The influence of disturbances of the carbohydrate metabolism and obesity upon functional state of endothelium of different caliber vessels in subjects over 50 years old
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Abstract
The aim – to estimate functional status of the endothelium depending on changes of carbohydrate metabolism and body mass index in subjects over 50 years old.
Materials and methods. The study involved 63 subjects, age 50–74 years, including 35 healthy subjects and
28 patients with prediabetes changes of carbohydrate metabolism. Standard glucose-tolerance test was performed, blood concentrations of glucose and insulin were measured. We also calculated insulin resistance index (HOMA-IR), the area under glucose curve, the indicators of the platelet aggregation, the functional status of endothelium, performed vital biomicroscopy of the vessels of bulbar conjunctiva.
Results. Prediabetes changes of the carbohydrate metabolism were associated with slight deterioration of endothelial function at the level of large vessels and the development of endothelial dysfunction at microcirculatory section of vasculature, along with increased platelet aggregation in obese patients (P<0,05). Conducting vital сapillaroscopy of bulbar conjunctiva we revealed slowing of the flow rate and sludge phenomena in venules, arterioles and capillaries.
Conclusions. Elderly subjects with prediabetes reveal evolving endothelial dysfunction at microcirculatory level, which probably precedes endothelial dysfunction at the level of large vessels. Thrombogenicity is increased in subjects with prediabetes. Pathological changes of microcirculation were found as well, being more pronounced in patients with obesity.
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