Сердечно-сосудистые заболевания и апноэ во сне у пациентов с сахарным диабетом 2-го типа

В статье представлена информация о таких сопутствующих сахарному диабету 2-го типа состояниях, как сердечнососудистые заболевания и синдром апноэ во сне. Обсуждаются вопросы о типах нарушения дыхания во сне и факторах, предрасполагающих к данному состоянию. Продемонстрированы данные по распространенности в мире обструктивного апноэ во сне. Показаны основные подходы к диагностике данного состояния. Продемонстрированы различия в подходах к терапии при обструктивном и центральном апноэ во сне. Рассмотрены вопросы взаимосвязи обструктивного апноэ во сне, сахарного диабета 2-го типа и сердечно-сосудистых заболеваний. Приведены данные клинических исследований, оценивающие взаимосвязь обструктивного апноэ во сне и сердечно-сосудистых заболеваний. Показано их взаимно отягощающее влияние. Представлена информация о влиянии обструктивного апноэ во сне на основные клинические исходы по данным клинических исследований. Обсуждается взаимосвязь обструктивного апноэ во сне и сердечной недостаточности, основные вопросы о воспалительном профиле обструктивного апноэ во сне, которые тесно связаны с сердечнососудистыми заболеваниями и сахарным диабетом 2-го типа и включают рекрутирование макрофагов и воспалительные биомаркеры, такие как С-реактивный белок, хемокины и цитокины, такие как интерлейкин 6, фактор некроза опухоли-α, ядерный фактор каппа-В, а также молекулы адгезий, такие как селектины, молекула внутриклеточной адгезии-1 (ICAM-1) и молекула внутриклеточной адгезии сосудов (VCAM-1), нарушение баланса между прооксидантными и антиоксидантными факторами. Эти факторы способствуют развитию микрои макрососудистых осложнений при сахарном диабете 2-го типа. Особое внимание в публикации уделяется обсуждению основных факторов, предрасполагающих к развитию обструктивного апноэ во сне при сердечной недостаточности у пациентов с сахарным диабетом 2-го типа. Приведены данные об основных диагностических тестах для пациентов с сердечной недостаточностью и сахарным диабетом 2-го типа. Представлена информация об использовании препаратов из группы ингибиторов натрий-глюкозного котранспортера 2-го типа у пациентов с сахарным диабетом 2-го типа и обструктивным апноэ во сне. Представлены обоснованные рекомендации по использованию указанных препаратов c учетом современной стратегии лечения сахарного диабета 2-го типа.

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