Saratov JOURNAL of Medical and Scientific Research

Andreeva E.I.

Stavropol State Medical University, Department of Endocrinology, Pediatric Endocrinology and Diabetology Assistant Professor, Candidate of Medical Science

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

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Features of the clinical course of gastroesophageal reflux disease associated with obesity

Year: 2018, volume 14 Issue: №1 Pages: 42-45
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

The research goal is to reveal the features of clinical manifestations of gastroesophageal reflux disease (GERD) in obesity. Material and Methods. A survey and anthropometric study of 51 patients suffering from GERD and obesity aged 30 to 60 years were conducted. The average age of the patients was 42.3±2.11 years. Patients were divided into groups according to the BMI score. The control group consisted of patients suffering from GERD without obesity. Results. The main complaint of the patients of the control group was heartburn, while the patients of the main group had complaints of dyspeptic nature. With an increase in BMI, there was an increase in the incidence of complaints, in addition, complaints of an extra-esophageal nature associated with the direct effect of acidic gastric contents on the pharyngeal mucosa were detected. This regularity is explained in the article by pathogenetic mechanisms of GERD development. In patients suffering from GERD without obesity, the development of the disease is caused by a change in the motor activity of the esophagus due to a decrease in the tone of the lower esophageal sphincter, and in patients with co-pathology the main role is given to increased intragastric pressure, which leads to disruption of the sphincter. Conclusion. Thus, the clinical picture of combination of GERD and obesity differs atypical for GERD current, the main features of which are the predominance of dyspeptic complaints, motor-evacuation disorders, and the presence of extraesophageal complaints.

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Peculiarities of clinical course of gastroesophageal reflux disease in patients with type 2 diabetes and obesity

Year: 2017, volume 13 Issue: №4 Pages: 809-812
Heading: Internal Diseases Article type: Original article
Authors: Andreeva E.l.
Organization: Stavropol State Medical University
Summary:

Aim: to study the clinical course of gastroesophageal reflux disease (GERD) in patients with type 2 diabetes and evaluation of the parameters of the esophagus 24-hour pH-metry. Material and Methods. In the examination of patients with GERD, three groups of patients were selected for 50 people each. The first group includes patients with GERD with combined course of obesity and type 2 diabetes (mean age 54.6±2.73 year; 32 females and 18 males). The second group included patients with GERD against obesity (mean age 42.3±2.11 year; 30 females and 20 males). The control group consisted of patients with GERD without excess body weight and concomitant pathology (average age43.6±2.11 year; 29 females and 21 males). In addition to collecting complaints and anamnesis, the patients and the control group underwent a 24-hour pH-metric study of the esophagus according to a conventional method. Results. Patients suffering from GERD in the background of type 2 diabetes have a clinically asymptomatic or asymptomatic course; there is a significant increase in the daily pH-metry, indicating a more pronounced nature of the changes. Conclusion. Patients suffering from GERD in the background of type 2 diabetes require a comprehensive examination of the upper digestive tract to identify GERD, even if there are no complaints characteristic of the disease.

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