Association of Polymorphic Variants of TCF7L2 and PPARG Genes with Metabolic Markers in Patients with Early Disorders of Carbohydrate Metabolism.

We performed complex analysis of the association of polymorphic variants rs7903146 of the TCF7L2 gene and rs1801282 of the PPARG gene with metabolic parameters, insulin resistance, and ß-cell function in a group of patients with early signs of carbohydrate metabolism disturbances in a sample of Tyumen citizens. The study group consisted of 64 people (39 women, 25 men) aged 40-70 years. The distribution of frequencies of alleles and genotypes of the polymorphic markers rs7903146 and rs1801282 was analyzed and associations of carriage of major homozygous polymorphisms with various phenotypic traits were identified. Genotyping for polymorphic variants of TCF7L2 and PPARG genes was performed using allele-specific PCR with primers provided by Synthol company. Carriers of homozygotes for allele C of the polymorphic marker rs7903146 significantly differed from other respondents by a higher level of C-peptide, as well as by the presence of associations with waist circumference, elevated level of glycated hemoglobin, and arterial hypertension. Carriers of homozygotes for the allele C of the rs1801282 polymorphism of the PPARG gene differed from the group of carriers of homozygotes for the allele G and the group of heterozygote carriers by higher levels of triglycerides, as well as the presence of associations with waist circumference and the level of glycated hemoglobin.

[The role of nutritional factors in the formation of cardiovascular risk in patients with type 2 diabetes mellitus].

Cardiovascular diseases are the most common complications of type 2 diabetes mellitus (T2DM) and remain the main cause of mortality in this category of patients. Currently, there is more and more data that confirm the influence of nutritional factors not only on the achievement of target values of metabolic parameters in diabetes, but also on predictors of cardiovascular risk, and also demonstrate their role as independent predictors. In this regard, the study of the role of nutritional factors in the formation of high cardiovascular risk in patients with T2DM is of high practical importance and relevance. The aim was to assess the role of nutritional factors in the formation of high total cardiovascular risk in patients with T2DM. Material and methods. An open clinical controlled prospective observation was carried out for one year in 110 patients with T2DM (87 women and 23 men, mean age 56.7±8.6 years). The average value of glycated hemoglobin (HbA1c) in the group was 8.95±2.09%, the av erage value of the body mass index was 32.3±6.2 kg/m2. All patients were assessed for traditional cardiovascular risk factors, markers of systemic inflammation and endothelial dysfunction, nutritional status was assessed by analyzing the frequency of consumption and a general semi-quantitative assessment of the intake of nutrients, food groups, and energy. During a one-year prospective follow-up, total cardiovascular endpoints were recorded and the effect of patient education on metabolic parameters, nutritional factors, and cardiovascular risk was assessed. Results. In patients with T2DM who had various clinical forms of cardiovascular diseases, the diet had an increased level of fats, which exceeded the intake in individuals without complications (p=0.013), and saturated fatty acids (SFA) (p=0.003). The risk of developing cardiovascular events in patients with T2DM increased by 5 times under excessive consumption of products containing SFA (meat, animal fats, sausages) (OR 5.34; CI 3.05-10.22, p=0.001). The decrease in body weight in the target range (by 7-10% during the year) was characterized by a decrease in the HbA1c by 11.9%, postprandial glycemia by 25.7%, total cholesterol by 20.4%, atherogenic coefficient by 25.0%, plasminogen activator inhibitor-1 by 8.5%, highly sensitive C-reactive protein by 27.4%, systolic blood pressure by 6.9%, and also was accompanied by significant decrease in unfavorable total cardiovascular events during the year (p=0.024). In addition, in the group of patients who underwent training, there was a decrease in the total amount of calories consumed (p=0.018), consumption of SFA (p=0.021) and mono- and disaccharides (p=0.001), an increase in dietary fiber in the diet (p=0.015). Conclusion. In the course of the study, an imbalance in the nutritional components of the diet in patients with T2DM was revealed. The significant role of alimentary factors in the formation of high cardiovascular risk has been demonstrated, as well as the effectiveness of therapeutic education of patients in terms of managing behavioral risk factors.