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The importance of the association of antiphospholipid antibodies (aPL Abs) with the features of type II diabetes mellitus has not yet been elucidated. The aim of this work was to investigate the association of aPL Abs with adiponectin and non-esterified fatty acids (NEFA) in type II diabetes mellitus patients without micro and/or macrovascular complications, and to analyze the differences between the male and female patients with regard to the abovementioned parameters. Male patients with type II diabetes mellitus showed a positive correlation between NEFA concentrations and anti-oxLDL antibodies (r=0.334, p=0.019). A weak, but statistically significant correlation between adiponectin concentrations and the IgM isotype of anti-annexin A5 antibodies was found in type II diabetes mellitus patients (r=0.285, p=0.011). The presence of a positive correlation between NEFA and anti-oxLDL antibodies might be useful in the detection of patients with premature atherosclerosis in type II diabetes mellitus patients without any micro and/or macrovascular complications among type II diabetes mellitus patients.

Introduction. Results of epidemiological analysis show that one third of patients with diabetes mellitus develop diabetic nephropathy (DN). Strategies used until now to slow down the progression of DN were initiated when the symptoms of DN were already present. Objective. Our objective was to analyze the prevalence and characteristics of DN and to determine the factors leading to DN. Methods. Fifty-two patients with diabetes mellitus (DM) - 32 with type 1 aged 32 years and 20 with type 2 aged 59 years - were referred from the Institute of Endocrinology, Diabetes and Metabolic Diseases to the Department of Nephrology for kidney function evaluation. Apart from routine laboratory analyses, glomerular filtration rate was calculated using the MDRD formula (modification of diet in renal disease), the size of the kidney was measured by ultrasound, and kidney volume was calculated using the ellipsoid formula. Results Thirty percent of the patients revealed normal (eight patients with DM type 1) or satisfactory kidney function (eight patients with DM type 1) with physiological proteinuria. Micro-albuminuria (MAU) or pathological proteinuria (PRT) were found in 10 and 9 patients, respectively, with DM type 1, while decreased kidney function was found in one patient without proteinuria. MAU or PRT were found in four and eight patients, respectively, with DM type 2 and decreased kidney function in four patients without proteinuria. Kidney function was significantly lower in patients with DM type 2 in comparison to DM type 1, while the patients with decreased kidney function had a higher PRT. Compared to DM type 2, in DM type 1 patients, the kidney was longer, and parenchymal artery resistance index was lower in DM type 1 patients compared to DM type 2. Factors associated with DN were patient's age, duration of diabetes, systolic blood pressure, HbA1c and kidney volume. Conclusion. The prevalence of DN among the studied patients was 70%. Treatable factors associated with the development of DN are strict control of blood pressure and glycaemia control.

INTRODUCTION The quality of life in patients with heart failure is diminished by symptoms of disease, affected social connections, frequent hospitalizations, side effects caused by medication, and costs of treatment borne by the patient himself. OBJECTIVE The objective of this research was to measure the quality of life of patients with heart failure and assess any potential changes during a six-month period. METHOD This research is a follow-up study, and comprised 56 patients who were treated from September 1998 to August 1999 at the Institute for Cardiovascular Diseases of The Clinical Center of Serbia. During the first hospitalization, an initial baseline measurement of quality of life was conducted. The measurement was then repeated after three and six months, during check-ups. The measurement was conducted by using a special questionnaire for patients suffering from heart disorders, the "Minnesota Living with Heart Failure Questionnaire." RESULTS The results showed a considerable improvement in the overall quality of life between the baseline and seeable improvement in the physical dimension of quality of life between the baseline and first measurements (F=6.797; p=0.016) and between the baseline and second measurements (F=5.351;p=0.030). CONCLUSION Thanks to the application of the special Minnesota questionnaire, it was possible to measure small but considerable changes in the patients’ quality of life.

Cardiovascular manifestation of diabetes has remarkable therapeutic and prognostic implications. Diabetic cardiomyopathy is a distinct heart muscle disease in patients with well-controlled diabetes mellitus that cannot be ascribed to coronary artery disease, hypertension or any other known cardiac disease. It is characterized by left ventricular diastolic dysfunction that can be detected in 52-60% of well-controlled type II diabetic subjects using contemporary Doppler techniques. Pathophysiologically, hyperglycaemia causes myocardial necrosis and fibrosis, as well as the increase of myocardial free radicals and oxidants, which decrease nitric oxide levels, worsen the endothelial function and induce myocardial inflammation. Insulin resistance with hyperinsulinaemia and decreased insulin sensitivity are responsible for left ventricular hypertrophy. Clinical manifestations of diabetic cardiomyopathy are dispnoea, arrhythmias, atypical chest pain or dizziness. The treatment of diabetic cardiomopathy should be initiated as early as diastolic dysfunction is identified. Various therapeutic options include improving diabetic control with both diet and drugs (metformin and thiazolidinediones), use of ACE inhibitors, beta blockers and calcium channel blockers. Daily physical activity and reduction in body mass index may improve glucose homeostasis by reducing the glucose/insulin ratio, and the increase of both insulin sensitivity and glucose oxidation by the skeletal and cardiac muscles. Metformin and thiazolidinendiones are used to treat insulin resistance, but have different mechanisms of action. Metformin reduces free fatty amino acids effluvium from fat cells, thereby suppressing hepatic glucose production and indirectly improving peripheral insulin sensitivity and the endothelial function. In contrast, thiazolidinediones improve peripheral insulin sensitivity by reducing circulating free fatty amino acids, but also increasing production of adiponectin, which improves insulin sensitivity. Beta-adrenoceptor blocking agents are effective in preventing or reversing myocardial dilatation and remodelling, while ACE inhibitors facilitate blood flow through microcirculation in coronary vascular bed, fat and skeletal muscle, as well as improve insulin action at the cellular level.