Search

BACKGROUND. One of the priority directions in the development of the health care system is to reduce the medical and social damage caused by the increase in the prevalence of diabetes mellitus (DM). From this point of view, the development of a diabetes register is very important as the main information and analytical platform for clinical and epidemiological monitoring of diabetes in the Russian Federation (RF).AIMS. The aim of our study was to analyze a dynamic (2016–2020) of the epidemiological characteristics of diabetes mellitus in the Russian Federation (prevalence, morbidity, mortality), the prevalence of complications, the level of HbA1c and the dynamics of the structure of glucose-lowering therapy (GLT) according to the Federal Diabetes Register (FDR).MATERIALS AND METHODs. The database of FRD (http://diaregistry.ru) 84 regions of the RF. The data are presented in dynamics 2016→2020.RESULTS. The total number of DM patients in the RF as of 01.01.2021 was 4,799,552 (3.23% of the population), including: Type 1 (T1) — 5.5% (265.4 ths) , T2 — 92.5% (4.43 million), other DM types — 2.0% (99.3 ths). The dynamics of prevalence was 168.7→180.9/100 ths people with T1, and 2709 → 3022/100 ths people with T2; morbidity in T1 10.5→7.7/100 ths population, in T2 219.6→154.2/100 ths population. Age and sex characteristics: the proportion of men in T1 — 54%, in T2 — 30%; the max proportion of patients with T1 at the age of 30–39 years, T2 65–69 years. Mortality: T1 3.0 → 2.7/100 ths population, T2 87.7→93.9/100 ths of the population, the main cause of death was cardiovascular: in T1 38,1% cases, in T2 — 52,0%. Life expectancy (average age of death of patients): T1 was 53.2years, the dynamics in males 50.7 → 50.5years, ­females 58.7→55.2years; in T2 — 73.5 years, males 70.2→70.1years, females 75.7→75.4 years. The dynamic of DM duration until the death: in T1 17.4→19.0 years; in T2 11→11.4 years. The incidence of diabetic complications in T1 and T2 patients: neuropathy 43.3% and 24.4%, nephropathy (CKD) 25.9% and 18.4%, retinopathy 31.7% and 13.5%, respectively. The ­proportion of ­patients with HbA1c CONCLUSIONS. The performed analysis demonstrates the importance of dynamic assessment of epidemiological characteristics and monitoring of clinical data on patients with diabetes through a registry for assessing the quality of diabetes care and the prospects for its development.

BACKGROUND: Less than a year has passed since the start of the new coronavirus infection COVID-19 pandemic caused by SARS-CoV-2 First published research results demonstrate a frequent increase in glycemia in patients without previously diagnosed carbohydrate metabolism disorders A possible relationship between the carbohydrate metabolism state and the course of COVID-19 is considered AIM: To identify the incidence of known and newly diagnosed diabetes mellitus (DM) in hospitalized patients with COVID-19 and evaluate the relationship between glycated hemoglobin (HbA1c), inflammation markers and infectious disease severity METHODS: A single-center, cross-sectional, retrospective study included 155 patients with confirmed COVID-19 and bilateral polysegmental viral pneumonia hospitalized in the Endocrinology Research Centre, Russian Federation Diagnosis of carbohydrate metabolism disorders was based on the HbA1c level, blood glucose level at admission (BGA) and fasting plasma glucose (FPG) Patients were divided into 2 groups: without the previously diagnosed DM (n=129, 83 3%) and with known history of DM (n=26, 16,7%) Patients without previously diagnosed DM were divided into subgroups according to HbA1c levels: ≤6,0% (Group A), >6,0% HbA1c

