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Currently the “rejuvenation” and an increase in the number of components of the metabolic syndrome (MS) determine its clinical significance in the earlier development of diabetes mellitus, cardiovascular diseases and related complications. Aim of the study was to investigate the features of the MS clinic picture in a population of young men and womenliving in the Khanty-Mansiysk autonomous region – Yugra.Material and methods. The study included 863 young people between 18 and 44 years of age, including 344 men and women with MS and 519 people in the comparison group. Studied subgroups are represented by non-indigenous men and women living in urban and rural areas, and indigenous rural residents. The analysis of MS clinical and laboratory parameters was carried out and its clinical variants in ethnic groups were identified.Results and its discussion. According to the results of the survey of young people with metabolic syndrome, it was revealed that the combination of abdominal obesity and two components of MS were most common in young people with MS (in 50.0 % men and in 55.5 % women). The study defined regression models for each MS group and threshold values for waist circumference were set, which changes in lipid and carbohydrate metabolism were predicted.Conclusions. In groups with MS, hypertriglyceridemia was determined as its most common component. The study identified the most frequent association of abdominal obesity with hyper-LDL cholesterol and hypertriglyceridemia in patients with metabolic syndrome, in ethnic groups, this combination is more common in indigenous rural men (53.3 %) and in non-indigenous urban women (54.3 %).

Aim. Maturity- onset diabetes of the young (MODY) is a group of monogenic diseases with an autosomal dominant inheritance. This is a rarely diagnosed disease, occurring in 1 of 10 thousand adults and in 1 of 23 thousand children. Brief description. We present a case report of a patient with a monogenic diabetes HNF4A-MODY, severe hypertriglyceridemia, progressive premature coronary artery disease and a HNF4A gene pathogenic variant (ENST00000316099.8:c.1145dup).Discussion. This case demonstrates the effectiveness of triple hypoglycemic therapy, including empagliflozin for the treatment of monogenic diabetes. Despite the fact that the patient with diabetes reached the target glycated hemoglobin level, the combination of the disease with other cardiovascular risk factors (hypertension, hypertriglyceridemia, obesity, smoking, male sex) led to the progression of coronary and peripheral atherosclerosis. Considering the data of genetic testing, returning to sulfonylurea therapy should be considered. It is important for patient to follow a strict lipid-lowering diet and taking combination lipid-lowering therapy (rosuvastatin, fenofibrate and omega-3 polyunsaturated fatty acids) in order to achieve the target level of low-density lipoprotein cholesterol

To date, there is no doubt about the participation of triglyceride-rich lipoproteins in atherogenesis. However, the variety of clinical manifestations of hypertriglyceridemia does not always allow timely recognition of patients with high cardiovascular risk for the timely initiation of therapy. The article presents 3 following cases: patient with isolated hypertriglyceridemia without clinical manifestations and with a good response to treatment, a patient with skin manifestations of hypertriglyceridemia and a patient with severe multifocal atherosclerosis, diabetes and recurrent pancreatitis. References are also provided for each case.

BACKGROUND: Studies have shown a high incidence of metabolic disorders and cardiovascular diseases in patients with primary hyperparathyroidism (PHPT). PHPT is usually diagnosed in people of age over 50 years and therefore age-associated changes of metabolism should be excluded. Researching predictors of cardiovascular pathology contributes to choosing optimal approaches to personalized patient management.AIM: To determine the features of metabolic disorders in patients of various age groups with confirmed active stage of PHPT.MATERIALS AND METHODS: A single-center observational retrospective comparative study of patients with active PHPT at the age of 18-49 years (Group 1, n=66) and over 50 years (Group 2, n=290) was carried out. The exclusion criteria for both groups were: persistent PHPT or recurrence after surgical treatment of the disease in history; clinical/genetically confirmed multiple endocrine neoplasia syndrome; for Group 1 — pregnancy, lactation. The assessment of laboratory parameters of mineral, carbohydrate, fat and purine metabolism obtained during a hospital examination was carried out, the frequencies of various metabolic disorders were determined and compared between age groups.RESULTS: There were no significant differences in parathyroid hormone and serum calcium levels between age groups, however, there were more severe hypercalciuria, a tendency to active bone metabolism and lower vitamin D level in Group 1. Patients of Group 2 had statistically significantly lower glomerular filtration rate and a higher frequency of bone complications. In the same group glycaemia and triglycerides levels were higher (the latter difference has the level of a statistical tendency). These patients also had a higher body mass index and, as a result, a higher incidence of obesity (37% vs 20%, p=0.006) and diabetes mellitus type 2 (12.5% vs 3%, p=0.013). At the same time, patients did not significantly differ in the rates of hypercholesterolemia (62% in Group 1 vs 70% in Group 2, p=0.228), hypertriglyceridemia (27% vs 32%, p=0.433) and hyperuricemia (42% vs 50%, p=0.302), significantly exceeding similar indicators in the general Russian population.CONCLUSION: Carbohydrate disorders are more often observed in patients older than 50 years, providing an increased prevalence of diabetes mellitus type 2 among patients with PHPT compared with the general population. The high incidence of various types of dyslipidemia and hyperuricemia in the primary parathyroid pathology has no age specific features. Thereby these disorders are significant risk factors of cardiovascular diseases, even in young people with PHPT.

