Enhancement of the effectiveness of treatment of metabolic syndrome

Objective. To enhance the effectiveness of treatment of metabolic syndrome (MS).

Patients and methods. 98 patients (51% women and 49% men) aged 20–45 years with MS were randomized. All received low calorie diet therapy 1200 kcal for women and 1500 kcal for men with limited carbohydrate-containing products (glycaemic index below 40) and fats. Not less than 5 times a week they took varied kinds of sea fish by 100 g of prepared product. Metformin was administered by 850 mg 2 times daily, melaxen 1.5 mg for 1 wk, then 3 mg for 12 wks, then for the first 10 days of each month – for 3 months. If the content of 25(ОН)-vitamin D decreased below 30 ng/ml colecalciferol 2000 IU was administered for 6 months, then 1000 IU for another 6 months. If the body initial mass decreased by 5% and weight was stabile during 2 months, the caloric content of foods was raised to calculated values. The diet included carbohydrate-containing products with glycaemic index 40–69 until weight decreased to the predetermined level, intake of metformin continued for 6 months. 

Results. Against the background of therapy, complaints of asthenia and daytime sleepiness disappeared, headaches, fatigue, exertional dyspnoea decreased or disappeared in 99% after 6 months. The MS main marker – waist circumference (WC) – исслеdecreased significantly (p < 0.05): in women from 99 ± 8.5 to 89 ± 6.7 cm after 6 months of therapy and to 80 ± 8.5 cm after 12 months, in men from 111 ± 7.8 to 96.5 ± 3.5 cm – after 12 months. A decrease of overweight for more than 5% of initial levels after 6 months of treatment was noted in 38.8% of patients, for more than 10% – in 61.2% of them. By that time, the mean body mass index decreased from 34.7 ± 8.5 to 25 ± 7.7 kg/m2 (p < 0.01), and insulin resistance index HOMA-IR – from 7.3 ± 3.7 to 0.7 ± 0.5 (p < 0.01). Along with increased sensitivity to insulin a significant (p < 0.05) improvement of lipid metabolism parameters was found: triglyceride levels (TG) decreased from 2.1 ± 1.3 to 1.0 ± 0.4 mmol/l, low density lipoprotein cholesterol (LDL Chol) – from 3.7 ± 1.2 to 1.6 ± 0.4 mmol/l, and concentrations of high density lipoprotein cholesterol (HDL Chol) increased from 1.5 ± 0.7 to 2.4 ± 0.4 mmol/l. Restoration of vitamin D levels from 17.3 ± 8.6 to 39.2 ± 5.3 nmol/l was recorded (p < 0.01). Systolic blood pressure significantly (p < 0.05) decreased from 135.7 ± 4.33 to 123.2 ± 3.18 mm Hg after 6 months of treatment and to 118.3 ± 5.17 mm Hg after 12 months, as well as diastolic blood pressure levels – from 88.1 ± 5.19 to 76.2 ± 3.38 mm Hg and to 71.5 ± 5.25 mm Hg, respectively.

Conclusion. Due to a competent combination of drug therapy and diet therapy the maximally favourable effect was obtained, a statistically significant decrease of the MS main component – insulin resistance index HOMA-IR – and the main marker of disease – WC – was observed. A sufficient hypotensive effect and improvement of BP profile were observed in combination with a decrease or disappearance of asthenic and autonomic disorders.

Key words: glycaemic index of products, diet therapy, insulin resistance, metabolic syndrome.

For citation: Alekseeva N.S. Enhancement of the effectiveness of treatment of metabolic syndrome. Vopr. dietol. (Nutrition). 2016; 6(1): 20–27.

DOI: 10.20953/2224-5448-2016-1-20-27

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