actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.12737/23790actabiomedica-331Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEОСОБЕННОСТИ ЛИПИДНОГО ОБМЕНА У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1-ГО ТИПА С НЕУДОВЛЕТВОРИТЕЛЬНЫМ ГЛИКЕМИЧЕСКИМ КОНТРОЛЕМ С ДИАБЕТИЧЕСКИМИ МИКРОАНГИОПАТИЯМИ И БЕЗ НИХABNORMALITY OF LIPID METABOLISM IN PATIENTS WITH DIABETES MELLITUS TYPE 1 AND POOR GLYCEMIC CONTROL WITH AND WITHOUT DIABETIC MICROANGIOPATHIESСъемщиковВ. С.SyomshchikovV. S.svs2491@mail.ruХамнуеваЛ. Ю.KhamnuevaL. Y.hamnueval@mail.ruЧугуноваЕ. В.ChugunovaE. V.E.V_Chugunova@mail.ruФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава РоссииRussian FederationФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава России; ГБУЗ «Иркутская ордена «Знак Почёта» областная клиническая больница»Russian Federation20162811201616113117Copyright © Съемщиков В.С., Хамнуева Л.Ю., Чугунова Е.В., 20162016Съемщиков В.С., Хамнуева Л.Ю., Чугунова Е.В.Syomshchikov V.S., Khamnueva L.Y., Chugunova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/331

С целью изучения особенностей липидного обмена у пациентов с сахарным диабетом (СД) 1-го типа проведён ретроспективный анализ данных историй болезни 106 пациентов, находившихся на лечении в эндокринологическом отделении ГБУЗ «Иркутская ордена «Знак Почёта» областная клиническая больница». Исследованыуровни липидов, гликированного гемоглобина (HbAlc). Дислипидемия наблюдалосьу 81 пациента при неудовлетворительном контроле СД 1 типа. У больных СД 1 типа с микрососудистыми осложнениями, с артериальной гипертензией и уровнем HbA1c > 8 % уровни атерогенных липидов значимо выше.

Hyperglycemia and dyslipidemia are common metabolic abnormalities in adults with type 1 diabetes mellitus (T1DM) and both increase cardiovascular disease risk. Normalization of lipid metabolism is a mandatory element in prevention of diabetic micro- and macroangiopathies in patients with T1DM and it is directly related to improvement of health outcome. We aimed to investigate serum lipid profiles in patients with T1DM and poor glycemic control. Among observed patients with T1DM, 76 % were classified as having dyslipidemia, dyslipidemia rate was higher in patients with diabetic microangiopathies. Patients with T1DM and microvascular complications, arterial hypertension (AH) and the level of glycated hemoglobin (HbA1c) > 8 % had significantly higher levels of total cholesterol (TC), very low density lipoproteins (VLDL), triglycerides (TG) and non-high density lipoproteins (non-HDL). Therefore, management of patients with T1DM at the outpatient stage requires a strict control of lipid metabolism.

