[Outpatient diagnosis of oxidant stress in patients with carbohydrate metabolism disturbance in metabolic syndrome].

AIM: To compare lipid peroxidation (LPO), (NO)-endothelium system in disorders of glucose tolerance (DGT) in patients with metabolic syndrome (MS) and diabetes mellitus type 2 (DM2). MATERIAL AND METHODS: The trial included 178 patients with DGT and DM2 within MS (WHO, 1999). The control group consisted of 40 healthy subjects free of MS. Mean age of the examinees was 52.26 +/- 0.79 years. Four groups of patients were identified. Group 1--34 patients with DM2 running for 6.73 +/- 1.01 years; group 2--92 patients with newly diagnosed DM2; group 3--52 patients with DGT; group 4--healthy controls matched by sex and age. 139 (78.1%) females and 39 (21.9%) males had impaired carbohydrate metabolism. Measurements were made of blood pressure, fasting and postprandial glucose, HbA1c, total cholesterol, triglycerides, beta-lipoproteins, dienic conjugates, malonic dialdehyde in erythrocytes and blood plasm. NO-endothelium system was assessed by concentration of nitrate-ions in plasm and erythrocytes, count of circulating desquamated endotheliocytes (CDE). RESULTS: A significant rise of LPO was seen depending on severity and duration of carbohydrate disbolism in all the patients compared to the controls. Concentration nitrate-ions of plasm and erythrocytes increases in newly diagnosed DM2 and DGT. In long-lasting DM2 NO3 in plasm and erythrocytes falls. Count of CDE elevates reaching maximum in DM2 running for 6.73 +/- 1.01 years. CONCLUSION: MS patients at the stage of DGT demonstrate intensified LPO, elevated concentration of the end metabolites NO-nitrates and conditions for endotheliocytes desquamation. These processes promote early development of angiopathy in DM. DGT are reversible, therefore, these MS patients are perspective for prophylaxis. The presence of oxidant stress in such patients should be considered in prescription of relevant medication.

[Outpatient follow-up and management of pregnant women with hypertension].

AIM: To study variants of the course of chronic hypertension in pregnant women and determination of factors predisposing to a persistent rise of arterial pressure (AP) in pregnancy. MATERIAL AND METHODS: A total of 50 pregnant women were examined (heart rhythm variability and psychological testing) who had AP 140/90 mm Hg and higher as shown by measurements at three outpatient check-ups. After delivery the patients were retrospectively devided into two groups. Twenty-seven group 1 women had frequent rises of AP to 140/90 and higher throughout pregnancy; twenty-three women of group 2 had high AP only at early terms of pregnancy, later they became normotensive without use of hypotensive drugs. 24-h AP monitoring was made in 29 patients. By its results, two subgroups were identified: 11 patients with essential hypertension and 18 women with neurocirculatory dystonia by hypertensive type. RESULTS: In group 1 there was an early fall of cardiac performance, higher values of SMIP test according to scales 2 (pessimism), 3 (emotional lability), 4 (impetuosity) and 7 (anxiety). CONCLUSION: The analysis of 24-h AP profiles revealed more persistent and significant rise of AP in patients with essential hypertension than in those with neurocirculatory dystonia. They also demonstrated high AP variability correlating with a risk of cardiovascular diseases.

[Diagnostics of disorders in lipid and carbohydrate metabolism in women with hypertension in outpatient clinic]. / Diagnostika v ambulatornykh usloviiakh narushenii lipidnogo i uglevodnogo obmena u zhenshchin s gipertonicheskoi bolezn'iu.

AIM: To study lipid and carbohydrate metabolism in young and middle-aged women with essential hypertension (EH). MATERIAL AND METHODS: Anthropometric parameters, arterial pressure (AP), glucose tolerance (GT), fasting glucose, immunoreactive insulin (IRI), glycosylated hemoglobin (HbA1), total cholesterol (TC), triglycerides (TG), HDLP cholesterol, atherogenic index were estimated in 93 women aged 20 to 50 years with EH stage II. RESULTS: TC was elevated in 75%, HDLP cholesterol--in 52%, TG--in 40% patients. Subnormal HDLP was only in 8% examinees. 6, 4, 21% of 53 examinees had elevated fasting glucose, GT, HbA1, respectively. Hyperinsulinemia was detected in 80%, insulin resistance in 92%. CONCLUSION: Disturbances of lipid metabolism were identified in more than half of the examined EH women. The HbA1 test is more sensitive than GT and fasting glucose tests in detection of abnormal carbohydrate metabolism.