CORRECTION OF CHRONIC LOW-INTENSITY INFLAMMATION IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE WITH CONCOMITANT TYPE 2 DIABETES MELLITUS USING QUERCETIN AND EMPAGLIFLOZIN

Nyshchuk-Oliynyk N. B.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The risk of developing cardiovascular complications is the same in people with type 2 diabetes mellitus and in patients with coronary artery disease. Type 2 diabetes mellitus is usually referred to as cardiovascular pathology and is considered as a pathogenetic link of the most common disorders of the body. Comprehensive correction of the cellular and mediator components of the inflammatory syndrome is the main target of therapy aimed at reducing the risk of progression of SCAD in patients with type 2 diabetes. It remains relevant to study the possibility and feasibility of using drugs with multimodal action, which could effectively affect the many pathogenetic components of this combined pathology. Objective: to evaluate the effectiveness of drug therapy of stable coronary artery disease with concomitant type 2 diabetes mellitus using bioflavonoid quartcetin and empagliflozin, taking into account the impact on the components of the low intensity systemic inflammatory response. Materials and methods of research. 96 patients with SCAD FC II–III and type 2 diabetes mellitus were examined. Depending on the treatment received, patients were divided into four groups: Group I (n=22) – patients who received basic therapy, Group II (n=26) – received quercetin with basic therapy, Group III (n=25) – took empagliflozin, and IV group (n=23) – patients who received quercetin with basic therapy and empagliflozin. Duration of therapy was 12 weeks. Results. The use of quercetin probably contributed to the reduction of integral indices of inflammation. Patients receiving empagliflozin are characterized by the ability to reduce the concentration of TMAO, hs – ST2. In addition, empagliflozin and quercetin probably contribute to the reduction of TLR 2, TLR 4 and the ratio of TLR 2/TLR 4, which can be considered as an another of its pleiotropic properties. Conclusions: 1. The course of SCAD with concomitant type 2 diabetes mellitus is accompanied by low-intensity inflammatory syndrome, which can be diagnosed by determining the hemogram and calculating leukocyte indices. It is appropriate to determine the levels of hs-CRP, sSN 2, TMAO, TLR 2 and TLR 4 and the TLR 2/TLR 4 ratio. 2. Quercetin has been shown to be effective in reducing hs-CRP, sSN 2, TMAO, TLR 2 and TLR 4 and the TLR 2/TLR 4 ratio, has anti-inflammatory effects, normalizes the immune system, reduces levels of leukocytes and their subpopulations (monocytes, neutrophils). 3. Empagliflozin, in addition to direct hypoglycemic effects, probably has numerous pleiotropic effects, including probably being able to reduce the intensity of the systemic inflammatory response and to normalize innate immunity. The mechanism of this effects is ambiguous and requires further study

coronary artery disease, type 2 diabetes mellitus, quercetin, empagliflozin, biological markers of inflammation.

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«Bulletin of problems biology and medicine» Issue 2 Part 1 (164), 2022 year, 208-225 pages, index UDK 616.12–008.1+616.43+616–092.19:616–08–031.81

10.29254/2077-4214-2022-2-1-164-208-225