Currently there are many experimental markers of diabetic nephropathy, but clinical practice focuses mainly on the presence of albuminuria, which usually manifests itself in both adults and children on average 5-7 years after the onset of diabetes. The aim of the study was to study the general clinical and anthropometric parameters in patients with type 1 diabetes mellitus (T1D) depending on the level of albumin in the urine. The study included 78 men and 62 women aged 22 to 26 years with T1D. The control group consisted of 8 healthy men and 13 healthy women of the same age. The level of microalbuminuria was determined in all patients by enzyme-linked immunosorbent assay. The assessment of general clinical (pulse, systolic, diastolic pressure) and anthropometric (height, weight, body surface area, waist circumference, body mass index) indicators was performed. Statistical processing of the obtained results was performed in the license package “Statistica 5.5”, using non-parametric evaluation methods. It was found that angio-, retino- and neuropathy occurred in all patients with T1D. Simultaneously with the increase in albuminuria, the percentage of patients with deeper degrees of these complications increased. It was found that with increasing levels of albumin in the urine in most cases increases the percentage of patients with a correspondingly severe degree of these complications. Thus, in patients with T1D men found: angiopathy of the III degree with normoalbuminuria – 12.5 %, with microalbuminuria – 40.0 %, with proteinuria – 53.8 %; retinopathy of the II-III degree with normoalbuminuria – 0 % and 7.5 %, with microalbuminuria – 4.0 % and 40.0 %, with proteinuria – 100 % and 0 %; II-III degree neuropathy with normoalbuminuria – 65.0 % and 0 %, with microalbuminuria – 92.0 % and 0 %, with proteinuria – 0 % and 92.3 %. In patients with T1D women were found: angiopathy of the III degree with normoalbuminuria – 29.0 %, with microalbuminuria – 13.0 %, with proteinuria – 62.5 %; retinopathy of the II-III degree with normoalbuminuria – 3.2 % and 9.7 %, with microalbuminuria – 4.3 % and 26.1 %, with proteinuria – 87.5 % and 0 %; II-III degree neuropathy with normoalbuminuria – 71.0 % and 0 %, with microalbuminuria – 91.3 % and 0 %, with proteinuria – 12.5 % and 75.0 %. In patients with T1D with normo-, microalbuminuria and proteinuria, the value of systolic, diastolic blood pressure and pulse, in most cases, significantly higher than in healthy subjects (respectively in men by 6.1-18.3 % – 3.6-20.3 % and 4.2-14.7 %; in women – by 5.0-20.0 % – 9.1-22.8 % and 8.0-31.6 %). The value of these indicators increased with the increase in the level of albumin in the urine (respectively in men by 11.4 % – 16.1 % and 10.1 %; in women –- by 13.3 % – 10.0 % and 21.8 %). Patients with T1D had lower values of growth (respectively in men by 4.6-9.2 %; in women – 2.2-4.1 %), weight (only in men by 9.0-26.4 %) and body surface area (respectively in men by 7.2-17.7 %, in women – 4.8 % only in the group of proteinuria). Body mass index in sick men, compared with healthy, was significantly lower only in the group of proteinuria (by 5.5 %); and in women it was higher in the groups of normo- and microalbuminuria (by 10.6 % and 11.2 %). Patients with T1D women compared to healthy women had a larger waist circumference (by 5.5-11.8 %), and in patients with T1D men – on the contrary, this figure was lower in the group of microalbuminuria (by 4.0 %). Thus, the differences in general clinical and anthropometric parameters between patients with T1D with different levels of albumin in the urine and the degree of complications from the vascular and nervous system allow to assess the severity and compensation of the disease, and comparison of these indicators with the control group possibilities of disease development and peculiarities of the pathological process.
Utility of the waist-to-height ratio, waist circumference and body mass index in the screening of metabolic syndrome in adult patients with type 1 diabetes mellitus
