DANGEROUS LIAISONS: BODY-MASS INDEX IN PATIENTS WITH ...

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blood pressure measurement, glomerular filtration rate and presence of ... Ankle-brachial index was used for determining the presence of arteriopathy, its.
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Medicina Internă 2017, volum XIV, număr 6 - www.srmi.ro

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DANGEROUS LIAISONS: BODY-MASS INDEX IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ITS CORRELATIONS WITH OTHER INDEPENDENT VARIABLES COMMONLY USED FOR MORBIDITY AND MORTALITY PREDICTION Vesa Cosmin Mihai1,2, Popa Loredana1, Zaha Dana1,2, Anca Ferician1,2, Moisi Madalina1,2, Moticiac Laura1, Popa Amorin1,2 1

Clinical County Emergency Hospital Oradea

2

Faculty of Medicine and Pharmacy of Oradea, University of Oradea

Abstract Background and aims. Current studies indicate that obesity is the ultimate target in glucose metabolism alterations. We conducted a study on Type 2 Diabetes patients, overweight or obese, aimed to prove the positive correlations between obesity and different variables used in current medical practice: fasting glucose, HbA1c percent, lipid levels, systolic and diastolic blood pressure measurement, glomerular filtration rate and presence of peripheral artery disease. Ankle-brachial index was used for determining the presence of arteriopathy, its determination being introduced as a result of studies that proved it to be a marker of silent atherosclerosis. Method. Patient's selection was conducted in a manner that we included subjects on similar glycemic-lowering regimens in order not to influence the results of the study. Results and conclusion. We observed positive correlations between obesity and all the above enumerated variables but, interestingly, analyzing random variable (ex. peripheral artery disease and GFR) correlations we were also given the same positive results, conducting to the idea that the diabetic patient is positioned in the middle of a vicious cycle, which modern therapies still can`t break it without lifestyle modification. Keywords: obesity, type 2 diabetes, atherosclerosis, insulin resistance Rezumat Scop. Studiile curente indică faptul că obezitatea este ţinta finală în modificările metabolismului glucozei. Am efectuat un studiu privind pacienţii cu diabet zaharat de tip 2, supraponderali sau obezi, menit să demonstreze corelaţiile pozitive dintre obezitate şi diferitele variabile utilizate în practica medicală actuală: glucoză à jeun, HbA1c, valorile lipidelor, presiunea arterială sistolică şi diastolică, rata de filtrare glomerulară şi prezenţa bolii arteriale periferice. Indicele gleznă-braţ a fost utilizat pentru determinarea prezenţei arteriopatiei, aceasta dovedindu-se, în studii, un marker de ateroscleroză silenţioasă.

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Metodă. Prin selecţia pacienţilor au fost incluşi în studiu subiecţi pe regimuri similare de scădere a glicemiei, pentru a nu influenţa rezultatele studiului. Rezultate şi concluzii. Am observat corelaţii pozitive între obezitate şi toate variabilele enumerate mai sus, dar, interesant, analizând corelaţiile cu variabile aleatoare (de exemplu, boala arterială periferică şi GFR) am obţinut aceleaşi rezultate pozitive, conducând la ideea că pacientul diabetic este poziţionat în mijlocul unui ciclu vicios, pe care terapiile moderne încă nu îl pot rupe fără modificări ale stilului de viaţă. Cuvinte cheie: obezitate, diabet de tip 2, ateroscleroză, rezistenţă la insulină.

Introduction

insulin resistance are not completely understood, but it seems that the high level

Diabetes Type 2 is a chronic metabolic

of free-fatty acids present in obesity induces

disease defined by impaired insulin secretion

lipotoxicity that alters the insulin signaling

and/or insulin resistance, leading to an

p a t h w a y. H i g h l e v e l s o f i n s u l i n a r e

excess of morbidity and mortality mainly as a

responsible for a proatherosclerotic state,

consequence of its chronic complications.

which leads to increased numbers of

Modern therapies for the management of

myocardial infarctions and strokes.

diabetes, like insulin analogues, SGLT-2 inhibitors and incretin mimetics have shown

Material and method

their efficacy for reducing blood glucose levels but despite this, even when the patient

We conducted an observational study on 34

reaches the therapeutic standard (HbA1c

subject diagnosed with Diabetes Type 2