Table Of ContentObesity and Diabetes Mellitus
OBESITY
AND
DIABETES MELLlTUS
E, /,
SOKOLOV
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Contents 3
CONTENTS
LIST OF ABBREViATIONS ............................................................................................ 5
INTRODUCTION ................ __. .......................................................................................8
CHAPTER 1.
FEATURES OF LIPID METABOLISM IN DIABETES MELLlTUS AND
ISCHEMIC HEART DiSEASE ...................................................................................... 10
1.1. Metabolic Reaction of Lipoproteins and Hormones in a H ealthy Person's
0rpnisIn. ............................................................................................................... 10
1.2. Syndrome X ( Hyperinsulinemia, Insulin Resistance) . ........................................... 30
1.2.1. Pathogenetic Mechanisms of Syndrome X Development ............................. 31
1.2.2. Syndrome X and Its Clinical Manifestations ................................................. 38
1.2.3. Obesity and the Syndrome X ........................................................................ 45
1.2.4. Syndrome X and Heart Pathology ................................................................. 58
1.3. Pathophysiological Relation between Obesity, Diabetes Mellitus, and
Ischemic Heart Disease .......................................................................................... 71
1.4. Disorders of Lipid Metabolism in Ischemic Heart Disease Patients ...................... 93
1.5. Lipid Metabolism Disorders in Diabetes Mellitus Patients ................................. 1 14
1.6. Conclusion ........................................................................................................... 1 36
CHAPTER 2.
DISORDERS IN THE HEMOST ASIS SYSTEM AND CHANGES IN THE
RHEOLOGICAL PROPERTIES OF T HE BLOOD IN ISCHEMIC HEART
DISEASE AND DIABETES MELLlTUS PATIENTS ............................................... 1 41
2.1. Hemostasis System and Rheological Properties of the Blood in Healthy
Persons ................................................................................................................. 1 41
2.1.1. Vessel Wall as a R egulator of the Functional State of the Hemostasis
System ......................................................................................................... 1 41
2.1.2. Rheological Properties of the Blood in Healthy Persons ............................ 1S S
2.2. Hemostasis System and Rheological Properties of the Blood in Ischemic
Heart Disease Patients ......................................................................................... 162
2.2.1. Rheological Properties of the Blood in Ischemic Heart Disease ................. 163
2.2.2. H emostasis System in Ischemic Heart Disease ........................................... 1 70
2.3. Hemostasis System and Rheological Properties of the Blood in Diabetes
Mellitus Patients .................................................................................................. 1 92
2.3. I. Injury of a V essel Wall in Diabetes Mellitus .............................................. 192
2.3.2. Rheological Properties of the Blood in Diabetes Mellitus . ......................... 1 97
2.3.3. Thrombocyte-Vessel Unit of Hemostasis in Diabetes Mellitus ................... 206
4
2.4. Correction of Blood Coagulating System in Ischemic Heart Disease and
Diabetes Mellitus Patients ................................................................................... 222
2.5. Conclusion ........................................................................................................... 240
CHAPTER 3.
DIABETES MELLITUS AND ISCHEMIC HEART DlSEASE ................................ 242
3.1. Pathophysiological Fundamentals of Development of Cardiac Insufficiency
in Diabetes Mellitus Patients •..•.........••.....•..•........•...............................••............. 243
3.2. Energy Metabolism in Diabetes Mellitus ............................................................. 248
3.3. Lesion of Myocardium in Diabetes Mellitus ....................................................... 270
3.4. Conclusion ........................................................................................................... 286
CONCLUSION ............................................................................................................... 290
BIBLIOGRAPHY . ......................................................................................................... 295
INDEX ............................................................................................................................. 326
List of Abbreviations 5
LIST OF ABBREVIATIONS
ACTH Adrenocorticotropic honnone
ADP Adenosine diphosphate
AI Atherogenic index
AP Arterial pressure
Apo-A(B, C) Apolipoprotein A ( B, C)
AT Antithrombin
ATP Adenosine triphosphate
BWI Body weight index
BPM Beats per minute
CA Catecholamines
cAMP Cyclic adenosine monophosphate
cGMP Cyclic guanosine monophosphate
Cl Clearance
CL Cardiolipin
CM Chylomicrons
CNS Central nervous system
CRLV Contraction rate of left ventricle
CS Cholesterol
CSE Cholesterol esters
DlC Disseminated intravascular coagulation (syndrome)
DLP Dyslipoproteinemia
DM Diabetes mellitus
DNA Desoxyribonucleic acid
DOPA Dihydroxyphenylalanine
DPR Duration of plasma recalcification
DT Diet-dependent thennogenesis
EDD End diastolic distance
EDV End diastolic volume
EEl Energy expenditure index
EF Ejection factor
ESD End systolic distance
ESV End systolic volume
F Fibrinogen
FAB Fibrinolytic activity of b lood
6
FC Free cholesterol
FFA Free fatty acids
FPOL Free-radical peroxide oxidation of l ipids
GC G1ucocorticoids
GHDLP Glycosylized high density Iipoproteins
HDLP High density Iipoproteins
HL Hyperlipacidemia
HMG 3-hydroxy-3-methyl glutaryl
HSL Hormonosensitive lipase
Ht Hematocrit
HTG Hypertriglyceridemia
IDLP Intermediate density Iipoproteins
IHO Ischemic heart disease
IIOM Insulin-independent diabetes mellitus
IRl Immunoreactive insulin
LA Lactic acid
LAT Lecithin acyl transferase
LCAT Lecithin cholesterol-acyl transferase
LDLP Low density Iipoproteins
LP Lipoprotein
LPC Lysophosphatidylcholine
LPL Lipoprotcinlipase
MOC Maximum oxygen concentration
NA Noradrenaline
NADP, NADPH2 Oxidized and reduced forms of nicotinamide adenine
dinucleotide phosphate (coenzyme 11)
NEFA Nonesteritied fatty acids
NMOC Normal maximum oxygen consumption
PC Phosphatidylcholine
pct Pulse coefficient
PEA Phosphatidylethanolamine
PG Prostaglandin
PL Phospholipids
PPh Plasmapheresis
PRA Pyruvic acid
PrC Prostacyc1in
List of A bbreviations 7
PS Phosphatidylserine
PUFA Polyunsaturated fatty acids
RNA Ribonucleic acid
RRLV Relaxation rate of l eft ventricle
SFMC Soluble fibrin·monomer complexes
SM Sphingomyelin
SNS Sympathetic nervous system
STH Somatotropic hormone
TAF Thrombocyte activation factor
TF Thrombocyte factor
TG Triglycerides
TP Total phospholipides
TPH Tolerance of p lasma to heparin
TPR Total peripheral resistance
TSH Thyroid-stimulating hormone
TX Thromboxan
Vcr Rate of circular shortening ofthe m yocardium fiber
VLDLP Very low density lipoproteins