Background. Diabetes mellitus (DM) is characterized by multiple risk factors for the combined development of disorders of phosphorus-calcium metabolism, due to more frequent overweight, decreased renal filtration function and vitamin D deficiency in this category of patients. Aim. To assess the level of calcium in blood serum and its correlations with parameters of carbohydrate metabolism, body mass index (BMI) and renal function in patients with type 1 and type 2 diabetes. Materials and methods. The object of the study: adult patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) ≥18 years old who underwent examination in Diamodule (n=294) in 2019 in the Voronezh region, who were additionally tested for serum calcium. The examination at the mobile medical center includes: assessment of anthropometric data (height, weight, BMI), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate (GFR-EPI), albuminuria and the albumin/creatinine in a single portion of urine, measurement of glycated hemoglobin (HbA1c), blood pressure, electrocardiogram, consultation with a cardiologist, ophthalmologist, specialist of the Diabetic Foot office, diabetologist. All biochemical parameters was carried out using commercial kits on a biochemical express analyzer Spotchem EZ ArkraySP-4430. Determination of HbA1c, albuminuria, albumin/creatinine was performed by immunochemical method on a DCA Vantage analyzer. Data analysis was carried out using the Statistica v.13.3 software package (TIBCO Software Inc., USA). The results are presented as medians and quartiles [25; 75], the level of reliability is taken as p

BACKGROUND: Glikogemoglobin (HbA1c) is a key clinical marker for evaluating the effectiveness of glucose-lowering therapy for patients with diabetes mellitus (DM) and the quality of diabetic care. AIMS: to conduct dynamic monitoring of the quality of glycemic control in DM patients based on a comprehensive examination in mobile medical center (Diamodul) during repeated visits to the regions in 2019 compared with visits of Based Federal program “Diabetes Mellitus” (2005–2010) and data of the National diabetes register (NDR). MATERIALS AND METHODS: The object of the study: patients with T1DM and T2DM examined in Diamodul in 2019 in Voronezh region (Vr), Krasnodar region (Kr) (n = 600), there were “dynamic” group of re-examined (Vr n = 224; Kr n = 113), “random” group of new patients (Vr n = 72; Kr n = 191); group of adult patients from NDR with indicated HbA1c in 2019 (n = 2410067). RESULTS: According to Diamodul, the HbA1c levels are significantly worse than they were reported to NDR: the proportion of patients achieved HbA1c

Background. Diabetes mellitus (DM) is a powerful factor in the development and progression of cardiovascular diseases (CVD), it produces poor prognosis, in-cluding disability and premature mortality in this category of patients. Aim. To carry out dynamic monitoring of the prevalence of CVD in adult DM patients with type 1 and type 2 (coronary heart disease, myocardial infarction, ce-rebrovascular diseases and arterial hypertension) based on a comprehensive examination in a mobile medical center (Diamodule) with repeated visits to the re-gions in 2019 compared to data of the Federal Program "Diabetes mellitus" (2005–2006). Materials and methods. The object of the study: adult patients with DM1 and DM2 (≥18 years old) who underwent examination in Diamodule (n=1480): 882 patients were in 2005/2006 (337 with DM1 and 545 with DM2) and 598 were in 2019 (275 with DM1 and 323 with DM2). Examination at the medical center in-cludes: assessment of anthropometric data (height, weight, body mass index), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate, measurement of glycated hemoglobin (HbA1c), blood pressure, ECG, cardiologist’s consultation with an assessment of the anamnesis data, la-boratory data, ECG. Results. Over the past 13–14 year period in both types of DM, the prevalence of coronary heart disease significantly decreased: in DM1 by 4,42% by 2 times (p=0,037), in DM2 by 18,34% by 2,7 times (p

The Federal Diabetes Register (FDR) has been conducting clinical and epidemiological monitoring of diabetes in the Russian Federation (RF) since 1996. Its methodological and organizational reference centre is Endocrinology Research Centre. FRD was created by Order of the Ministry of Health of RF №404 of December 10, 1996 as part of implementation of the Federal target program "Diabetes Mellitus". Over the 20-year period, the registry has played a key role in assessing the prevalence of diabetes and diabetic complications in the RF. Since 2014, the register has been transformed into online system as a unified federal database with an authorized code access. Personal data protection is carried out in accordance with the laws and regulations of the Russian Federation.

