Endocrine Abstracts

2 type diabetes mellitus (2DM) determines high risk of cardio-vascular disorders and pathologies of cardio-vascular system, to name arterial hypertension, ischemic heart disease and hypercholesterolemia. In addition, prolonged insufficient DM compensation results in onset of macrovascular complications eventually causing adverse effects. UKPDS findings demonstrated that intense glycemia control significantly reduced the risk of microvascular diabetic complications, but produced no significant effect on the macrovascular ones and total mortality. The conclusions confirm necessity for the complex control of glycemia, arterial pressure and blood lipids. In our study, patients received metformin as the first line therapy in 2DM. The work was initiated to study lipid profiles of the 2DM patients with IHD and its correction with metformin. We examined 38 2DM patients with IHD to analyze concentrations of triglycerides (TG), total cholesterol (TC), HDL C, LDL and VLDL. 20 donors were included in the control group. Lipid profile in 2DM is characterized with ‘lipid triad’ including increase in TG, reduction in HDL cholesterol and predominance of small dense particles of LDL. In diabetes, the latter prevail. Due to higher atherogenicity of the particles in question, the risk of atherogenicity is higher in the diabetics with the similar LDL C. The LDL levels were proved to be a risk factor for IHD. In our patients, levels of TG and TC were significantly increased, while those of LDL and VLDL were significantly reduced, as compared to the controls. In contrast, the HDL C was significantly reduced. Metformin therapy results in positive changes in the lipidogram. In the patients, TC significantly reduced, as compared to the pre-therapy values (219.6±8.3 vs 2317±10.7 mg%, Р<0.05). TG were found to decrease to 280.0±34.1 mg%, as compared to the initial values (394.6±29.0 mg%, Р<0.001). Post-therapy total sum of LDL and VLDL was reduced to 735.0±48.3 mg% vs 948.2±52.4 mg% (Р<0.001) before therapy. The therapy insignificantly increased HDL C concentrations (31.4±5.03 vs 28.0±2.7 mg%). Despite reduction in atherogenic lipids and increase in anti-atherogenic ones, all parameters under study were found not to reach the levels in the controls. Metformin significantly reduced atherogenic lipoproteins; the anti-atherogenic ones tended to increase. As in metformin therapy the parameters under study in our experiments did not reach the control values, it can be concluded that statins are necessary to be added to the hypoglycemics in therapy of the dislipidemia in DM.