cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2011-4-77-82cardiovascular-1900Research ArticleМЕТАБОЛИЧЕСКИЙ СИНДРОМMETABOLIC SYNDROMEПерспективы лечения нарушения толерантности к глюкозе у больных с метаболическим синдромомPerspectives of impaired glucose tolerance management in patients with metabolic syndromeИвановК. П.IvanovK. P.МычкаВ. Б.MychkaV. B.

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victoria-mychka@yandex.ruЖернаковаЮ. В.ZhernakovaYu. V.ТишинаЕ. В.TishinaE. V.ТолстовС. Н.TolstovS. N.

зав. кардиологическим отделением МУЗ 1-я ГКБ им. Ю.Я. Гордеева

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МасенкоВ. П.MasenkoV. P.ЧазоваИ. Е.ChazovaI. E.Институт клинической кардиологии им. А.Л. Мясникова ФГУ РКНПК Минздравсоцразвития РоссииA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex2011200820111047782Copyright © Иванов К.П., Мычка В.Б., Жернакова Ю.В., Тишина Е.В., Толстов С.Н., Масенко В.П., Чазова И.Е., 20112011Иванов К.П., Мычка В.Б., Жернакова Ю.В., Тишина Е.В., Толстов С.Н., Масенко В.П., Чазова И.Е.Ivanov K.P., Mychka V.B., Zhernakova Y.V., Tishina E.V., Tolstov S.N., Masenko V.P., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1900

Цель. Определить эффективность лекарственного препарата вилдаглиптин, его влияние на висцеральное ожирение (ВО), показатели углеводного, липидного обменов и суточного профиля (СП) артериального давления (АД) у пациентов с метаболическим синдромом (МС), артериальной гипертензией (АГ) 1 степени (ст.) и нарушением толерантности к глюкозе (НТГ). Материал и методы. В исследование были включены 30 пациентов в возрасте 18-60 лет, 16 мужчин и 14 женщин. У всех пациентов было диагностировано НТГ в сочетании с ВО, АГ 1 ст. Предыдущая антигипертензивная терапия (АГТ) не менялась. У всех пациентов проводилась сравнительная оценка показателей углеводного обмена, липидов. СП АД, массы тела в начале исследования и на фоне 24-недельного лечения вилдаглиптином. Результаты. На фоне лечения вилдаглиптином у пациентов отмечалось значительное снижения веса тела; окружности талии; постпрандиальной глюкозы, уровня глюкозы натощак; общего холестерина, липопротеинов низкой плотности, а также стойкое снижение систолического АД и диастолического АД. Заключение. В результате терапии вилдаглиптином было достигнуто снижение веса, достоверно уменьшились показатели углеводного и липидного обменов, и удалось достичь целевых значений АД. Случаи гипогликемии отсутствовали.

Aim. To assess the effectiveness of vildagliptin, its effects on visceral obesity (VO), carbohydrate and lipid metabolism parameters, and circadian profile (CP) of blood pressure (BP) in patients with metabolic syndrome (MS), Stage I arterial hypertension (AH), and impaired glucose tolerance (IGT). Material and methods. The study included 30 patients, aged 18-60 years (16 men and 14 women). All patients had IGT, VO, and Stage I AH. Previously prescribed antihypertensive therapy (AHT) was not modified after the start of the study. In all participants, carbohydrate and lipid metabolism parameters, BP CP, and body weight were measured at baseline and after 24 weeks of vildagliptin treatment. Results. Vildagliptin therapy was associated with a significant reduction in body weight, waist circumference, postprandial and fasting glucose levels, the levels of total cholesterol and low-density lipoprotein cholesterol, as well as with a sustained reduction in systolic and diastolic BP levels. Conclusion. Vildagliptin therapy resulted in weight reduction, improved carbohydrate and lipid profiles, and target BP achievement, without inducing hypoglycemia episodes.

