Background. Variability of glycemia is an important problem in the control of diabetes mellitus. It can be assumed that cognitive impairment associated with this disease is due to the fact that variability of glycemia affects not only the structure, but also metabolism of the brain. Objective — the study was aimed at assessing the values of glycemia variability, as well as their relationship with neuropsychological testing and magnetic resonance imaging data in patients with type 1 diabetes mellitus (DM1). Material and methods. We carried out a one-stage observational study of sex and age matched patients with DM1 and individuals without diabetes. All participants underwent neuropsychological testing, magnetic resonance imaging (MRI), and proton magnetic resonance spectroscopy (PMRS) of the brain; fasting plasma glucose and glycated hemoglobin (HbA1c) levels were assessed. The results of continuous monitoring of glycemia were analyzed in DM1 patients followed by calculation of glycemic variability coefficients. Results. DM1 58 patients demonstrated decrease in neuropsychological testing scores (p<0.05), decrease in the gray matter volume (p=0.004), and increase in the white matter volume (p=0.001), as well as impaired metabolism of the brain (p<0.05). Correlations between the total result of the MoCa test and LI (r=–0.34; p=0.008), MODD (r=–0.36; p=0.005), and ADRR (r=–0.28; p=0.032) were found. Negative relationship between the CONGA index and the volume of the left hippocampus (r=–0.27; p=0.044) was found. There were also some correlations between the glycemic variability indexes and the content of the main metabolites in different areas of the brain (p<0.05). Conclusion. MD1 patients with cognitive dysfunction demonstrated anatomical and metabolic brain disorders associated with glycemic variability.

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Diabetes mellitus type 1 and 2 is associated with cognitive impairment. Previous studies have reported a relationship between changes in cerebral metabolite levels and the variability of glycemia. However, the specific risk factors that affect the metabolic changes associated with type 1 and type 2 diabetes in cognitive dysfunction remain uncertain. The aim of the study was to evaluate the specificity of hippocampal spectroscopy in type 1 and type 2 diabetes and cognitive dysfunction. Materials and methods: 65 patients with type 1 diabetes with cognitive deficits and 20 patients without, 75 patients with type 2 diabetes with cognitive deficits and 20 patients without have participated in the study. The general clinical analysis and evaluation of risk factors of cognitive impairment were carried out. Neuropsychological testing included the Montreal Scale of Cognitive Dysfunction Assessment (MoCA test). Magnetic resonance spectroscopy (MRS) was performed in the hippocampal area, with the assessment of N-acetylaspartate (NAA), choline (Cho), creatine (Cr), and phosphocreatine (PCr) levels. Statistical processing was performed using the commercially available IBM SPSS software. Results: Changes in the content of NAA, choline Cho, phosphocreatine Cr2 and their ratios were observed in type 1 diabetes. More pronounced changes in hippocampal metabolism were observed in type 2 diabetes for all of the studied metabolites. Primary risk factors of neurometabolic changes in patients with type 1 diabetes were episodes of severe hypoglycemia in the history of the disease, diabetic ketoacidosis (DKA), chronic hyperglycemia, and increased body mass index (BMI). In type 2 diabetes, arterial hypertension (AH), BMI, and patient’s age are of greater importance, while the level of glycated hemoglobin (HbA1c), duration of the disease, level of education and insulin therapy are of lesser importance. Conclusion: Patients with diabetes have altered hippocampal metabolism, which may serve as an early predictive marker. The main modifiable factors have been identified, correction of which may slow down the progression of cognitive dysfunction.

Sarcopenia is a condition that is characterized by a progressive loss of muscle mass, strength, and function, resulting in reduced quality of life. The aim of the study was to analyze the significance of pro-inflammatory markers in the prognostic diagnosis of sarcopenia. The participants were divided into two groups: the main group of 146 people and the control—75 people. The complex of examinations included neuropsychological testing (Hospital Anxiety and Depression Scale (HADS), quality-of-life questionnaire for patients with sarcopenia (SarQoL), and short health assessment form (MOS SF-36)), a 6 m walking speed test, manual dynamometry, bioimpedancemetry, and metabolic markers (nitrates, fibroblast growth factor 21, and malondialdehyde). When analyzing metabolic markers in the main group, a twofold increase in nitrates in the main group was recorded in a subsequent analysis adjusted for multiple variables, there was a negative association between the nitrate levels for weak grip strength and appendicular muscle mass. An additional analysis revealed that the complaint of pain in the lower extremities was more frequent in patients of the main group, as well as constipation and the pathology of thyroid gland, and they were more frequently diagnosed with arterial hypertension. At the same time, patients from the main group more frequently took vitamin D. When conducting body composition, the main group recorded a higher weight visceral fat content, as well as a decrease in appendicular and skeletal muscle mass; these changes were accompanied by a decrease in protein and minerals. Among the markers that differed significantly were nitrates, and it was this that was associated with decreased muscle strength and appendicular mass, which may indicate both a possible mechanism and a possible predictive marker. The results of this study can be used to develop a screening method for diagnosing sarcopenia at the outpatient stage.

Aim. To analyze risk factors for sarcopenia in atherosclerosis involvement of target organs in patients with type 2 diabetes (T2D).Material and methods. The study included 84 patients with T2D, divided into groups according to the 2019 criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). All patients were surveyed using a 36-item short-form health survey (SF-36), Sarcopenia and Quality of Life (SarQoL), Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F), grip test, 4-meter walk test, bioelectrical impedance analysis, 24-hour blood pressure monitoring and cardiac ultrasound. Differences were considered significant at p<0,05.Results. Patients with sarcopenia have lower levels of fat, muscle, cell mass, appendicular mass index, fluid, protein, and minerals. In the group with sarcopenia, higher levels of total cholesterol, low-density lipoprotein cholesterol, glycated hemoglobin, and hypocalcemia were detected. Triglyceride levels were high in those with presarcopenia. In the same group, unstable blood pressure, increased myocardial mass and severe lower limb atherosclerosis were recorded.Conclusion. Sarcopenia is one of the important medical and social problems and is accompanied by unfavorable outcomes. The combination of sarcopenia and T2D can contribute to the rapid development of macro- and microangiopathy and increase the cardiovascular risk.

Obesity takes epidemic proportions, encompassing different groups of society. In turn, cerebrovascular pathology holds a leading position in the spectrum of neurological disorders. Researchers indicate a role of obesity in the development of cognitive impairment. However, the cellular and biochemical mechanisms underlying that connection are still poorly understood. In addition, despite the obvious association of obesity with the deterioration of mental activity demonstrated in clinical trials for a long time it was unclear whether these disorders are caused by obesity per se or related conditions, such as metabolic syndrome, diabetes or cardiovascular disease. Currently there is scarse systematic data on a cause-effect relationships of these two pathologies.