Aim. To study clinical and functional manifestations of hypertriglyceridemia and its association with risk factors for cardiovascular and renal complications in individuals with high cardiovascular risk.Material and methods. The study included 272 patients (129 men and 143 women; mean age, 53,9±13,7 years) with a high cardiovascular risk, which was stratified using Systematic Coronary Risk Evaluation (SCORE) model by the presence of cardiovascular disease, and/or diabetes, and/or age ≥65 years, and/or blood pressure (BP) >180/110 mm Hg, and/or total cholesterol (TC) level >8,0 mmol/l. All study participants underwent clinical and paraclinical examination. Serum content of triglycerides (TGs) ≥1,7 mmol/L was considered hypertriglyceridemia (HTG). Depending on TG level, the entire sample was divided into 2 following subgroups: subgroup 1 (n=178) — serum triglycerides ≤1,6 mmol/l; subgroup 2 (n=94) — serum triglycerides ≥1,7 mmol/l, i.e. HTG.Results. We revealed significantly more persons with obesity (46,8%) and type 2 diabetes (28,7%) in HTG subgroup. There were 56,3% and 36,1% patients of HTG subgroup with hypertension (HTN) and coronary artery disease (CAD), respectively. A mid-high TG level (from 1,7 to 2,3 mmol/l) in the subgroup of patients with HTG was detected in 38,3% of cases. The serum content of TG from 2,3 to 5,6 mmol/l was detected in 54,2% of patients. TG level ≥5,6 mmol/l was detected in 7,5% of cases. In the subgroup of patients with HTG, high levels of systolic, diastolic and central (aortic) BP, body mass index, phosphorus, creatinine, cystatin C, estimated glomerular filtration rate (eGFR), and carotid intima-media thickness (IMT) were detected significantly more common. In the general sample, a significant direct relationship between TG concentration and cystatin C (r=0,168) and an inverse (negative) relationship with eGFR (r=-0,220) was obtained.Conclusion. Elevated serum TG levels are often observed in individuals with obesity, type 2 diabetes, hypertension and CAD. Patients with HTG had a pronounced cardiovascular and renal risk, including a significant increase in BP and carotid IMT, high levels of total cholesterol, low-density lipoprotein cholesterol, phosphorus, creatinine, cystatin C, and a decrease in eGFR. HTG was associated with an increase in serum cystatin C and a deterioration in renal nitrogen excretion.

In the presented case report, 27-year-old female patient consulted a dermatologist and a lipidologist due to the appearance of small red spots on the skin. At the stage of examination in the lipid center, the patient was diagnosed with diabetes. During additional examination in the department of endocrinology, the following diagnosis was made: "Newlu-diagnosed type 1 diabetes. Target glycated hemoglobin level 6,5%. Secondary dyslipidemia. Skin xanthomatosis". After the start of therapy, laboratory parameters improved and the number of eruptive xanthomas decreased. Eruptive xanthomatosis in clinical practice is rare, and requires apprehensive attitude of doctors of various specialties. Timely detection of lipid metabolism disorders allows patients to recommend not only rational measures to prevent the development and progression of atherosclerosis, but also to diagnose the causes of secondary dyslipidemia.

Aim. To analyze prevalence of cardiovascular risk factors in the Kemerovo region based on the results of epidemiological studies (2013 and 2016).Material and methods. The study was based on two large epidemiological studies of the Kemerovo region: on 2013, «The epidemiology of cardiovascular diseases and their risk factors in the Russian Federation» and on 2016, «The prospective study of urban and rural epidemiology: study of the influence of social factors on chronic non-infectious diseases in low, middle and high income countries». In the study we analyzed cardiovascular risk factors using identical questionnaires, functional, anthropometric, biochemical means and measured on identical scales. As a result, we analyzed the prevalence of smoking, diabetes mellitus, overweight and obesity, abdominal obesity, hypercholesterolemia and hypertriglyceridemia, high levels of low-density lipoprotein (LDL).Results. Univariate analysis indicates that in the sample of 2016, compared to the sample of 2013, the prevalence of smoking is statistically significantly lower, as well as the proportion of participants with high cholesterol levels, but not taking lipid-lowering drugs. In contrast, the prevalence of diabetes, hypercholesterolemia and hypertriglyceridemia is higher. In women, the frequency of abdominal obesity on 2016 is lower than on 2013: at 35-44 age group odds ratio (OR) =0.67 with 95% confidence interval (CI) 0.44-1.03, at 45-54 age group OR =0.47 with 95% CI 0.31-0.72, 55-65 age group OR =0.49 with 95% CI 0.30-0.79. A high incidence of diabetes, hypercholesterolemia and hypertriglyceridemia is characteristic mainly of older women (55-65 age group): accordingly, OR =1.96 with 95% CI 1.19-3.22, OR =1.42 with 95% CI 1,02-1.97, OR =1.51 at 95% CI 1.08-2.12. In the 45-54 age group of men, they smoked statistically significantly less often on 2016 compared to 2013, OR =0.59 with 95% CI 0.36-0.96. The prevalence of overweight and obesity in both samples is the same: for women, the OR for overweight in different age groups is within 0.74-0.87, for men - within 0.95-1.78; for obesity OR in women is from 0.70 to 0.79, in men - from 1.03 to 1.34.Conclusion. A significant advantage of the study is the analysis of changes in prevalence in age and gender groups, which showed significant differences in the dynamics of men and women in different age categories for a number of risk factors. Analysis of the dynamics of the prevalence of cardiovascular risk factors makes it possible to assess the effectiveness of state and regional policies in the field of health protection and, first of all, "risk groups” that require closer attention, development and implementation of targeted health-saving technologies.