сахарный диабетдислипидемияхолестеринЛПВПЛПНПЛПОНПтриглицеридыхолестерин не-ЛПВПdiabetes mellitusdyslipidemiacholesterolHDLLDLVLDLtriglyceridesnon-HDLReferencesАлгоритмы специализированной медицинской помощи больным сахарным диабетом (7-й выпуск) / Под ред. И.И. Дедова, М.В. Шестаковой // Сахарный диабет. - 2015. - Т. 18. - № 1S. - 112 с. Dedov II, Shestakova MV (eds.) (2015). Standards of specialized diabetes care [Algoritmy spetsializirovannoy meditsinskoy pomoshchi bol’nym sakharnym diabetom (7-y vypusk)]. Sakharnyy diabet, 18 (1S), 112.Алгоритмы специализированной медицинской помощи больным сахарным диабетом (7-й выпуск) / Под ред. И.И. Дедова, М.В. Шестаковой // Сахарный диабет. - 2015. - Т. 18. - № 1S. - 112 с. Dedov II, Shestakova MV (eds.) (2015). Standards of specialized diabetes care [Algoritmy spetsializirovannoy meditsinskoy pomoshchi bol’nym sakharnym diabetom (7-y vypusk)]. Sakharnyy diabet, 18 (1S), 112.Сахарный диабет: острые и хронические осложнения / Под ред. И.И. Дедова, М.В. Шестаковой. - М.: Медицинское информационное агентство, 2012. - 480 с. Dedov II, Shestakova MV (eds.) (2012). Diabetes mellitus: acute and chronic complications [Sakharnyy diabet: ostrye i khronicheskie oslozhneniya], 480.Сахарный диабет: острые и хронические осложнения / Под ред. И.И. Дедова, М.В. Шестаковой. - М.: Медицинское информационное агентство, 2012. - 480 с. Dedov II, Shestakova MV (eds.) (2012). Diabetes mellitus: acute and chronic complications [Sakharnyy diabet: ostrye i khronicheskie oslozhneniya], 480.Самойлова Ю.Г., Юрченко Е.В. Особенности липидного обмена у пациентов с сахарным диабетом 1-го типа в зависимости от наличия диабетических микроангиопатий и характера питания // Бюллетень сибирской медицины. - 2014. - № 5. - С. 87-92. Samoylova YG, Yurchenko EV (2014). Features of lipid metabolism in patients with type 1 diabetes, depending on diabetic microvascular complications and diet [Osobennosti lipidnogo obmena u patsientov s sakharnym diabetom 1-go tipa v zavisimosti ot nalichiya diabeticheskikh mikroangiopatiy i kharaktera pitaniya]. Byulleten'sibirskoy meditsiny, (5), 87-92.Самойлова Ю.Г., Юрченко Е.В. Особенности липидного обмена у пациентов с сахарным диабетом 1-го типа в зависимости от наличия диабетических микроангиопатий и характера питания // Бюллетень сибирской медицины. - 2014. - № 5. - С. 87-92. Samoylova YG, Yurchenko EV (2014). Features of lipid metabolism in patients with type 1 diabetes, depending on diabetic microvascular complications and diet [Osobennosti lipidnogo obmena u patsientov s sakharnym diabetom 1-go tipa v zavisimosti ot nalichiya diabeticheskikh mikroangiopatiy i kharaktera pitaniya]. Byulleten'sibirskoy meditsiny, (5), 87-92.ACCORD Study Group and ACCORD Eye Study Group. (2012). Effects of medical therapies on retinopathy progression in type 2 diabetes. N. Engl. J. Med., 367 (25), 2458.ACCORD Study Group and ACCORD Eye Study Group. (2012). Effects of medical therapies on retinopathy progression in type 2 diabetes. N. Engl. J. Med., 367 (25), 2458.American Diabetes Association (2014). Executive summary: Standards of medical care indiabetes - 2014. Diabetes Care, 37 (1), 5-13.American Diabetes Association (2014). Executive summary: Standards of medical care indiabetes - 2014. Diabetes Care, 37 (1), 5-13.Chowdhury TA, Hopkins D, Dodson PM, Vafidis GC (2002). The role of serum lipids in exudative diabetic maculopathy: is there a place for lipid lowering therapy? Eye (Lond.), 16 (6), 689-693.Chowdhury TA, Hopkins D, Dodson PM, Vafidis GC (2002). The role of serum lipids in exudative diabetic maculopathy: is there a place for lipid lowering therapy? Eye (Lond.), 16 (6), 689-693.Daae LN, Vierult P, Landaas S, Urdal P (1993). Cardiovascular risk factors: interactive effect of lipids, coagulation and fibrinolysis. Scand. J. Clin. Lab. Invest., (215), 19-27.Daae LN, Vierult P, Landaas S, Urdal P (1993). Cardiovascular risk factors: interactive effect of lipids, coagulation and fibrinolysis. Scand. J. Clin. Lab. Invest., (215), 19-27.Expert Dyslipidemia Panel, Grundy SM (2013). An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia. J. Clin. Lipidol., 7 (6), 561-565.Expert Dyslipidemia Panel, Grundy SM (2013). An International Atherosclerosis Society Position Paper: global recommendations for the management of dyslipidemia. J. Clin. Lipidol., 7 (6), 561-565.Hoffiner SM (1993). Lipoprotein (a) and diabetes. An update. Diabetes Care, (16), 835-843.Hoffiner SM (1993). Lipoprotein (a) and diabetes. An update. Diabetes Care, (16), 835-843.Keech AC, Mitchell P, Summanen PA, O’Day J, Davis TM, Moffitt MS, Taskinen MR, Simes RJ, Tse D, Williamson E, Merrifield A, Laatikainen LT, d’Emden MC, Crimet DC, O’Connell RL, Colman PG, FIELD study investigators. (2007). Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomized controlled trial. Lancet, 370 (9600), 1687-1697.Keech AC, Mitchell P, Summanen PA, O’Day J, Davis TM, Moffitt MS, Taskinen MR, Simes RJ, Tse D, Williamson E, Merrifield A, Laatikainen LT, d’Emden MC, Crimet DC, O’Connell RL, Colman PG, FIELD study investigators. (2007). Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomized controlled trial. Lancet, 370 (9600), 1687-1697.Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N (2004). Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann. Intern. Med., (141), 413-420.Khaw KT, Wareham N, Bingham S, Luben R, Welch A, Day N (2004). Association of hemoglobin A1c with cardiovascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann. Intern. Med., (141), 413-420.Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH, Jung MH, Suh BK (2014). Serum lipid profiles and glycemic control in adolescents and young adults with type 1 diabetes mellitus. Ann. Pediatr. Endocrinol. Metab., (19), 191-196.Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH, Jung MH, Suh BK (2014). Serum lipid profiles and glycemic control in adolescents and young adults with type 1 diabetes mellitus. Ann. Pediatr. Endocrinol. Metab., (19), 191-196.Maahs DM, Ogden LG, Dabelea D (2010). Association of glycaemia with lipids in adults with type diabetes: modification by dyslipidaemia medication. Diabetologia, 53 (12), 2518-2525.Maahs DM, Ogden LG, Dabelea D (2010). Association of glycaemia with lipids in adults with type diabetes: modification by dyslipidaemia medication. Diabetologia, 53 (12), 2518-2525.Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ (2000). Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int., 58 (1), 293-301.Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ (2000). Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int., 58 (1), 293-301.Thomas MC, Rosengard-Barlund M, Mills V, Rönnback M, Thomas S, Forsblom C, Cooper ME, Taskinen MR, Viberti G, Groop PH (2006). Serum lipids and the progression of nephropathy in type 1 diabetes. Diabetes Care, 29 (2), 317-322.Thomas MC, Rosengard-Barlund M, Mills V, Rönnback M, Thomas S, Forsblom C, Cooper ME, Taskinen MR, Viberti G, Groop PH (2006). Serum lipids and the progression of nephropathy in type 1 diabetes. Diabetes Care, 29 (2), 317-322.

The authors declare that there are no conflicts of interest present.