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Abstract
The purpose of this study was to evaluate the peculiarities of ω‑3 polyunsaturated fatty acids (ω‑3 PUFAs) and simvastatin prescription on the blood lipid profile and heart rate variability (HRV) parameters in patients with type 2 diabetes mellitus (T2DM) and functional stage of cardiovascular autonomic neuropathy (CAN). Materials and methods. The study involved 75 patients with T2DM and functional stage of CAN aged 50-59 years, HbA1c (7.1±0.4)%, who received traditional hypoglycemic therapy within 3 months. Patients were stratified into four groups: 21 patients received 1 capsule/day of ω‑3 PUFAs in addition to hypoglycemic therapy; 22 patients received simvastatin 20 mg/day; 17 patients
received 1 g/day of ω‑3-PUFAs and simvastatin 10 mg/day; control group (n=15). The duration of the study was 3 month. Results. The prescription of ω‑3 PUFAs promoted to the more significant decrease in triglycerides (TG) level compared to treatment with simvastatin, a significant decrease of atherogenic coefficient (AC), and an increase of high-density lipoprotein-cholesterol (HDL-C) and, at the same time, did not affect the concentration of the total cholesterol and low density lipoprotein-cholesterol (LDL-cholesterol). Treatment with simvastatin was accompanied by the significant decrease in total cholesterol, LDL cholesterol, TG, AC and an increase in HDL cholesterol; significant decrease in total cholesterol, LDL-cholesterol and TG levels (compared to the ω‑3 PUFAs). Prescription of ω‑3 PUFAs promoted significant increase of time-domain measures of HRV, however simvastatin showed a more pronounced positive effect on the temporal and spectral parameters of HRV. The combination of ω‑3 PUFAs and simvastatin in the treatment of patients with T2DM and functional stage of CAN was accompanied by the most pronounced, positive, reliable changes in lipid metabolism, temporal and spectral parameters of HRV. Conclusion. Obtained results of our study could prove the expediency of combined ω‑3 PUFAs and statins prescription to patients with T2DM and functional stage of CAN.
References
2. Vinik AI, Erbas T. Diabetic autonomic neuropathy. Handb Clin Neurol. 2013;117:279-94.
3. Valensi P. Cardiovascular autonomic neuropathy.Amsterdam: Elsevier Saunders. 2015:361-8.
4. Serhiyenko VA, Serhiyenko AA. Diabetic cardiac autonomic neuropathy: Do we have any treatment perspectives? World J. Diabetes. 2015;6(2):245-58.
5. Сергієнко ВО, Сергієнко ОО. Діабетична кардіоваскулярна автономна нейропатія. Львів: Львівський національний медичний університет імені Данила Галицького, 2016:268 с.
(Serhiyenko VO, Serhiyenko O.O. Diabetic cardiovascular autonomic neuropathy. Lviv: Danylo Halytsky Lviv National Medical University, 2016:268 p.).
6. Sytze Van Dam P, Cotter MA, Bravenboer B, Cameron NE. Pathogenesis of diabetic neuropathy: focus on neurovascular mechanisms. Eur J Pharmacol. 2013;5(7):1-3.
7. Nikishin AG, Nurbaev TA, Khasanov MS, Abdullaeva SY, Yakubbekov NT. Possibility of the heart rate variability correction with a high dose of omega‑3-polyunsaturated fatty acids in
patients with acute myocardial infarction and concomitant type 2 diabetes mellitus. J BM. 2014;4(3):138-42.
8. Goit RK, Paudel BH, Khadka R, Roy RK, Shrewastwa MK. Mildtomoderate intensity exercise improves cardiac autonomic drive in type 2 diabetes. J Diabetes Investig. 2014;56(6):722-7.
9. Ascaso JF. Advances in cholesterol-lowering interventions. Endocrinol Nutr. 2010;57(1):210-9.
10. Сергієнко ВО. Дисліпопротеїнемії при цукровому діабеті 2 типу: основні напрямки лікування (огляд літератури та власних досліджень). Журн. НАМН України. 2012;18(2):205-
16.(Serhiyenko VO. Dyslipoproteinemia in type 2 diabetes mellitus: basic treatment directions (review of literature and own data). Zhurn NAMN Ukainy. 2012;18(2):205-16).
11. Endo J, Arita M. Cardioprotective mechanism of omega‑3 polyunsaturated fatty acid. J Cardiol. 2016;67(1):22-7.
12. Ewing D, Clarke B. Diagnosis and management of diabetic autonomic neuropathy. Br Med J. 1982;285(2):916-8.
13. Spallone V, Ziegler D, Freeman D, Bernardi L, Frontoni S, Pop-Busui R, et al. Cardiovascular autonomic neuropathy in diabetes: clinical impact, assessment, diagnosis, and management on behalf of The Toronto Consensus panel on diabetic neuropathy. Diabetes Metab Res Rev. 2011;27(7):639-53.
14. DePace NL, Mears JP, Yayac M, Colombo J. Cardiac autonomic testing and diagnosing heart disease. «A clinical perspective». Heart Int. 2014;9(2):37-44.