BACKGROUND AND OBJECTIVE: There is an emerging role for optical coherence tomography angiography (OCTA) in detecting microvasculature changes in diabetic retinopathy (DR). This study aimed to investigate visual functions and OCTA parameters of retinal and choriocapillaris (CC) flow in patients with type 1 diabetes mellitus (T1DM) without apparent DR. PATIENTS AND METHODS: Patients and age-matched healthy volunteers were enrolled. All participants underwent low-luminance visual acuity assessment, OCT, and OCTA. Assessed OCTA parameters included foveal avascular zone area, acircularity index, vessel density (VD), skeletonized density, and CC flow deficits. RESULTS: Low-luminance deficit (LLD) was significantly higher in patients with diabetes mellitus and correlated with skeletonized density and VD in the superficial vascular plexus (SVP). In the T1DM group, vessel density and skeletonized density were reduced in the SVP and deep capillary plexus. Flow deficits density and the mean size of the flow deficits were increased in patients with T1DM. CONCLUSION: Functional and microvasculature changes were observed at the preclinical stage of DR. Correlation of LLD and OCTA parameters can be a sign of early neurovascular impairment. [ Ophthalmic Surg Lasers Imaging Retina . 2021;52:S30–S34.]

BACKGROUND: Cardiovascular diseases (CVD) are the main cause of death for patients with diabetes mellitus (DM). AIMS: To evaluate the CVD epidemiology: coronary heart disease (CHD), myocardial infarction (MI) and cerebrovascular diseases in adult patients with type 1 (T1DM) and type 2 (T2DM) diabetes, compare dynamics with data of implementation of the Federal Program «Diabetes mellitus» in 2007–2012 and over the online period 2013–2016. MATERIALS AND METHODS: The database of the Federal Diabetes register (81 regions at 12.2017). We estimated prevalence and incidence rates/10 thousand (th) adult DM patients over 18 years. RESULTS: The prevalence of CVD for the period 2007 – 2016 significant decreased in CHD for T1DM from 14,9% to 3,5%, for T2DM from 20,1% to 11,7%; MI for T1DM from 5,7% to 1,3%, for T2DM from 7,6% to 3,5%; cerebrovascular diseases for T1DM from 4,9% to 1,7%, for T2DM from 7,6% to 4,3%, respectively. In 2013→2016 positive trends continued: MI for T1DM 8,2→5,9/10th patients, for T2DM 19,2→14,7/10th patients, respectively; CVD for T1DM 11,3→10,5, for T2DM 29,4→25,4/10th patients, respectively. There was a large heterogeneity of the prevalence of CVD in the regions. MI varied in patients for T1DM from 319/10 th patients to absence, for T2DM from 800 to 7/10 th patients; the development of cerebrovascular diseases for T2DM from 900 to less than 100/10 th patients, which is largely due to differences in their registration. A small number of cases may be due to insufficient filling of the database, the facts of a huge number require further analysis. The average age of development of MI had increased: for T1DM 51,2→53 years, for T2DM 63,5→65 years, cerebrovascular diseases for T1DM 52,3→52.5 years, for T2DM 65,2→66,5, respectively. CONCLUSIONS: The prevalence of CVD significantly decreased in the Russian Federation compared to 2007–2012, as well as for the period 2013–2016: the prevalence of CHD and cerebrovascular diseases declined, the number of new cases of MI decreased, the average age and duration of DM before the development of CVD significantly increased. These data reflect the results of the program for improvement medical care and prevention measures for patients with diabetes.

