2 research outputs found
Π₯ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ΠΎΡ β ΡΠΈΠ·ΠΈΠΊ ΡΠ°ΠΊΡΠΎΡ ΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡ Π²ΠΎ ΠΏΠΎΡΠ°Π²Π°ΡΠ° Π½Π° Π²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2
BACKGROUND: Homocysteine (HCY) is a sulphur containing amino acid. The entire amount of homocysteine in the body is formed through the cycle of methylation of the amino acid methionine, as the primary and only source of homocysteine. The plasma free HCY is only 1%, while 70% is bound to albumin. The metabolism of HCY involves three enzymes: methionine synthase (MS) methylenetetrahydrofolate reductase (MTHFR), cystathionine B synthase (CBS) and the vitamins B6, B12 and folic acid as cofactors of these enzymes. In case of metabolic disturbance of the metabolism of HCY due to enzymatic defect or because of lack of intracellular cofactor, HCY accumulates in the cells, after which it is excreted from the cells and its plasma levels rise.
AIM: The purpose of this study is to obtain data that would prove the correlation of plasma homocysteine regarding the etiology of the microvascular and macrovascular complications of diabetes and the possibility of its use as an early predictor in the diagnosis of vascular complications in patients with diabetes mellitus.
METHODS: This paper is a retrospective-prospective study conducted at the Clinic for Endocrinology, Diabetes and Metabolic Diseases in Skopje. The study have included 80 patients with diabetes mellitus 2. Patients who are recruited were divided into two groups: 50 patients diagnosed with vascular complications and a group of 30 patients without associated complications, which will be the control group. The test group of patients will be made up of patients with type 2 diabetes mellitus, with confirmed diagnosis and treated with insulin and oral treatment.
RESULTS: From the preliminary results of the microvascular complications the most frequent and statistically significant is the prevalence of the nephropathy with 32%. Retinopathy was represented with 29 % and microalbuminuria was detected in 27.5% of the patients. Among the macrovascular complications 31 % of the patients were diagnosed with arterial hypertension and 12.50% with peripheral arterial diseases. In the present study higher levels of homocysteine were detected in group of diabetic subjects with microvascular and macrovascular complications comparing to control group of patients where no complications were diagnosed and levels of homocysteine were among reference ranges.
