scholarly journals FEATURES OF BONE TISSUE RECONSTRUCTION IN PERIAND POSTMENOPAUSAL WOMEN WITH TYPE 1 DIABETES MELLITUS

2021 ◽  
Vol 17 (4) ◽  
pp. 304-307
Author(s):  
O.A. Goncharova

Background. The climacteric period in women with type 1 diabetes mellitus (DM1) initiates an additional damaging effect on the existing cardinal pathology associated with DM. The purpose was to establish the features of geometric remodeling of the left ventricle (LV) of the heart in women with DM1 during the climacteric period. Materials and methods. The study involved 60 women with type 1 diabetes at the age of 48.74 ± 0.65 years, inclu­ding 41 perimenopausal and 19 postmenopausal ones. The control group consisted of 20 women without diabetes mellitus at the age of 50.02 ± 0.71 years. According to echocardiography, taking into account the stage of menopause, the indicators of the end-diastolic volume (EDV) and size (EDS), the posterior wall thickness of the LV (LVPWT) and the interventricular septum (IVST) were analyzed. The frequency of various types of geometric remodeling of the left ventricle of the heart was analyzed using the Penn Convention formula; for this, the LV myocardial mass index (LVMI) was calculated according to the formulas LVMI = 1.04 [(EDS + LVPWT + IVST)3 – EDS3] – 13.6 (LVMI = ratio LVMI to the plane of the body surface (A) in m2; AM2 = 1 + Weight + Δh / 100, where Δh is the difference between the height of a woman and 160 cm) and the relative wall thickness of the LV (LVRWT) LVRWT = 2LVPWT / EDS. Based on these data, the frequency of various types of geometric remodeling was established: normal geometry, concentric remode­ling, concentric or eccentric LV hypertrophy. Results. The data obtained indicate that postmenopausal women present a significant decrease in the frequency of normal heart geometry compared to perimenopausal women (26.4 versus 75.6 %, p < 0.001) and the frequency of concentric LV remodeling 3.5 times increases (26.3 versus 7.3 %, respectively). Concentric hypertrophy and eccentric LV hypertrophy prevailed 2.5 times in postmenopausal women (31.6 versus 12.1 % and 12.7 versus 4.9 %). Conclusions. In perimenopausal women with type 1 diabetes mellitus, in almost a quarter of cases, geometric remodeling of the left ventricle of the heart takes place. In postmenopausal women with estrogen deficiency, the frequency of pathologi­cal forms of heart geometry exceeds 75 %. The strategy of therapy for cardiac pathology in menopausal women against the background of DM1 should take into account the pathogenetic mechanisms of pathology associated with impaired carbohydrate metabolism and atherogenic measurements against the background of estrogen deficiency as well as limit polypharmacy.


2019 ◽  
Author(s):  
Volha Vadzianava ◽  
Yuliya Dydyshka ◽  
Nadzeya Karytska ◽  
Alla Shepelkevich ◽  
Natalya Vasilyeva

2018 ◽  
Vol 25 (5) ◽  
pp. 35-47
Author(s):  
L. G. Ivchenko ◽  
I. M. Bykov ◽  
A. A. Basov ◽  
F. N. Gilmiyarova ◽  
D. A. Domenyuk ◽  
...  

Aim. This study was conducted to develop the optimal methodological approaches to early diagnosis and comprehensive treatment of type 1 diabetes mellitus in children by creating an estimation algorithm of the bone system metabolism based on the results of the studies of calcium phosphorus metabolism, calcium-regulating hormones and bone mineral density.Materials and methods. There was carried out a general clinical, laboratory, X-ray examination of 114 children with type 1 diabetes mellitus aged 7 to 12 years with an endocrinopathy experience from eight months to ten years. The obtained data were compared with the results of the examination of 35 “healthy” and “practically healthy” children of this age group. The densitometric measurement of the bone tissue mineral density in the lumbar spine was performed by the densitometer "Lunar iDXA" with the automatic calculation of the Z-test. Orthopantomography of the jaw bones was carried out by a digital orthopantomograph "ORTHOPHOS XG 3 DS" with the subsequent calculation of the Fuchs index and the X-ray index. Laboratory diagnosis of serum indicators included calcium study (total, ionized), inorganic phosphorus, alkaline phosphatase, calcitonin, osteocalcin, parathormone, 25- Hydroxyvitamin D. Indices of the bone resorption were evaluated by the level of a product of degradation of helical protein collagen type I C-terminal telopeptides (CTx, Beta-Cross laps) in blood serum.Results. At the early stages of development of type 1 diabetes mellitus the speed of bone tissue remodeling increases with increased bone formation. At the late stages of development of endocrine pathology the processes of bone remodeling are slowed down with the predominance of bone resorption processes over bone formation processes as well as a significant decrease in bone mineral density (Z-score <-1SD) with the predominance of criteria "within the expected age norms" and "low mineral density in relation to the average age norm" in the bone tissue structure. A statistically significant decrease in bone mineral density in children with a history of type 1 diabetes mellitus for more than five years is indicative of absolute insulin deficiency of pancreatic β cells as well as an early debut of endocrinopathy during the growth and development of bone tissue, triggering the formation of osteopenic syndrome.Conclusion. The introduction of the algorithm for evaluating bone tissue metabolism based on modern high-tech laboratory radiology methods for diagnosing the state of musculoskeletal system in practical public health will make it possible to identify the pathological changes at early stages, when the implementation of integrated therapeutic and prophylactic measures will have the greatest impact and improve the quality of life of children suffering from type 1 diabetes mellitus. 


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