Parameters of endothelial function and insulin resistance in patients with metabolic syndrome before and after weight loss

Abstract

In clinical practice, physicians of different specialties often faced with the metabolic syndrome (MS) is a set of hormonal and metabolic disorders that share a common pathophysiological mechanism - insulin resistance (IR) [1, 5, 11]. MS is important for the clinician not only how widespread pathology, but primarily as a life-threatening condition. Of course, this syndrome plays an important role in accelerating the development and progression of diseases associated with atherosclerosis, which, according to experts WHO, ranks first among the causes of mortality in industrialized countries [12, 16, 19]. This situation is particularly important for Russia due to the relatively high spread of the syndrome, component, according to several authors, about 20% of the population, and high rates of death from coronary heart disease and stroke in the Russian population [2, 4, 5]. It is known that the risk of coronary heart disease (CHD), stroke, and total coronary mortality increases with the number of components of metabolic syndrome [14, 15, 20]. The study J.H. Park et al., Which included 478 patients with ischemic stroke, MS was diagnosed in 53.4% of patients (criteria NCEP ATP III), the thickness of the complex value of the index "intima-media" of the carotid arteries was increased in direct proportion to an increase in the number of available components of MS [20] . Link between R D and cardiovascular disease, apparently, is endothelial dysfunction, which is the study at various metabolic diseases received much attention [9, 10, 22]. Endothelial dysfunction, which is typical for many patients with MS, is a marker of metabolic and vascular disorders [15, 22]. In the initial period of development of the atherosclerotic process, even when there are no obvious clinical manifestations and visible morphological changes of blood vessels, the main role is played by endothelial dysfunction [9, 21]. Endothelial dysfunction is also discussed as one of the reasons for the rapid development, progression of atherosclerosis and its complications in patients with MS [11,18]. For example, recent studies have shown that tears plaques leading to myocardial infarction, do not always occur in the zone of maximum stenosis of the coronary arteries [13]. Rather, they tend to occur in places restrictions of small - less than 50% by angiography. The study of endothelial function in patients with MS is at the initial stages of the study [8, 15, 18]. In addition, of particular interest is the study of the effect of weight loss on the state of the endothelium in the syndrome of insulin resistance.