes, as well as formation of risk factors, to name arterial hypertension, obesity and dyslipidemia.