Background: Despite the improvement in the quality of diabetes care in the Russian Federation (RF), coma remain one of the causes of death in patients with diabetes. Aim: To assess dynamic of epidemiological characteristic of acute complications in adult patients with T1D and T2D in 2013–16. Materials and methods: The database of the Russian Federal Diabetes register (81 regions). The indicators of coma for 2013–16 were estimated for 10000 adult patients with diabetes (>18 years). Results: In 2016, the prevalence of coma in RF was 225.9 with T1D and 11.6/10000 adults with T2D. For the period from 2007 the prevalence of ketoacidotic coma decrease three times in T1D, 4 times for T2D.Totally in 2016, 165 new cases of coma for both types of diabetes were registered, an average of 0.4/10000 adults. Interregional differences in the prevalence of coma were observed 0–4.2/10000 adults. The frequency of new cases of coma has a tendency to decrease: 0,9→0,4/10000 adults: T1D 5.7→3.4, T2D 0.6→0.2/10000 adults. When evaluating the structure of coma, redistribution is evident in their form. So in 2016 the proportion of hypoglycemic coma increased to 40.7%, and ketoacidotic coma decreased to 56.6% in T1D. With T2D, the difference expressed in a lesser degree. The mean duration of diabetes at the time of coma development increased with T1D from 3.8→9.1 years, with T2D 3.5→7.0 years. The maximum frequency of development of coma is recorded with the diabetes duration more than 30 years, regardless of the type. The patients’ age at the time of coma development in T1D increased to 27.5 years old, and in T2D it was 60.4 years, it didn’t change significantly. The assessment of glycemic control showed a significant improvement: a decrease in the proportion of patients with HbA1c≥ 9.0% (23% with T1D, 8.8% with T2D), an increase with HbA1c

The National diabetes register (NDR) was created as unified dynamic database in online format. It allows providing clinical and epidemiological monitoring of diabetes mellitus (DM) in the whole country. Aim. To analyze the epidemiological characteristics of diabetes over the past decade, to access the dynamics of the prevalence of acute (coma) and chronic (micro - and macrovascular) complications of DM. Materials and methods. The object of the study was the depersonized NDR database of DM patients. It consists of 84 regions of the Russian Federation (RF), included in the online registry system on 01.01.2019. Results and discussion. The total number of patients with DM in RF on 01.01.2019 was 4 584 575 (3.12% of the population), comprising 256.2 thousand patients with T1DM, 4.24 million with T2DM, 89.9 thousand other types of DM. Since 2000, the number of DM patients in RF has grown 2.2 times. 34.7% patients with T1DM reached target level of HbA1c

Background: Diabetic retinopathy (DR) is one of the most common causes of blindness in patients with diabetes mellitus (DM) that is why it’s necessary to study the epidemiological characteristics of this complication. Aims: The aim of the study was to evaluate the epidemiological characteristics of DR and blindness in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation (RF) for period 2013–16years. Materials and methods: Database of Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (>18years). Results: In 2016 the DR prevalence in RF was T1 38,3%, T2 15,0%, with marked interregional differences: 2,6–66,1%, 1,1–46,4%, respectively. The DR prevalence within 2013→2016 years was: T1 3830,9→3805,6; T2 1586,0→1497,0. Trend of new DR cases/per year increased: T1 153,2→187,8; T2 99,7→114,9. The structure of new cases of DR in 2016: non-proliferative stage (T1 71,4%, T2 80,3%), pre-proliferative stage 16,4%, 13,8%, proliferative 12,1%, 5,8%, terminal 0,2%, 0,1%, respectively, these data indicated the earlier detection of DR. The mean age of DR diagnosis increased: T1 by 1,2 years, T2 by 2,6. The average DM duration of DR determine increased T1 9,6→13,1 years, T2 6,0→9,1. The prevalence of blindness tends to decrease: T1 92,3→90,8; T2 15,4→15,2/10.000 DM adults. The amount of new cases of blindness/per year increased: T1 4,3→4,6; T2 1,2→1,4. The mean age of blindness increased: T1 39,1→41,6 years, T2 64,4→67,4; the mean duration of diabetes before blindness occur (from the time of DM diagnosis) increased: T1 20,2→21,2 years, in T2 10,7→11,3. We observed growth of DR treatment (laser surgery, vitrectomy, anti-VEGF medication) but the frequency of use in T2 patients is about 2 times less than in T1. Conclusions: There was a decrease in the overall incidence of eye damage in diabetes (DR and blindness) in the analyzed period in RF. DR and blindness develops at advanced age and with a longer duration of diabetes. As the main directions of eye care development in diabetes it is necessary to standardize primary care in the regions, to unify the examination algorithms and methods of early diagnostic, to increase the continuity and interaction of endocrinologists and ophthalmologists in managing patients with diabetes in order to prevent the development of new cases of vision loss.

