CLINICAL AND LABORATORY CHARACTERISTICS OF COMORBID COURSE TYPE 2 DIABETES MELLITUS WITH OVERWEIGHT/OBESITY AND ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.11603/mcch.2410-681X.2021.i3.12578Keywords:
type 2 diabetes mellitusAbstract
Introduction. Arterial hypertension (AH) is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), which is associated with cardiovascular disease.
The aim of the study – to analyze the main clinical and laboratory factors of comorbid type 2 diabetes mellitus with overweight/obesity and hypertension.
Research Methods. A retrospective analysis of medical records was performed in 579 patients with type 2 diabetes mellitus (T2DM). The concentration of glucose and other biochemical parameters were determined using a standard kit on an automatic biochemical analyzer "COBAS INTEGRA® 400" (Roche Diagnostics). General blood counts were determined on an automatic hematology analyzer "Yumizen H500 CT".
Results and Discussion. The analysis of Kraskel-Wallis rank variations did not reveal the diagnostic value of general blood and urine tests in the diagnosis of comorbid course of diabetes mellitus, overweight/obesity and hypertension. The analysis of biochemical parameters revealed the highest levels of urea and uric acid in patients with diabetes mellitus, obesity and hypertension. Analysis of carbohydrate metabolism showed that the level of glucose, insulin and HOMA-index in the blood of patients from different experimental groups probably differed when analyzing the rank variations of Kraskel-Wallis.
Conclusions. The analysis of sexual dimorphism revealed a predominance of females with comorbid type 2 diabetes, overweight/obesity and hypertension. At the same time, among patients with type 2 diabetes mellitus with comorbid arterial hypertension, a significantly higher percentage of sick men with normal body weight was found. In the analysis of anthropometric parameters of patients of different groups, it was found that in patients of group 6 the growth was probably lower than in patients with T2DM with normal body weight and in combination with AH. BMI was likely to be higher in overweight/obese patients. Patients with comorbid type 2 diabetes, overweight/obesity, and arterial hypertension had significantly higher levels of urea (24.4 %) and uric acid (93.0 %) compared to patients with diabetes mellitus type 2 and normal body weight.
References
Kahya Eren, N., Harman, E., Dolek, D., Tutuncuoglu, A.P., Emren, S.V., Levent, F., ... Nazli, C. (2014). Rate of blood pressure control and antihypertensive treatment approaches in diabetic patients with hypertension. Turk Kardiyol. Dern. Ars., 42 (8), 733-740. DOI:10.5543/tkda.2014.53384
Emdin, C.A., Rahimi, K., Neal, B., Callender, T., Perkovic, V., & Patel, A. (2015). Blood pressure lowering in type 2 diabetes: a systematic review and meta-analysis. JAMA, 313 (6), 603-615. DOI:10.1001/jama.2014.18574
Chen, G., McAlister, F.A., Walker, R.L., Hemmelgarn, B.R., & Campbell, N.R. (2011). Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure. Hypertension, 57 (5), 891-897. DOI:10.1161/HYPERTENSIONAHA.110.162446
Nouh, F., Omar, M., & Younis, M. (2017). Prevalence of hypertension among diabetic patients in Benghazi: a study of associated factors. Asian J. Med. Heal., 6 (4), 1-11. DOI:10.9734/AJMAH/2017/35830
Vargas-Uricoechea, H., & Caceres-Acosta, M.F. (2018). Control of blood pressure and cardiovascular outcomes in type 2 diabetes. Open Med. (Wars), 13, 304-323. DOI:10.1515/med-2018-0048
Akalu, Y., & Belsti, Y. (2020). Hypertension and its associated factors among type 2 diabetes mellitus patients at Debre Tabor General Hospital, Northwest Ethiopia. Diabetes Metab. Syndr. Obes., 13, 1621-1631. DOI:10.2147/DMSO.S254537
Forlemu, A., Menanga, A., Ashuntantang, G., & Kingue, S. (2013). Urinary protein excretion is associated with left ventricular hypertrophy in treatment-naive hypertensive patients in an african hospital setting. Cardiorenal Med., 3 (1), 57-62. DOI:10.1159/000349938
Rodrigues, J.C., Amadu, A.M., Ghosh Dastidar, A., McIntyre, B., Szantho, G.V., Lyen, S., ... Bucciarelli-Ducci, C. (2017). ECG strain pattern in hypertension is associated with myocardial cellular expansion and diffuse interstitial fibrosis: a multi-parametric cardiac magnetic resonance study. Eur. Heart J. Cardiovasc. Imaging, 18 (4), 441-450. DOI:10.1093/ehjci/jew117
American Diabetes, A. (2019). Standards of medical care in diabetes-2019 abridged for primary care providers. Clin. Diabetes, 37 (1), 11-34. DOI:10.2337/cd18-0105
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., ... Group, E.S.C.S.D. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur. Heart J., 39 (33), 3021-3104. DOI:10.1093/eurheartj/ehy339
Body Mass Index: Considerations for Practitioners. Retrieved from: https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf
Mansour, A.A. (2012). Prevalence and control of hypertension in iraqi diabetic patients: a prospective cohort study. Open Cardiovasc. Med. J., 6, 68-71. DOI:10.2174/1874192401206010068
Mengesha, A.Y. (2007). Hypertension and related risk factors in type 2 diabetes mellitus (DM) patients in Gaborone City Council (GCC) clinics, Gaborone, Botswana. Afr. Health Sci., 7 (4), 244-245.
