Предіабет і метаболічний синдром. Характеристика і маркери

The metabolic state prior to the development of type 2 diabetes mellitus (T2DM) is prediabetes characterized by insulin resistance and primary or secondary  β-cell dysfunction. This concept includes such changes in carbohydrate metabolism as impaired fasting glycemia and impaired glucose tolerance. Biomarkers for prediabetes are: HbA1c and glycated albumin levels; a state of glucose tolerance; 1.5 anhydroglucitol; fructosamine. New markers include: adiponectin;fetuin A; lipoprotein α; triglycerides (TG); high density lipoprotein (HDL), low density (LDL), and very low density levels; the ratio of TG/HDL and LDL/HDL; total cholesterol levels; ceramide; ferritin; lectin associated serine proteases; thrombospondin 1; acyl carnitines; microRNA; C-reactive protein; fibrinogen, IL‑18. Risk factors for developing prediabetes: close relatives with T2DM; ethnicity; cardiovascular disease (CVD); hypertension; TG and HDL cholesterol content; inwomen — polycystic ovary syndrome; physical inactivity; the presence of severe obesity; acanthosis black and/or papillomas on the skin. Metabolic syndrome (MS) is a set of risk factors that determine the predisposition to the development of T2DM and CVD. Five risk factors for MS were identified: high TG level; low content of HDL-C; high blood pressure and high fasting glucose concentration or previously detected type 2 diabetes. Additional factors are hypertension;ultra-low level of HDL-C; central obesity; high waist-to-hip ratio and microalbuminuria. Later, they were proposed as possible additional factors of MS: hyperuricemia, microvascular angina and an increased level of plasminogen activator inhibitor. Given the global nature of prediabetes, high rates of T2DM progression, and an increased risk of micro- and macrovascular complications and death, efforts to prevent the progression of diabetes and its complications are critical. Lifestyle activation and drug therapy have proven effective in preventing and delaying diabetes.