Comparative analysis of clinical and metabolic parameters in patients with dyslipidemia in obesity and type 2 diabetes mellitus

Purpose. To analyze disturbances in clinical and metabolic parameters in patients with dyslipidemia with impaired composition and function of fatty acids (FA), impaired structure and function of cell membranes in obesity and type 2 diabetes mellitus (T2DM) with insulin resistance, complicated by arterial hypertension (AH) and diabetic cataracts (DC). Material and methods. In 65 patients aged 38 to 63 years with grade I–II obesity and T2DM, a comprehensive study of the condition of the eye lens, the lipid composition of serum and blood cell membranes, the level of FA in erythrocytes, the degree of lipid peroxidation, and the content of enzymes of antioxidant defense system and glucose utilization by erythrocytes was performed. 65 patients were examined, including: 22 patients aged 39–56 years with type 2 diabetes, 26 patients aged 40–63 years with grade I–II obesity and 17 patients with metabolic syndrome. The control group included 20 patients without endocrine pathology. Results. In patients with obesity and T2DM structural and functional disorders of erythrocyte membranes were revealed: an increase in the microviscosity of the lipid bilayer of membranes, changes in the structure of membrane-bound proteins, correlating with indicators of glucose-insulin homeostasis and the level of lipid peroxidation, the development of DC, as well as with severe hypertension. In T2DM, the changes were more significant. Conclusion. All information mentioned is the basis for prescribing adequate therapy aimed to eliminate oxidative stress and other metabolic defects in the membrane-receptor apparatus of blood cells, as well as hypertension due to impaired insulin-dependent vasodilation in conditions of hyperinsulinemia (i.e., due to blockade of the vasodilating effect of insulin). The initiating factor for lens opacification in cataracts, T2DM and obesity is, apparently, a shift in osmolarity in the membrane cells of the lens fibers as a result of the accumulation of insoluble forms of sorbitol, fructose and protein aggregates in them. Key words: obesity, diabetes mellitus type 2, metabolic syndrome, arterial hуpertension, insulin resistance, diabetic cataract, senile cataract