nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical Universitynefr-155Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES CLINICAL STUDIESКЛИНИЧЕСКАЯ ОЦЕНКА ФАКТОРОВ РИСКА КАРОТИДНОГО АТЕРОСКЛЕРОЗА У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 2 ТИПА, ОСЛОЖНЕННЫМ ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕКCLINICAL EVALUATION OF RISK FACTORS FOR CAROTID ATHEROSCLEROSIS IN PATIENTS WITH TYPE 2 DIABETES COMPLICATED WITH CHRONIC KIDNEY DISEASEВасильковаОльга НиколаевнаVasilkovaOlha N.olga.n.vasilkova@gmail.comМохортТатьяна ВячеславовнаMokhortTatiana V.tat_mokh@mail.ruНауменкоЕлена ПетровнаNaumenkoElena P.noemail@neicon.ruПчелинИван ЮрьевичPchelinIvan Yu.i.pchelin@spbu.ruХудяковаНаталья ВалерьевнаHudiakovaNatalia V.natalia_ temnaja@mail.ruГомельский государственный медицинский университетRussian FederationБелорусский государственный медицинский университетRussian FederationРеспубликанский научно-практический центр радиационной медицины и экологии человекаRussian FederationСанкт-Петербургский государственный университетRussian Federation2016010120162015762Copyright © Василькова О.Н., Мохорт Т.В., Науменко Е.П., Пчелин И.Ю., Худякова Н.В., 20162016Василькова О.Н., Мохорт Т.В., Науменко Е.П., Пчелин И.Ю., Худякова Н.В.Vasilkova O.N., Mokhort T.V., Naumenko E.P., Pchelin I.Y., Hudiakova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/155

ЦЕЛЬ. Целью исследования являлась оценка взаимосвязи факторов риска (артериальной гипертензии, дислипидемии и снижения СКФ <60 мин/мин/1,73 м2) и основных маркеров атеросклероза сонных артерий у пациентов с сахарным диабетом 2 типа (СД2), осложненном ХБП С1-3 стадий. ПАЦИЕНТЫ И МЕТОДЫ. Было обследовано 100 пациентов с СД2 и ХБП С1-3 стадий в возрасте 56,54±12,17 года. Контрольная группа включала 26 здоровых лиц этой же возрастной категории. Общая площадь атеросклеротических бляшек (ОПАБ) рассчитывалась как сумма площади всех атеросклеротических бляшек в сонной артерии. СКФ определяли по формуле CKD-EPI. РЕЗУЛЬТАТЫ. Пациенты с СД2 и ХБП были разделены на 3 подгруппы с разным количеством факторов риска атеросклероза: подгруппа 1 (26 пациентов) - СД 2 типа без других факторов риска атеросклероза; подгруппа 2 (28 пациентов) - СД 2 типа + один из факторов риска атеросклероза (ХБП/АГ/дислипидемия) и подгруппа 3 (46 пациентов) - СД 2 типа + два и более фактора риска атеросклероза (ХБП/АГ/дислипидемия). Атеросклеротические бляшки в сонных артериях были обнаружены у 8%, 21% и 28% пациентов в группах 1, 2 и 3 соответственно. Было также установлено наличие статистически значимых различий между толщиной КИМ левой и правой сонных артерий (0,70±0,16 и 0,66±0,13 мм, p<0,001 соответственно). В то же время, толщина КИМ у пациентов, имеющих каротидные атеросклеротические бляшки, и пациентов без них не отличалась (p=0,171). ЗАКЛЮЧЕНИЕ. Результаты исследования подтверждают кумулятивное влияние артериальной гипертензии, дислипидемии и сниженной фильтрационной способности почек на состояние сонных артерий у пациентов с СД2, осложненном ХБП 1-3 стадий.

THE AIM: to assess the additive effects of dyslipidemia, hypertension and decreased GFR (<60 ml/min/1.73m2) on the characteristics of carotid atherosclerosis in patients with type 2 diabetes (DT2) and CKD stages 1-3. PATIENTS AND METHODS. We investigated 100 patients with DT2 and CKD stages 1-3 aged 56.54±12.17 years. Control group included 26 healthy subjects of the same age. Total plaque area (TPA) was calculated as the sum of all plaque areas. GFR was estimated by CKI-EPI equation. RESULTS. We divided patients with DT2 and CKD into 3 groups: group 1 (n=26) - without additional risk factors for atherosclerosis, group 2 (n=28) - with 1 additional risk factor and group 3 (n=46) - with 2-3 additional risk factors. The prevalence of carotid atherosclerotic plaques was 8% in group 1, 21% in group 2 and 28% in group 3 (p<0.05). We found a significant difference in IMT between left and right carotid artery (0.70±0.16 mm versus 0.66±0.13 mm, p<0.001, respectively). However, there was no significant difference in carotid IMT between patients with plagues and without them (p=0.171). CONCLUSION. The results of the study suggest that dyslipidemia, hypertension and decreased GFR have additive effects on the development of carotid atherosclerosis in patients with DT2 and CKD stages 1-3.

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