Сахарный диабет 2-го типа и ишемическая болезнь сердца

2017 
In recent years, the growth in the number of diabetic patients has been registered in the most countries. In turn, the diseases of the cardiovascular system are still the leading cause of death in many countries. Against the background of rapid growth in the incidence of diabetes mellitus, the number of patients with combined pathology including coronary heart disease and type 2 diabetes mellitus increases. Oxidation of LDL with the subsequent generation of cytokines and other biologically active molecules is considered one of the major pathogenic mechanisms of atherosclerosis. Hyperglycemia contributes to the processes of lipid peroxidation with activation of atherogenesis with increased risk of vascular lesions. The modern views on commonality of the mechanisms of the development of diabetes and coronary heart disease are studied. Attention is paid to the generation of free radicals, which being highly reactive unstable chemical compounds damage the endothelium. However, activation of free radical processes in the conditions of hyperglycemia stimulate the increased synthesis of pro-inflammatory cytokines, including necrosisfactor-a tumor, interleukins, which are a reflection of local and systemic inflammation. This review presents detailed description of the main pro-inflammatory cytokines (interleukin-1s, interleukin-6, interleukin-8, TNF-a) and C-reactive protein. The value of insulin resistance and hyperfibrinogenemia in diabetes mellitus combined with coronary heart disease and the factors, which increase the risk for adverse outcomes of coronary heart disease, is presented in the article.
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