CONCLUSION: Hiperhomocisteinemia represents a risk factor in etiology of chronic complications in patients with diabetes mellitus type 2. However, further research would provide clear evidence of the impact of increased levels of homocysteine and its role in damage to the endothelium of blood vessels and the emergence of long-term vascular complications.ΠΠ‘ΠΠΠΠ: Π₯ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ΠΎΡ (ΠΡΡ) Π΅ Π°ΠΌΠΈΠ½ΠΎ ΠΊΠΈΡΠ΅Π»ΠΈΠ½Π° ΠΊΠΎΡΠ° ΡΠΎΠ΄ΡΠΆΠΈ ΡΡΠ»ΡΡΡ. Π¦Π΅Π»ΠΎΡΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ Π²ΠΎ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠΎΡ ΡΠ΅ ΡΠΎΡΠΌΠΈΡΠ° ΠΏΡΠ΅ΠΊΡ ΡΠΈΠΊΠ»ΡΡΠΎΡ Π½Π° ΠΌΠ΅ΡΠΈΠ»ΡΠΈΡΠ° ΠΎΠ΄ Π°ΠΌΠΈΠ½ΠΎΠΊΠΈΡΠ΅Π»ΠΈΠ½Π°ΡΠ° ΠΌΠ΅ΡΠΈΠΎΠ½ΠΈΠ½, ΠΊΠ°ΠΊΠΎ ΠΎΡΠ½ΠΎΠ²Π΅Π½ ΠΈ Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½ ΠΈΠ·Π²ΠΎΡ Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½. ΠΠΎ ΠΏΠ»Π°Π·ΠΌΠ°ΡΠ° ΠΡΡ ΡΠ΅ Π½Π°ΠΎΡΠ° ΡΠ»ΠΎΠ±ΠΎΠ΄Π΅Π½ ΡΠ°ΠΌΠΎ 1%, Π΄ΠΎΠ΄Π΅ΠΊΠ° 70% ΡΠ΅ Π½Π°ΠΎΡΠ° Π²ΡΠ·Π°Π½ Π·Π° Π°Π»Π±ΡΠΌΠΈΠ½ΠΈΡΠ΅. ΠΠΎ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠΎΡ Π½Π° ΠΡΡ ΡΠ΅ ΠΈΠ½Π²ΠΎΠ»Π²ΠΈΡΠ°Π½ΠΈ ΡΡΠΈ Π΅Π½Π·ΠΈΠΌΠΈ: ΠΌΠ΅ΡΠΈΠΎΠ½ΠΈΠ½ ΡΠΈΠ½ΡΠ°Π·Π° (ΠΠ‘), ΠΌΠ΅ΡΠΈΠ»Π΅Π½ΡΠ΅ΡΡΠΈΡ
ΠΈΠ΄ΡΠ°ΡΠΎΠ»Π°Ρ ΡΠ΅Π΄ΡΠΊΡΠ°Π·Π° (ΠΠ’Π₯Π€Π ), ΡΠΈΡΡΠ°ΡΠΈΠΎΠ½ΠΈΠ½ Π ΡΠ΅Π½ΡΠΈΡΠ°Π·Π° (Π¦ΠΠ‘) ΠΊΠ°ΠΊΠΎ ΠΈ Π²ΠΈΡΠ°ΠΌΠΈΠ½ΠΈΡΠ΅ B6, B12 ΠΈ ΡΠΎΠ»Π½Π°ΡΠ° ΠΊΠΈΡΠ΅Π»ΠΈΠ½Π°, ΠΊΠ°ΠΊΠΎ ΠΊΠΎΡΠ°ΠΊΡΠΎΡΠΈ Π½Π° ΠΎΠ²ΠΈΠ΅ Π΅Π½Π·ΠΈΠΌΠΈ. ΠΠΎ ΡΠ»ΡΡΠ°Ρ Π½Π° Π½Π°ΡΡΡΡΠ²Π°ΡΠ΅ Π½Π° ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠΎΡ Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ΠΎΡ ΠΏΠΎΡΠ°Π΄ΠΈ Π΅Π½Π·ΠΈΠΌΡΠΊΠΈ Π΄Π΅ΡΠ΅ΠΊΡ ΠΈΠ»ΠΈ ΠΏΠΎΡΠ°Π΄ΠΈ Π½Π΅Π΄ΠΎΡΡΠΈΠ³ Π½Π° Π½Π΅ΠΊΠΎΡ ΠΈΠ½ΡΡΠ°ΡΠ΅Π»ΡΠ»Π°ΡΠ΅Π½ ΠΊΠΎΡΠ°ΠΊΡΠΎΡ, Π΄ΠΎΠ°ΡΠ° Π΄ΠΎ Π°ΠΊΡΠΌΡΠ»ΠΈΡΠ°ΡΠ΅ Π½Π° ΠΡΡ Π²ΠΎ ΠΊΠ»Π΅ΡΠΊΠ°ΡΠ° ΠΈ ΠΏΠΎΡΠΎΠ° Π΄ΠΎ Π½Π΅Π³ΠΎΠ²ΠΎ Π΅ΠΊΡΠΊΡΠ΅ΡΠΈΡΠ°ΡΠ΅ ΠΈ Π·Π³ΠΎΠ»Π΅ΠΌΡΠ²Π°ΡΠ΅ Π½Π° Π½ΠΈΠ²ΠΎΠ°ΡΠ° Π²ΠΎ ΡΠΈΡΠΊΡΠ»Π°ΡΠΈΡΠ°ΡΠ°.
Π¦ΠΠ: Π¦Π΅Π»ΡΠ° Π½Π° ΠΎΠ²Π° ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ Π΅ Π΄Π° ΡΠ΅ Π΄ΠΎΠ±ΠΈΡΠ°Ρ ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈ ΡΠΎ ΠΊΠΎΠΈ Π±ΠΈ ΡΠ΅ Π΄ΠΎΠΊΠ°ΠΆΠ°Π»Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡΠ°ΡΠ° Π½Π° ΠΏΠ»Π°Π·ΠΌΠ° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ΠΎΡ Π²ΠΎ ΠΎΠ΄Π½ΠΎΡ Π½Π° Π΅ΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ°ΡΠ° Π½Π° ΠΌΠΈΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΈ ΠΌΠ°ΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°ΠΊΠΎ ΠΈ ΠΌΠΎΠΆΠ½ΠΎΡΡΠ° Π·Π° Π½Π΅Π³ΠΎΠ²Π° ΡΠΏΠΎΡΡΠ΅Π±Π° ΠΊΠ°ΠΊΠΎ ΡΠ°Π½ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡ Π²ΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ°ΡΠ° Π½Π° Π²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ.
