Biochemical risk factors of vascular complications in children with type 2 diabetes mellitus in the late postoperative period following reconstructive surgery

The objective of the present study was to compare levels of homocysteine (HC), total cholesterol (TC), triglycerides, high and low density lipoproteins (HDLP and LDLP respectively), and C-reactive protein (CRP) and to evaluate their role in the development of atherosclerosis in patients with type 2 diabetes mellitus (DM2) or without it in the late postoperative period following aortofemoral reconstructive (AFR) operations. A total of 79 patients (40 with DM2 and 39 without it) examined after AFR surgery had the above parameters enhanced compared with the respective baseline values. In the majority of the cases, hyperhomocysteinemia (HHC) was associated with the increased levels of CRP, fibrinogen, and LDLP. However, they were higher in patients with DM2 than without it and correlated with the HbA1c level (r=0.32-0.45; p<0.05). In DM2 patients with HHC, simultaneous hyperlipidemia and elevated CRP levels, the thickness of the intima-media complex in aorta, popliteal artery, anterior and posterior tibial arteries significantly increased. Moreover, these patients experienced more apparent stenosis of these arteries (>50%). Patients with DM2 more frequently exhibited a combination of several markers of the atherosclerotic process especially in the presence of the smouldering inflammatory process in the vascular wall.

type 2 diabetes mellitus, hyperhomocysteinemia, cholesterol of low density lipoproteins, triglycerides, C-reactive proteins, inflammation, atherosclerosis

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