BACKGROUND: Chronic kidney disease (CKD) is one of the most severe complications of diabetes mellitus (DM), this determines the importance of the study of epidemiological characteristics of the disease. AIMS: To assess the epidemiological characteristics of CKD in adult DM patients with type 1 (T1), 2 (T2) in Russian Federation in 2013–16. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in online register. Indicators were estimated per 10,000 adult DM patients (>18years). RESULTS: In 2016, the CKD frequency registration was T1 23%, T2 6.9% with marked interregional differences 1.5-49.9%, 0.6–23.5%, respectively. The CKD prevalence in dynamics 2013→2016 was 2171.4→2303.0 in T1 and 512.→687.2 in T2. The incidence of new CKD cases increased 2 times in T1 (215.5 vs 104.2), and 3.7 times in T2 (190.4 vs 51.8). The analysis of distribution by CKD stages by KDIGO indicates the increase in the proportion of patients with low and moderate cardiovascular risk and end stage renal disease (ESRD) (with the initial stages of CKD, C1/2 A1) - 12.0→46.8% in T1; 10.0→50.4% in T2. The proportion of patients with a very high risk (stages C4/5 C3aA3 and C3bA2-3) progressively decreases: 13.4→6.7% in T1, 11.3→4.4% in T2. We observed relation between the CKD prevalence and DM duration. CKD develops in 5.1% patients if T130years; in T2 3.5% and 20.3%, respectively. The average age of CKD onset in T1 increased for 4,3yr (36,1→40,2), in T2 for 2,4yr (64,4→66,8), DM duration until CKD development increased in T1 11.8→14.2yr, in T2 7.6→8.2yr. CONCLUSIONS: There is a significant improvement in the quality of CKD diagnostics at the earlier stages, older age and a longer DM duration before CKD onset in both types while we observed the increasing trends in CKD prevalence in Russian Federation in the dynamics of 2013-2016. Advances in the management of patients with DM in recent years do not reduce the risk of CKD, but give us a delay in its development. The marked interregional differences frequency of registration of CKD might indicate some remaining problems in verification in a number of regions where the standard for mandatory assessment of albuminuria and glomerular filtration rate not implemented.

