Saratov JOURNAL of Medical and Scientific Research

The influence of different variants of glucose-lowering therapy on indices of inflammation in patients with diabetes type 2 on a background of gastroesophageal reflux disease and obesity

Year: 2018, volume 14 Issue: №3 Pages: 368-372
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

Aim: to evaluate the effect of different types of hypoglycemic therapy on the level of leptin, interleukin-6, C-reactive protein, tumor necrosis factor-alpha, as well as body mass index. Material and Methods. The study involved 250 people. 200 case histories of patients with the main diagnosis Gastroesophageal Reflux Disease were analyzed. Group I consisted of 50 suffering from diabetes type II diabetes in combination with obesity of varying severity and GERD. Treatment of diabetes in this group was carried out with the help of Metformin. Group II consisted of 50 patients with type II diabetes mellitus combined with obesity of varying severity and gastroesophageal reflux disease. Patients in this group took exenatide. Group III consisted of 50 patients suffering from obesity of different severity and gastroesophageal reflux disease. The comparison group (IV) consisted of 50 patients with gastroesophageal reflux disease without overweight and comorbidities. For the treatment of GERD in the study subjects used — omeprazole. The control group (V) consisted of 50 healthy volunteers. Laboratory tests (General blood test, biochemical, immunological parameters) were performed on automated hematological (Ruby), immunochemical (Architect 2000) and biochemical (Architect 4000) analyzers (Abbott, USA). Results. In the course of assessing the indicators before therapy, we can note an increase in the level of leptin in the group of patients with obesity, while against the background of type 2 diabetes. Assessing the level of interleukin-6, C-reactive protein, tumor necrosis factor-alpha statistically significant increase in indicators was observed in the groups of patients with obesity (I, II, III study group). As a result of treatment, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF. Conclusion. As a result of treatment with exenatide, weight loss in patients of group II correlated with a decrease in the level of leptin, interleukin 6, C-reactive protein and TNF, indicating a decrease in the metabolic activity of visceral fat, which consists in the activation of lipolysis, release of free fatty acids and adipocytokines

Bibliography:
1. Korneeva NV, Fedorchenko YuL, Bogatkov SD. Features of the course of gastroesophageal reflux disease in diabetes mellitus. Siberian Medical Journal 2011; 26 (3-1): 57-61
2. Bardymova ТР, Berezina MV, Mikhaleva OG. Prevalence of obesity in patients with diabetes mellitus in Irkutsk. Siberian Medical Journal (Irkutsk) 2013; 121 (6): 130-2
3. AtesF, Francis DO, VaeziMF. Refractory gastroesophageal reflux disease: advances and treatment. Expert Rev Gastroenterol Hepatol2014;8(6):657-67
4. Zvenigorodskaya LA, Khomeriki SG, Shinkin MV. Gastroesophageal reflux disease in patients with obesity: clinical, functional and morphological features. Doctor.Ru 2017; (2): 46-52
5. Khan A, Kim A, Sanossian С, et al. Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol 2016; 22 (4): 1627-38
6. Kryuchkova ON, Shahbazidi D, Shahbazidi G. Leptin is a key link in the pathogenesis of obesity. Crimean Journal of Internal Diseases 2012; (1): 31-6
7. Lapteva IV, Livzan MA. Optimization of therapy of gastroesophageal reflux disease in persons with obesity and overweight. Modern problems of science and education 2016; (2): 29
8. Punjabi Р, Hira A, Prasad S, et al. Review of gastroesophageal reflux disease (GERD) in the diabetic patient. J Diabetes 2015; 7 (5): 599-609
9. Fadeenko GD, Solomentseva ТА, Kushnir IE, et al. The activity of adipokines and inflammation in the development of esophagitis in patients with gastroesophageal reflux disease with overweight. Gastroenterology 2013; 47 (1): 43-7
10. Klaritskay IL, Krivoy VV, Semenikhina VE, et al. Infringement of a motility of digestive organs in patients with gastroesophageal reflux disease and obesity on diabetes mellitus type 2. Crimean Therapeutic Journal 2015; (2): 73-8
11. Pasechnikov VD, Pasechnikov DV Modern ideas about the pathogenesis of gastroesophageal reflux disease: News of medicine and pharmacy. Gastroenterology 2011; (382): 2-3. Russian (Пасечников В. Д., Пасечников Д. В. Современные представления о патогенезе гастроэзофагеальной рефлюксной болезни: новости медицины и фармации. Гастроэнтерология 2011; (382): 2-3.

AttachmentSize
2018_3_368-372.pdf358.27 KB

No votes yet