ΠΠΠ’ΠΠΠ: Π’ΡΡΠ΄ΠΎΡ ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ-ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ΅ ΠΊΠΎΠ΅ ΡΠ΅ ΠΎΠ΄Π²ΠΈΠ²Π°ΡΠ΅ Π½Π° ΠΊΠ»ΠΈΠ½ΠΈΠΊΠ°ΡΠ° Π·Π° Π΅Π½Π΄ΠΎΠΊΡΠΈΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ° ΠΈ Π±ΠΎΠ»Π΅ΡΡΠΈ Π½Π° ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΠΌΠΎΡ Π²ΠΎ Π‘ΠΊΠΎΠΏΡΠ΅. Π‘ΡΡΠ΄ΠΈΡΠ°ΡΠ° Π²ΠΊΠ»ΡΡΠΈ 80 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ 2. Π Π΅Π³ΡΡΡΠΈΡΠ°Π½ΠΈΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Π±Π΅Π° ΠΏΠΎΠ΄Π΅Π»Π΅Π½ΠΈ Π²ΠΎ Π΄Π²Π΅ Π³ΡΡΠΏΠΈ: 50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ Π΄ΠΈΡΠ°Π³Π½ΠΎΡΡΠΈΡΠΈΡΠ°Π½ΠΈ Π²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΈ Π³ΡΡΠΏΠ° ΠΎΠ΄ 30 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Π±Π΅Π· ΠΏΡΠΈΠ΄ΡΡΠΆΠ½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ, ΠΊΠΎΡΠ° Π²ΠΎΠ΅Π΄Π½ΠΎ Π΅ ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π° Π³ΡΡΠΏΠ°.
Π ΠΠΠ£ΠΠ’ΠΠ’Π: ΠΠ΄ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ°ΡΠ° Π½Π° ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈΡΠ΅, ΠΏΠΎΠΌΠ΅ΡΡ ΠΌΠΈΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ Π½Π°ΡΠ·Π°ΡΡΠ°ΠΏΠ΅Π½Π° Π±Π΅ΡΠ΅ Π½Π΅ΡΡΠΎΠΏΠ°ΡΠΈΡΠ°ΡΠ° ΡΠΎ 32%, ΠΏΠΎΡΠΎΠ° ΡΠ΅ΡΠΈΠ½ΠΎΠΏΠ°ΡΠΈΡΠ°ΡΠ° ΡΠΎ 29% ΠΈ ΠΌΠΈΠΊΡΠΎΠ°Π»Π±ΡΠΌΠΈΠ½ΡΡΠΈΡΠ°ΡΠ° ΡΠΎ 27.5%. ΠΠ΄ ΠΌΠ°ΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ ΠΊΠΎΠΌΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΡΠΈΠ³Π½ΠΈΡΠΈΠΊΠ°Π½ΡΠ½ΠΎ ΠΈ Π·Π½Π°ΡΠ°ΡΠ½ΠΎ Π½Π°ΡΠ·Π°ΡΡΠ°ΠΏΠ΅Π½ΠΈ Π±Π΅Π° Ρ
ΠΈΠΏΠ΅ΡΡΠ΅Π½Π·ΠΈΠ²Π½Π°ΡΠ° Π±ΠΎΠ»Π΅ΡΡ ΡΠΎ ΠΏΡΠΎΡΠ΅Π½ΡΡΠ°Π»Π½Π° Π·Π°ΡΡΠ°ΠΏΠ΅Π½ΠΎΡΡ ΠΎΠ΄ 31%, ΠΈ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠ½Π°ΡΠ° Π°ΡΡΠ΅ΡΠΈΡΠΊΠ° Π±ΠΎΠ»Π΅ΡΡ ΡΠΎ 12.50%. ΠΠΈΡΠΎΠΊΠΈ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈ Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ Π±Π΅Π° Π½ΠΎΡΠΈΡΠ°Π½ΠΈ ΠΊΠ°Ρ Π΄Π²Π΅ΡΠ΅ Π³ΡΡΠΏΠΈΡΠ΅ Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ ΡΠΎ ΠΌΠΈΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΠΈ ΠΌΠ°ΠΊΡΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ Π²ΠΎ ΠΎΠ΄Π½ΠΎΡ Π½Π° ΠΊΠΎΠ½ΡΡΠΎΠ»Π½Π°ΡΠ° Π³ΡΡΠΏΠ° Π½Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ, ΠΊΠ°Π΄Π΅ Π²ΡΠ΅Π΄Π½ΠΎΡΡΠΈΡΠ΅ Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ Π±Π΅Π° ΠΏΠΎΠΌΠ΅ΡΡ Π½ΠΎΡΠΌΠ°Π»Π½ΠΈΡΠ΅ Π³ΡΠ°Π½ΠΈΡΠΈ.
