Authors: Dzugkoev SG, Mozhaeva IV, Margieva OI and Dzugkoeva FS
In order to study the pathogenetic mechanisms of vascular complications (peripheral angiopathy), 39 patients with type 1 diabetes mellitus were diagnosed with the phenomena of the beginning diabetic foot and changes in metabolism of different degrees of compensation: decompensated, subcompensated and compensated, and also on 20 healthy individuals. All patients received basic therapy with insulin preparations of short and intermediate action, and some patients with a subcompensated form received coenzyme Q10 simultaneously with hypoglycemic therapy. The parameters of lipid peroxidation and antioxidant system, concentration of total metabolites of nitric oxide, low density lipoproteins, activity of organo-specific enzymes: alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase were determined. The change in blood flow in the vessels of the lower extremities (shin and foot segments) was judged by the rheovasogram determined by the "Valenta" diagnostic system. The obtained data testified to the presence of oxidative stress in patients with diabetes mellitus decompensated with subcompensated forms. At the same time, the concentration of nitric oxide and its bioavailability decreased due to an increase in the blood of atherogenic lipoproteins: low-density cholesterol and high-density cholesterol. These biochemical changes in the blood were accompanied by a violation of hemodynamics in the vessels of the shin and foot. Against the background of traditional treatment, there were positive changes in carbohydrate and lipid metabolism, but the indicators were significantly different from the control level, and hemodynamic changes in the segments of the shin and foot were preserved. Inclusion of coenzyme Q10 in the complex treatment of antioxidant led to a decrease in malonic dialdehyde content, an increase in the activity of antioxidant defense enzymes, and a concentration of total metabolites of nitric oxide. Bioavailability of nitric oxide also increased, due to a decrease in the concentration of low-density atherogenic lipoproteins. In the vessels of microcirculation, the tone of arterioles and precapillaries decreased, the modulus of elasticity increased, pulse blood filling increased in the segments of the shin and foot, and venous congestion decreased.
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