Аннотация
Исследована частота факторов риска неблагоприятных сердечно-сосудистых и почечных осложнений при сахарном диабете 2-го типа (СД 2) в пожилом (n=70) и старческом (n=19) возрасте. У пациентов пожилого возраста часто отмечались хронический коронарный синдром (ХКС) (67,1%), артериальная гипертензия (АГ) (65,7%) и ожирение (45,7%).
Распространенными вариантами поражения сердца являлись гипертрофия левого желудочка (ЛЖ) (51,4%) и диастолическая дисфункция ЛЖ (70%). Нарушения в метаболизме липидов были представлены преимущественно дислипидемией (32,8%). Гиперхолестеринемия (ГХС) существенно чаще выявлялась у женщин, а гипергликемия натощак и повышенные уровни цистатина С у мужчин. Лица старческого возраста чаще характеризовались наличием избыточной массы тела (ИзМТ) (68,4%) и АГ (52,6%). У женщин значимо чаще выявлялись ИзМТ, АГ, ХКС, хроническая сердечная недостаточность с низкой фракцией выброса, атеросклеротическое поражение сонных артерий, диастолическая дисфункция ЛЖ и гипертрофия левого предсердия (ГЛП). Наиболее распространенными вариантами поражения сердечно-сосудистой системы являлись ГЛП (84,1%), диастолическая дисфункция ЛЖ (57,8%) и атеросклеротическое поражение сонных артерий (57,8%). Нарушение липидного обмена было представлено ГХС (42,1%). Атерогенная дислипидемия и гликемия натощак чаще выявлялись среди женщин, а гиперфосфатемия – у мужчин. У пациентов пожилого возраста на величину
индекса массы миокарда ЛЖ существенное влияние оказывали концентрация цистатина С, величина почечной фильтрации и протеинурия, а у лиц старческого возраста – содержание фосфора крови. На величину фильтрационной функции почек у пациентов пожилого возраста оказывали влияние уровень систолического артериального давления и концентрация общего холестерина
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