There is a tendency in the world for an increase in life expectancy and the proportion of people over 65, which can lead not only to age — dependent pathology, but also to cardiovascular disease (CVD) and their complications (heart attacks and strokes, sudden cardiac death). In addition, obesity and pre-diabetes are independent factors for cardiovascular risk. The study shows the relationship between cardiovascular risk factors (obesity, pre-diabetes) and changes in the vascular bed at the level of microcirculation of the bulbar conjunctiva in persons of all ages, with the aim of detecting them early to prevent the development of acute circulatory disorders. The study involved 189 people of all ages were surveyed and distributed according to the standard glucose tolerance test and obesity test. The indices of blood lipid spectrum were evaluated, the insulin resistance index (HOMA-IR) was calculated, the functional activity of β-pancreatic cells and insulin sensitivity was determined, and a vital biomicroscopy of the vessels of the bulbar conjunctiva was performed.
As a result, it is shown that obesity and pre-diabetic disorders of carbohydrate metabolism are associated with the formation of atherogenic type of dyslipidemia regardless of age, which can be considered a pathomorphological substrate for the development of CVD and their complications in middle-aged people. It has been established that impaired glucose tolerance in the elderly is likely to precede the development of impaired fasting glucose, in contrast to middle-aged individuals who experience only impaired fasting glucose. This difference can be explained by the increased incidence of type 2 diabetes in the elderly. When conducting capillaroscopy of vessels of the bulbar conjunctiva in persons with pre-diabetes, regardless of age, the slowing of the blood flow rate and the slage-phenomenon with microthrombosis in all parts of the peripheral vascular bed (venules, arterioles, capillaries). It is an independent factor in the destabilization of hemovascular homeostasis as early as middle age. Thus, it is necessary to comprehensively evaluate the nature of insulin supply using HOMA-IR and functional activity of pancreatic β-cells calculation methods, insulin sensitivity index, and cardiovascular risk indices in obese and pre-diabetic subjects. They must to change their lifestyle and have dietary recommendations. Also used medicines that can improve the blood lipid spectrum, carbohydrate
metabolism and microcirculation and hemorheology.
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