BACKGROUND: The epidemiological study of diabetic foot (DF) is very important because of high risk lower limbs amputations in patients with diabetes mellitus (DM). AIMS: The aim of the study was to evaluate the DF prevalence in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation for period 2013–16years. METHODS: We have used the database of the Russian Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (>18years). RESULTS: In 2016, the prevalence of DF in RF was T1 4,7%, T2 1,9%, with marked interregional differences: 0,15–19,9%, 0,07–10,3%, respectively. The DF prevalence in RF decreased: T1 506,3→473,6, T2 214,60→194,8. The incidence of new DF cases/per year was stable in adults with T1: 20,8→20,4/; increased in T2 13.2→14.2. The mean age of DF diagnosis increased by 2years for both DM types. The average DM duration of DF determine increased T1 15.4→19.0years, T2 7.4→10.1years. Proportion of DF forms: neuropathic with trophic ulcer 41.6%, neuropathic form (Charcot's foot) 17.9%, the neuroischemic 28.3%, ischemic 12.2%, in T2: 41.6%, 7,4%, 32,4%, 18,5%, respectively. The amount of new cases of amputations/per year in dynamics: T1 10,5→12,4, T2 9,6→10,9, with marked interregional differences 0.13–2.9% in T1, 0.04-6.0% in T2. The mean DM duration before amputation increased in T1 18.4→21.3years, in T2 9.1→9.9. The average amputation age: T1 51.7years, T2 66.2years. There was marked decrease in proportion of major amputations: T1 43,6→37,0%, T2 52.2→45.5 by redistribution in one toe amputations T14,0→10.0%, in T22,8→9.1%. CONCLUSIONS: The dynamic of new DF cases in adult patients in Russian Federation is stable at T1, in T2 tends to increase. The interregional differences in frequency of DF and amputations may be due to differences in the quality of specialized care, the lack or shortage of diabetic foot cabinets, treatment of patients with DF in general surgical practice in a number of regions, which is recognized as a less effective strategy. A positive fact that proportion of high amputations declines, DF develops in later age and longer diabetes duration, that may reflect the increasing effectiveness of preventive lower limbs in diabetes.

BACKGROUND: The enormous social lesion caused by high prevalence of diabetes mellitus (DM) determines the state importance of clinical and epidemiological monitoring organization. AIMS: To analyze epidemiological characteristics (prevalence, mortality, morbidity), the level ofHbA1c, evaluate the therapy in Russian Federation in 2013–2017. METHODS: We have used the database of the Russian Federal Diabetes register – 81 regions included in the online register system. RESULTS: The total number of patients with DM was 4,498m. (3.06% RF population), including: Type 1 (T1) 5,7% (0,26 m), T2 92,1% (4,15m), other DM types 1,9% (83,8 ths). Distribution male/female: T1 53.5%/46.5%, T2 29%/71%, other DM types 24%/76%. The proportion of men decreases with aging. Number of patients >65 years was 2.293.520, including T1 21.97ths (3.6%), T2 2m271.5ths (54.7%). The prevalence 2013→2017 per 100,000 population was as follows: T1 159,8→169,6; T2 2455.3→2775.6; other DM types 51,2→65,8. Morbidity: T1 9,8→7,0; T2 226,7→185,2; other DM types 7,8→12,4. The structure of causes of death 2013→2017: T1: diabetic coma 2,0→1,5%, myocardial infarction 4,0→4,4%, cerebral circulation disorders 8,2→7,6%, cardiovascular insufficiency 18,5→16,4%, chronic renal failure 6,1→6,0%; T2 0,2→0,2%, 4,5→4,5%, 12,7→12,2%, 29,0→28,6%, 1,2→1,8%, respectively. Mortality: T1 2.3; T2 68.4, other DM types 0,8. Life expectancy (average age of death of patients): T1 male 50.3→50.2, female 60.2→57.2; T2 69.8→70.3, 75.1→75.9 respectively. The number of patients with targetHbA1clevel