ΠΠΠΠΠ£Π§ΠΠ: Π₯ΠΈΠΏΠ΅ΡΡ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½Π΅ΠΌΠΈΡΠ°ΡΠ° ΠΏΡΠ΅ΡΡΡΠ°Π²ΡΠ²Π° ΡΠΈΠ·ΠΈΠΊ ΡΠ°ΠΊΡΠΎΡ Π²ΠΎ Π΅ΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ°ΡΠ° Π½Π° Ρ
ΡΠΎΠ½ΠΈΡΠ½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ ΠΊΠ°Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈΡΠ΅ ΡΠΎ Π΄ΠΈΡΠ°Π±Π΅ΡΠ΅Ρ ΠΌΠ΅Π»ΠΈΡΡΡ ΡΠΈΠΏ 2. Π‘Π΅ΠΏΠ°ΠΊ, ΠΏΠΎΡΡΠ΅Π±Π½ΠΈ ΡΠ΅ ΠΏΠΎΠ½Π°ΡΠ°ΠΌΠΎΡΠ½ΠΈ ΠΈΡΡΡΠ°ΠΆΡΠ²Π°ΡΠ° ΠΊΠΎΠΈ Π±ΠΈ Π΄Π°Π»Π΅ ΡΠ°ΡΠ½ΠΈ ΠΏΠΎΠ΄Π°ΡΠΎΡΠΈ Π·Π° Π²Π»ΠΈΡΠ°Π½ΠΈΠ΅ΡΠΎ Π½Π° Π·Π³ΠΎΠ»Π΅ΠΌΠ΅Π½ΠΈΡΠ΅ Π½ΠΈΠ²ΠΎΠ° Π½Π° Ρ
ΠΎΠΌΠΎΡΠΈΡΡΠ΅ΠΈΠ½ ΠΈ Π½Π΅Π³ΠΎΠ²Π°ΡΠ° ΡΠ»ΠΎΠ³Π° Π²ΠΎ ΠΎΡΡΠ΅ΡΡΠ²Π°ΡΠ΅ΡΠΎ Π½Π° Π΅Π½Π΄ΠΎΡΠ΅Π»ΠΎΡ Π½Π° ΠΊΡΠ²Π½ΠΈΡΠ΅ ΡΠ°Π΄ΠΎΠ²ΠΈ ΠΈ ΠΏΠΎΡΠ°Π²Π° Π½Π° Π΄ΠΎΠ»Π³ΠΎΡΡΠ°ΡΠ½ΠΈ Π²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈ ΠΊΠΎΠΌΠΏΠ»ΠΈΠΊΠ°ΡΠΈΠΈ
Maternal and Neonatal Outcomes in Pregnant Women with Gestational Diabetes Mellitus Treated with Diet, Metformin or Insulin
AIM: Aim of the study was to compare outcomes of pregnancy in gestational diabetes mellitus (GDM) treated with metformin, insulin, or diet.MATERIAL AND METHODS: The study included 48 women with GDM treated with metformin, 101 with insulin, and 200 women on a diet from the Outpatient Department of Endocrinology and University Clinic of Obstetrics and Gynecology in Skopje.RESULTS: The groups were comparable in age, smoking cigarettes and positive family history of diabetes. Mean glycosylated haemoglobin (HbA1c) at 37 gestation week, mean fasting, postprandial glycaemia, and gestational age at delivery were lower in diet and metformin than insulin group. No differences in mode of delivery were observed between the metformin and insulin group. Women in metformin group had a significantly lower incidence of LGA newborns than diet and insulin groups. The percent of SGA new-borns was higher in insulin group than diet and metformin groups. The incidence of neonatal hypoglycemia was statistically significantly higher in the insulin group than in the metformin and diet group.CONCLUSION: Metformin in women with GDM can improve maternal and neonatal outcomes compared with those treated with diet or insulin