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Cariovascular Profile, Level of Its Control in Relation to Complications in Type 2 Diabetic Patients
Nussbaumerová, Barbora ; Rosolová, Hana (advisor) ; Lacigová, Silvie (referee) ; Málková, Jana (referee) ; Soška, Vladimír (referee)
1. A sample of 415 type 2 diabetic (DM2) subjects was examined. The control of cardiovascular risk factors, e.g. blood pressure, lipids and glucose metabolism, is unsatisfactory in this sample. There is a lack in nonpharmacological treatment and regimen - physical activity, smoking, low energy diet. The choice of antihypertensive treatment is satisfactory. Many patients have only the monotherapy. The antihypertensives are underdosed. We are not sure about the compliance. The treatment of dyslipidemia is not sufficient enough, there is a lack of the statin + fibrate combination therapy. The nonpharmacological regimen in needed for better glucose metabolism compensation. The pharmacotherapy should be indicated earlier (esp. metformin). 2. The prevalence of microvascular complications (mvc) was high in this sample (54%), especially the diabetic nefropathy (95%). The macrovascular compliactions (MVC) were present in 27% subjects, more in men, 55% of them had coronary heart disease. Subjects with MVC had more often mvc. The risk profile was worse in subjects with any vascular complications. The common risk factors in association with both MVC and mvc were the age over 60 years and hsCRP plasma level over 1 mg/L. We follow the sample prospectively to estimate predictive factors for vascular complications. 3. We...
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Lipoprotein-associated Phospholipase A2 in Geriatric Diabetic Patients
Fortunato, Joao ; Blaha, Vladimír (advisor) ; Nachtigal, Petr (referee) ; Soška, Vladimír (referee)
v anglickém jazyce Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an extracellular Ca2+- independent 45 KDa secreted enzyme formed by 441 amino acids. It circulates in plasma in the active form and is encoded in the PLA2G7 gene located on chromosome 6p12-21.1. Lp-PLA2 hydrolyzes several types of short-chain and oxidized phospholipids that harbor acyl groups at the second position of the glycerol backbone. It is mostly bound to low density liproprotein (LDL) particles and it is thought to play a role in the development of cardiovascular diseases (CVDs). Indeed, multiple studies propose that elevated mass concentration and/or activity of Lp-PLA2 is an independent risk factor for the development or recurrence of CVDs. We performed a cross-sectional analysis on 44 geriatric patients aged 79.6 ± 5.6 years that had undergone transcatheter aortic valve implantation (TAVI) or ballon valvuloplasty (BV) for the treatment of severe aortic stenosis. Lp-PLA2 mass concentration was already increased in elderly patients before TAVI or BV and significantly increased after the procedures. We found strong correlations with LDL concentration (LDL-C), total cholesterol and triglycerides. Baseline Lp-PLA2 mass concentration was increased in diabetic patients comparing to non-diabetic patients. We then discuss and...
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Lipoprotein-associated Phospholipase A2 in Geriatric Diabetic Patients
Fortunato, Joao ; Blaha, Vladimír (advisor) ; Nachtigal, Petr (referee) ; Soška, Vladimír (referee)
v anglickém jazyce Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an extracellular Ca2+- independent 45 KDa secreted enzyme formed by 441 amino acids. It circulates in plasma in the active form and is encoded in the PLA2G7 gene located on chromosome 6p12-21.1. Lp-PLA2 hydrolyzes several types of short-chain and oxidized phospholipids that harbor acyl groups at the second position of the glycerol backbone. It is mostly bound to low density liproprotein (LDL) particles and it is thought to play a role in the development of cardiovascular diseases (CVDs). Indeed, multiple studies propose that elevated mass concentration and/or activity of Lp-PLA2 is an independent risk factor for the development or recurrence of CVDs. We performed a cross-sectional analysis on 44 geriatric patients aged 79.6 ± 5.6 years that had undergone transcatheter aortic valve implantation (TAVI) or ballon valvuloplasty (BV) for the treatment of severe aortic stenosis. Lp-PLA2 mass concentration was already increased in elderly patients before TAVI or BV and significantly increased after the procedures. We found strong correlations with LDL concentration (LDL-C), total cholesterol and triglycerides. Baseline Lp-PLA2 mass concentration was increased in diabetic patients comparing to non-diabetic patients. We then discuss and...
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Cariovascular Profile, Level of Its Control in Relation to Complications in Type 2 Diabetic Patients
Nussbaumerová, Barbora ; Rosolová, Hana (advisor) ; Lacigová, Silvie (referee) ; Málková, Jana (referee) ; Soška, Vladimír (referee)
1. A sample of 415 type 2 diabetic (DM2) subjects was examined. The control of cardiovascular risk factors, e.g. blood pressure, lipids and glucose metabolism, is unsatisfactory in this sample. There is a lack in nonpharmacological treatment and regimen - physical activity, smoking, low energy diet. The choice of antihypertensive treatment is satisfactory. Many patients have only the monotherapy. The antihypertensives are underdosed. We are not sure about the compliance. The treatment of dyslipidemia is not sufficient enough, there is a lack of the statin + fibrate combination therapy. The nonpharmacological regimen in needed for better glucose metabolism compensation. The pharmacotherapy should be indicated earlier (esp. metformin). 2. The prevalence of microvascular complications (mvc) was high in this sample (54%), especially the diabetic nefropathy (95%). The macrovascular compliactions (MVC) were present in 27% subjects, more in men, 55% of them had coronary heart disease. Subjects with MVC had more often mvc. The risk profile was worse in subjects with any vascular complications. The common risk factors in association with both MVC and mvc were the age over 60 years and hsCRP plasma level over 1 mg/L. We follow the sample prospectively to estimate predictive factors for vascular complications. 3. We...
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