FATTY ACID COMPOSITION OF SERUM LIPIDS IN PATIENTS WITH DECOMPENSATED TYPE 1 DIABETES MELLITUS DEPENDING ON THE DIABETIC KETOACIDOSIS SEVERITY

Summary. In diabetic ketoacidosis, significant metabolic disorders develop in all organs and tissues, including the myocardium. The main energy substrate in the myocardium are fatty acids.

The objective was to study the fractional composition of serum lipids in patients with T1DM, complicated by diabetic ketoacidosis, depending on the severity ketoacidosis.

Materials and methods. Determination of fatty acid spectrum of serum lipids was carried out in the following groups of patients: 68 patients with compensated type 1 diabetes mellitus (group 1), 54 patients with type 1 diabetes complicated by mild ketoacidosis (group 2); and 42 patients with diabetes mellitus complicated by moderate and severe ketoacidosis (3 group). Extraction of lipids from serum was performed according to the method developed by J. Folh et al. (1957), after which methylation of fatty acids was carried out according to the method proposed by K.M. Sinyak et al., with subsequent analysis using the Crystal-2000M gas chromatograph (Russia).

Results. All patients with type 1 diabetes mellitus compared with a group of healthy individuals showed an increase in the total content of saturated fatty acids, a decrease in the total concentration of unsaturated fatty acids, as well as an increasing in the ratio of saturated / unsaturated fatty acids. At the same time, a significant difference between the studied groups was revealed. The most pronounced changes were found in the group of patients with type 1 diabetes mellitus complicated by moderate to severe ketoacidosis.

Conclusions. These changes develop as part of a general systemic metabolic disorder in a given cohort of patients.

1. Govorin A.V. Non-coronary myocardial damage. Novosibirsk: «Science». 2010; 231 р. [in Russian].

2. Dedov I.I., Shestakova M.V., Vikulova О.K. The prevalence, morbidity, mortality, parameters of carbohydrate metabolism and the structure of glucose-lowering therapy according to the federal diabetes mellitus registry, status 2017. Diabetes mellitus. 2018; 21 (3): 144-159. [in Russian].

3. Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes in the adult population of Russia (NATION study). Diabetes. 2016; 19 (2): 104-112. [in Russian].

4. Kotkina, T.I., Titov, V.N., Parkhimovich R.M. Other ideas on the β-oxidation of fatty acids in peroxisomes, mitochondria and ketone bodies. Diabetic, acidotic coma as an acute deficiency of acetyl CoA and ATP. Clinical laboratory diagnosis. 2014; 3: 14-23. [in Russian].

5. Dedov I.I., Melnichenko G.A. Endocrinology: national leadership. M.: GEOTAR-Media. 2008; 1072 р. [in Russian].

6. Enert A.V., Kravets E.B., Ivanov S.N. Cardiovascular disorders in type 1 diabetes mellitus in children and adolescents (literature review). Siberian Medical Journal. 2009; 2 (4): 77-84. [in Russian].

7. Horrabin D., Mancy M., Hyang Y. Effect of essential fatty acids on prostaglandin biosynthesis. Biomed. Biohim. Acta. 1984; 72(8/9): 114 — 120.