Background: The data of the register is the main source of up-to-date information about patients with diabetes mellitus (DM). It’s very important for improving the quality of medical care organization. Aims: to analyze the main epidemiological DM characteristics in Russian Federation (RF) (prevalence, incidence, mortality) in children and adolescents, to assess the dynamics of these parameters for the period 2013 – 2016, to analyze the status of compensation for carbohydrate metabolism, therapy of DM1, prevalence of diabetic complications and the reasons for hospitalizations in these age groups. Materials and methods: The database of Federal DM registry of 81 regions was included in the online system. Results: The total number of patients under the age of 18 with DM in RF on 31.12.2016 was 33081 people, there were 95,9% (31727 people) with DM1 and 4,1% (1354 patients) with DM2. The prevalence of DM1 in 2013–2016 in children: 81.0 – 91.4 / 100 ths., in adolescents – 212,8–209,5 / 100 ths. The DM1 incidence/100 thousand population in 2016 in children was 14,2/100 ths., in adolescents 10,0/100 ths. HbA1c levels in DM1 was in children: 9% in 35% of the patients; in adolescents 9% in 45% of the patients. Among complications in children and adolescents with DM1, diabetic neuropathy is the most often recorded (in 10,9% of cases and 40,8%, respectively); among DM2 patients, diabetic neuropathy is registered in 4,7% and 8,8% in children and adolescents, respectively. There are associated diseases in DM2 patients – arterial hypertension and dyslipidemia. 43,8% of children and 49,2% of adolescents were hospitalized in the anamnesis, most hospitalizations in 2016 (children 71,9%, adolescents 67,1%) were due to diabetes. Conclusions: It is established that in the dynamics of 2013–2016 the prevalence of DM1 in children continues to increase, with relatively stable indicators in adolescents. According to the register, during last two years there has been a decrease in the incidence of DM1 and, on the contrary, an increase in the prevalence/incidence of DM2 in children. Significant interregional differences in the level of incidence/prevalence have been established, especially in regions located in various geographic regions of the RF. The frequency of diabetic complications in children and adolescents with diabetes varies. There is an association of hospitalizations with higher HbA1c level. In the structure of therapy of this age group the ratio of insulin therapy in syringes-pens and pump therapy is 80.9% / 15.1% according to the register.

Patients with diabetes mellitus (DM) represent a risk group for developing chronic kidney disease (CKD), the terminal stages of which require renal replacement therapy. The study of genetic predisposition to CKD is of special significance from the perspective of the prediction and identification of risk groups at the preclinical stage. The present study is a review of the world literature on the genetics of CKD in diabetes and also includes data of our own studies.

Genetic susceptibility plays an important role in the risk of developing chronic complications in patients with type 2 diabetes mellitus (T2DM). Aims. In this study, we evaluated the possible association of the polymorphic variants that encode key renal damage mediators (endothelial dysfunction, lipid metabolism and insulin secretion/sensitivity) with the risk of chronic kidney disease (CKD) in patients with T2DM. Materials and Methods. We enrolled 435 patients with T2DM using case-control study design. In 253 patients, we used non-overlapping criteria to form groups with/without CKD (defined as GFR 2 ) according to the duration of T2DM (?5 years/>=10 years) (n=75 and 178, respectively) and analysed the following 4 polymorphic markers: I/D in ACE, ecNOS4a/4b in NOS3, I/D in APOB and e2/e3/e4 in APOE genes. We then divided 182 patients in groups with/without CKD (n=38 and 144, respectively) regardless of the duration of diabetes and studied pro12ala in PPARG2, rs5219 in KCNJ11, rs12255372 in TCF7L2 and rs13266634 in SLC30A8 genes. 2 test, and data were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Values of p Results. Four genes were found to have a significant association with CKD occurrence. For the eNOS3 the allele 4a and 4a/4a genotype was associated with a twofold CKD risk (OR=2.2/9.88) and the allele 4b and 4b/4b polymorphism were protective regarding CKD development (OR=0.44/0.45). For APOB I/D, the genotype DD was associated with lower risk of CKD [OR for DD=0.2 (95% CI: 0.05?0.88)]. In the second group, genotype TT of TCF7L2 predisposed to CKD (OR=3.03, 95% CI: 1.07?8.58). For KCNJ11 group genotype AA predisposed to CKD (OR=2.25, 95% CI: 1.02?4.97) compared to the allele G (OR=0,57, 95% CI: 0.34?0.96). Conclusions. In conclusion, our findings indicate a significant role of functional genetic variants associated with genes of endothelial factors (NOS3), lipid metabolism (APOB), and insulin secretion factors (KCNJ11, TCF7L2) in modulating the risk of CKD and their significant involvement in the mechanism of kidney damage in patients with T2DM.

