The authors investigated the incidence of different disorders of the lipid metabolism and their age dependence in a group of 67 patients with type 2 diabetes hospitalized at the First Medical Clinic in Kosice. Some disorder of the lipid metabolism was recorded in 67% of the patients. The most frequently encountered disorder was hypertriglyceridaemia (21%). Hypercholesterolaemia was recorded in 16%, combined hyperlipidaemia in 18% and hypoalphalipoproteinaemia in 12% of the patients. Patients with diabetic nephropathy had significantly elevated mean triglyceride levels and reduced HDL-cholesterol levels, as compared with patients without nephropathy. In diabetic women a significantly higher incidence of combined hyperlipidaemias was recorded, as compared with men and the mean total cholesterol and triglyceride levels were also significantly higher in women with type 2 diabetes.
The authors examined the plasma renin activity (PRA), serum uric acid and creatinine in 53 patients with essential hypertension (EH). They recorded low renin EH in 28%, normorenin EH in 53% and high-renin EH in 19% of the hypertensive patients. Assessment of basal PRA levels does not suffice for the classification of EH because the PRA response after stimulation is not related to its basal values. The authors found significantly higher levels of serum creatinine in low-renin EH. They did not confirm a relationship between PRA and the uric acid serum level in any form of EH.
The authors examined the plasma renin activity (PRA) in 80 patients and plasma aldosterone (PA) in 27 patients with essential hypertension (EH). They confirmed the significant drop of stimulated PRA with age. The PA levels of hypertonic patients did not change with age and did not change significantly in relation to PRA. In obese hypertonic patients a satisfactory response of PRA to stimulation was lacking, while PA reacted adequately. The PA levels are thus in older age groups as well as in obese subjects much higher, as compared with relatively low PRA levels. In relation to the stage of EH the authors did not find any significant differences of PRA levels.
Serum lipid concentrations were assessed in 147 type 2 diabetics. The patients were divided into different sub-groups in order to follow up different factors which could have an impact on serum lipids. The mean total cholesterol concentrations were significantly higher in diabetic women as compared with men. The authors did not reveal significant differences in lipid concentrations between obese and non-obese diabetics. Hypertensive diabetics had higher mean total cholesterol levels and LDL-cholesterol levels, as compared with diabetic patients without hypertension. Patients using oral antidiabetics had significantly higher mean triglyceride levels and lower HDL-cholesterol levels, as compared with insulin-treated diabetics. In a multiple stepwise regression analysis correlated triglycerides with three independent variables: total cholesterol, diastolic blood pressure and inversely with HDL-cholesterol. On the other hand, total cholesterol correlated significantly with triglycerides, HDL-cholesterol and proteinuria/day. To sum up, it may be stated, that the results of the present investigation are consistent with Reaven's concept of the syndrome X, however the cholesterol concentration is affected also by the proteinuria.