сахарный диабетметаболический синдромсердечно-сосудистые осложнениянарушение толерантности к глюкозеингибитор ДПП-4ГПП-1вилдаглиптинDiabetes mellitusmetabolic syndromecardiovascular eventsimpaired glucose toleranceDPP-4 inhibitorGLP-1vildagliptinReferencesДедов И.И., Шестакова М.В., Миленькая Т.М. Сахарный диабет: ретинопатия, нефропатия. М.: Медицина 2001; 175 с.Дедов И.И., Шестакова М.В., Миленькая Т.М. Сахарный диабет: ретинопатия, нефропатия. М.: Медицина 2001; 175 с.Deb N, Thuret G, Estour B, et al. Screening for diabetic retinopathy in France. Diabetes Metab 2004; 30 (2): 140-5.Deb N, Thuret G, Estour B, et al. Screening for diabetic retinopathy in France. Diabetes Metab 2004; 30 (2): 140-5.Wong JS, Aiello LP. Diabetic retinopathy. Ann Acad Med Singapore 2000; 29 (6): 745-52.Wong JS, Aiello LP. Diabetic retinopathy. Ann Acad Med Singapore 2000; 29 (6): 745-52.Sobel BE, Frye R, Detre KM. Burgeoning dilemmas in the management of diabetes and cardiovascular disease: rationale for the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D). Trial Circulation 2003; 107 (4): 636-42.Sobel BE, Frye R, Detre KM. Burgeoning dilemmas in the management of diabetes and cardiovascular disease: rationale for the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D). Trial Circulation 2003; 107 (4): 636-42.Derek J. Hausenloy and Derek M. Yellon; GLP-1 Therapy. Circulation: Heart Failure 2008; 1: 147-9.Derek J. Hausenloy and Derek M. Yellon; GLP-1 Therapy. Circulation: Heart Failure 2008; 1: 147-9.European Diabetes Policy Group. Guidelines for a desktop guide to Type 2 Diabetes Mellitus. — International Diabetes Federation European Region. — 1998-1999.European Diabetes Policy Group. Guidelines for a desktop guide to Type 2 Diabetes Mellitus. — International Diabetes Federation European Region. — 1998-1999.Stratton I, Adler A, Neil H, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405-12.Stratton I, Adler A, Neil H, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405-12.UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837-53.UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837-53.Чазова И.Е., Мычка В.Б., Метаболический синдром. М: Медиа Медика 2008; 319 с.Чазова И.Е., Мычка В.Б., Метаболический синдром. М: Медиа Медика 2008; 319 с.Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycaemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo Study. Diabetes Care 1998; 21: 1236-9.Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycaemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo Study. Diabetes Care 1998; 21: 1236-9.Shaw J, Hodge A, De Courten M, et al. Isolated postchallenge hyperglycemia confirmed as a risk factor for mortality. Pacific an Indian Ocean Study. Diabetologia 1999; 42: 1050-4.Shaw J, Hodge A, De Courten M, et al. Isolated postchallenge hyperglycemia confirmed as a risk factor for mortality. Pacific an Indian Ocean Study. Diabetologia 1999; 42: 1050-4.Мамедов М.Н. Нарушение толерантности к глюкозе: кто и как должен лечить? Кардиоваск тер профил 2005; 4(6): Ч. 1: 89-96.Мамедов М.Н. Нарушение толерантности к глюкозе: кто и как должен лечить? Кардиоваск тер профил 2005; 4(6): Ч. 1: 89-96.Viberti G, Kahn SE, Greene DA et al. A diabetes outcome progression trial (ADOPT). N international multicenter study of the comparative efficacy of rosiglitazone, glyburide, and metformin in recently diagnosed type 2 diabetes. Diabetes Care 2002; 25: 1737-43.Viberti G, Kahn SE, Greene DA et al. A diabetes outcome progression trial (ADOPT). N international multicenter study of the comparative efficacy of rosiglitazone, glyburide, and metformin in recently diagnosed type 2 diabetes. Diabetes Care 2002; 25: 1737-43.Rosenstock J, Foley JE, Rendell M, et al. Effect of the DPP-4 inhibitor vildagliptin on incretin hormones, islet function, and postprandial glycemia in subjects with impaired glucose tolerance. Diabetes Care 2007; [Epub].Rosenstock J, Foley JE, Rendell M, et al. Effect of the DPP-4 inhibitor vildagliptin on incretin hormones, islet function, and postprandial glycemia in subjects with impaired glucose tolerance. Diabetes Care 2007; [Epub].Richter G, Feddersen O, Wagner U, et al. GLP-1 stimulates secretion of macromolecules from airways and relaxes pulmonary artery. Am J Physiol 1993; 265: L374-81.Richter G, Feddersen O, Wagner U, et al. GLP-1 stimulates secretion of macromolecules from airways and relaxes pulmonary artery. Am J Physiol 1993; 265: L374-81.Yu M, Moreno C, Hoagland KM, et al. Antihypertensive effect of glucagon-like peptide 1 in Dahl salt-sensitive rats. J Hypertens 2003; 21: 1125-35.Yu M, Moreno C, Hoagland KM, et al. Antihypertensive effect of glucagon-like peptide 1 in Dahl salt-sensitive rats. J Hypertens 2003; 21: 1125-35.Nystrom T, Gutniak MK, Zhang Q, et al. Effects of glucagonlike peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease. Am J Physiol Endocrinol Metab 2004; 287: E1209-15.Nystrom T, Gutniak MK, Zhang Q, et al. Effects of glucagonlike peptide-1 on endothelial function in type 2 diabetes patients with stable coronary artery disease. Am J Physiol Endocrinol Metab 2004; 287: E1209-15.Nikolaidis LA, Elahi D, Hentosz T, et al. Recombinant glucagonlike peptide-1 increases myocardial glucose uptake and improves left ventricular performance in conscious dogs with pacinginduced dilated cardiomyopathy. Circulation.2004; 110: 955-61.Nikolaidis LA, Elahi D, Hentosz T, et al. Recombinant glucagonlike peptide-1 increases myocardial glucose uptake and improves left ventricular performance in conscious dogs with pacinginduced dilated cardiomyopathy. Circulation.2004; 110: 955-61.Nikolaidis LA, Doverspike A, Hentosz T, et al. Glucagon-like peptide-1 limits myocardial stunning following brief coronary occlusion and reperfusion in conscious canines. J Pharmacol Exp Ther 2005; 312: 303-8.Nikolaidis LA, Doverspike A, Hentosz T, et al. Glucagon-like peptide-1 limits myocardial stunning following brief coronary occlusion and reperfusion in conscious canines. J Pharmacol Exp Ther 2005; 312: 303-8.

The authors declare that there are no conflicts of interest present.