An in vivo study was performed to see whether deterioration of the muscle cytoskeleton caused by eccentric exercise could be counteracted by raising the tissue content of nitric oxide. In Wistar rats that ran downhill on a treadmill inclined at 16° for 40 min at 20 m/min, the desmin content in m. soleus measured 24 h later declined by 15%, and the percentage of ruptures in the dystrophin layer was three times higher than in the control. Destruction of cytoskeletal proteins was also pronounced in rats pretreated with a blocker of NO synthase before exercise. By contrast, animals that received a nitric oxide donor (L-arginine) prior to running had control levels of desmin and dystrophin. It was concluded that nitric oxide can protect muscle cytoskeletal proteins in a single eccentric exercise.

An attempt was made to determine whether or not the concentration of NFATc1 (nuclear factor of activated T-cells, cytoplasmic, calcineurin-dependent 1) in nuclear and cytoplasmic extracts is related to an increase in the concentration of fibers containing type IIa myosin heavy chains under modeled gravitational unloading of m. soleus. Experiments were carried out on Wistar rats using the Morey-Holton tail suspension model. It was found that the soleus contains three isoforms of NFATc1 (140, 110, and 86 kDa). Under unloading, the 140-kDa isoform is translocated into the nucleus, the concentration of the 110-kDa isoform in the cytoplasmic extract decreases, and the concentration of the 86-kDa isoform in the nuclear extract increases. Under gravitational unloading of the muscle, the concentration of fibers containing type IIa myosin heavy chains increases. The increase in the concentration of the 140-and 86-kDa NFATc1 isoforms in the nucleus is accompanied by a decrease in the fraction of muscle fibers containing type I myosin heavy chains and an increase in the fraction containing type IIa chains.

Background. Chronic kidney disease is one of the most serious diabetic complications, which end-stage leads to a dramatic decline of renal function and needs for renal replacement therapy. Due to the progressive nature of CKD and the limited efficacy of treatment for advanced stages the prediction of risks and diagnostics on preclinical stage are of great importance. All of the above determines the high relevance of search for genetic markers predict the chronic kidney disease (CKD) development.The aim of our study was to investigate association between polymorphic marker (PM) of gene involved in insulin secretion with development of CKD in type 2 diabetic (T2D) patients. Polymorphism of KCNJ11 gene is associated with different phenotypes of glycemic disorders: neonatal diabetes, hyperinsulinemia, reduced insulin secretion and increased risk of type 2 diabetes. This gene coding Kir6.2 subunit of ATP-dependent potassium channels. The pathogenesis of it’s involvement in renal damage development referred to the fact that this type of potassium channels found not only in the beta- cells, but also in smooth muscle cells of blood vessels, and therefore might have an effect on risk of vascular complications, including CKD.Materials and methods. We enrolled 444 T2D patients. PM rs5219 in KCNJ11 gene was analysed among patients divided in 2 groups: with and without CKD (n=123/321) based on glomerular filtration rate (GFR) < and ≥ 60 ml/min/1,73m2 calculated by MDRD formula. PM studied using PCR. Differences in alleles/genotypes frequencies were assessed by χ² and odds ratio (OR) were calculated. The study was approved by local ethical committee; informed concern was obtained from all the patients.Results. We studied the main clinical parameters: age, HbA1c, serum levels of cholesterol and triglycerides, BP between the groups. We observed significant differences in alleles/genotypes distribution of rs5219 in KCNJ11 gene between groups with and without CKD: the prevalence of allele C and genotype CC in patients without CKD: OR=0,53, 95%CI: 0,40-0,72 and OR=0,46, 95%CI: 0,27-0,79, respectively; while allele T and genotype TT did as risk factors: χ²=17,33; р=0,0002; OR=1,87, 95%CI: 1,39-2,53; genotype TT OR=2,39, 95%CI: 1,52-3,76.Conclusions. We conclude that T2D patients might have genetic susceptibility to CKD development caused by polymorphism rs5219 of KCNJ11 gene with protective role of allele C and genotype CC and risk allelе/genotype is T/TT.