Noh, J.W., Chang, Y., Park, M., Kwon, Y.D., & Ryu, S. (2019). Self-rated health and the risk of incident type 2 diabetes mellitus: A cohort study. Sci. Rep., 9 (1), 3697. DOI:10.1038/s41598-019-40090-y
Alice, Y. (2019). Canadian diabetes association clinical practice guidelines expert committee. Can. J. Diabetes, 37 (2013), 1-3.
Head, T., Daunert, S., & Goldschmidt-Clermont, P.J. (2017). The aging risk and atherosclerosis: A fresh look at arterial homeostasis. Front Genet., 8, 216. DOI:10.3389/fgene.2017.00216
Kohn, J.C., Lampi, M.C., & Reinhart-King, C.A. (2015). Age-related vascular stiffening: causes and consequences. Front Genet., 6, 112. DOI:10.3389/fgene. 2015.00112
Arnetz, L., Ekberg, N.R., & Alvarsson, M. (2014). Sex differences in type 2 diabetes: focus on disease course and outcomes. Diabetes Metab. Syndr. Obes., 7, 409-420. DOI:10.2147/DMSO.S51301
Sattar, N. (2013). Gender aspects in type 2 diabetes mellitus and cardiometabolic risk. Best Pract. Res. Clin. Endocrinol. Metab., 27 (4), 501-507. DOI:10.1016/j.beem.2013.05.006
Awa, W.L., Fach, E., Krakow, D., Welp, R., Kunder, J., Voll, A., ... German BMBF Competence Networks Diabetes mellitus and Obesity. (2012). Type 2 diabetes from pediatric to geriatric age: analysis of gender and obesity among 120,183 patients from the German/Austrian DPV database. Eur. J. Endocrinol., 167 (2), 245-254. DOI:10.1530/EJE-12-0143
Legato, M.J., Gelzer, A., Goland, R., Ebner, S.A., Rajan, S., Villagra, V., ... Writing Group for The Partnership for Gender-Specific, M. (2006). Gender-specific care of the patient with diabetes: review and recommendations. Gend. Med., 3 (2), 131-158. DOI:10.1016/s1550-8579(06)80202-0
Szalat, A., & Raz, I. (2008). Gender-specific care of diabetes mellitus: particular considerations in the management of diabetic women. Diabetes Obes. Metab., 10 (12), 1135-1156. DOI:10.1111/j.1463-1326.2008.00896.x
Lundberg, V., Stegmayr, B., Asplund, K., Eliasson, M., & Huhtasaari, F. (1997). Diabetes as a risk factor for myocardial infarction: population and gender perspectives. Journal of Internal Medicine, 241 (6), 485-492. https://doi.org/10.1111/j.1365-2796.1997.tb00006.x
Gress, T.W., Nieto, F.J., Shahar, E., Wofford, M.R., & Brancati, F.L. (2000). Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis risk in communities study. N. Engl. J. Med., 342 (13), 905-912. DOI:10.1056/NEJM200003303421301
Lago, R.M., Singh, P.P., & Nesto, R.W. (2007). Diabetes and hypertension. Nat. Clin. Pract. Endocrinol. Metab., 3 (10), 667. DOI:10.1038/ncpendmet0638
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Medical and Clinical Chemistry
This work is licensed under a Creative Commons Attribution 4.0 International License.