The purpose of the work. Learning the features of spreading of hypertriglyceridemia among elderly population and its connection with hypercholesterolemia (HXS).Materials and methods. At the same time a survey questionnaire (SF-36 uestionnaire) was conducted and finger-prick blood was tested. The blood test trial was carried out with the help of «Accutrend Plus» portable device. The concentration of triglycerides and cholesterol appeared on the screen within 1-2 minutes with the help of the test system.Results. TG was found in 33,7±1,1% of the population, it was 1,8±2,2 mmol/l in 24,5±1,0%, correspondingly 2,3±5.6 mmol/l (Р

In opinion the Expert council provides management tactics for patients with hypertriglyceridemia (HTG). It is demonstrated that HTG is a common condition in overweight patients and is an important component of residual risk. HTG creates additional conditions for the progression of atherosclerosis, so the level of triglycerides (TG) is recommended to be measured in patients with a high, very high and extremely high risk level. An indication for the appointment of drugs that reduce the concentration of TG is its level of more than 2,3 mmol/L. Statins are the agents of choice to reduce the risk of cardiovascular disease in high-risk patients with hypercholesterolemia and HTG. Fenofibrate is used to correct HTG, and in case of intolerance to it or when the target level of TG is not reached, omega-3 ethers of polyunsaturated fatty acids in a dose of 2-4 g/day are recommended. In patients with HTG with a TG level >5,6 mmol/L, fenofibrate is the agent of choice.

Tactics for the management of patients with hypertriglyceridemia (HTG) is provided in the conclusion of the Advisory Board. It is demonstrated that HTG is quite prevalent in patients with excessive body weight and is an important component of residual risk. HTG creates additional conditions for the progression of atherosclerosis, and thus it is recommended to test triglyceride in patients with high, very high and extremely high cardiovascular risk. The indication for the pharmacological treatment to reduce the triglycerides concentration is their level more than 2.3 mmol/l. Statins are drugs of choice aimed to decrease the cardiovascular risk in patients with hypercholesterinemia and HTG. Fenofibrate is used to correct HTG; in case of its intolerance or if the triglyceride target level is not reached, ethyl esters of omega-3 polyunsaturated fatty acid can be used in the dosage of 2-4 g daily. In patients with triglyceride level higher than 5.6 mmol/l, fenofibrate is the main option of treatment.

Materials and methods. The results of lipid profile cross-sectional study of 2088 Bishkek residents aged 18—65 years who came to “Bonetsky Laboratory” from January to December 2016 were analyzed.Results. Among 2088examined residents there were 938 (44.9 %) men and 1150 (55.1 %) women; 48.4 % of them had an increased level of total cholesterol (≥5.2 mmol / l). The prevalence of hypercholesterolemia (HC) in women was higher (52.3 %) than in men (43.6 %). With age in both men and women, the increased frequency of HC was found, in men the peak was observed at the age of50—59years (50.3 %), and in women >60 years (61.2 %). HC associated with lipoprotein content (low-density lipoprotein >2.58 mmol/l) was found in 80.0 %, and in women more often than in men (81.6 and 78.1 % respectively). In both male and female, the greatest rise in HC dynamics was observed at the age of30—39years, then a monotonous rise of HCfrequency was observed in women (86.0 %) >60years, and in men the subsequent rise of HC from the age of 30—39 years was not observed. Reduced levels of high density lipoproteins up to 30 years of age were more common in women than in men (46.4 % vs 29.0 %). The peak in the frequency of low level of high density lipoproteins was found at the age of40—49years and was more often in women. Hypertriglyceridemia (>1.7 mmol/l) up to 30 years of age was registered with the same frequency regardless of gender and age (36.0 % in women, 37.0 % in men). Two-factor variance analysis for the lipid profile showed a high statistical significance of gender and age.Conclusion. The study showed a high prevalence of dyslipidemia among the population of Bishkek city. The presented data justify the necessity of active prophylaxis for primary and secondary prevention of ischemic heart disease among the population.

Acute pancreatitis is rarely observed during pregnancy, but it is connected with high mortality rate for the mother and fetus and deserves special attention. We present two clinical cases of hyperlipidemia during pregnancy, as in one of the cases hyperlipidemia induced acute pancreatitis. The outcomes in presented cases were favorable for the pregnant women and their fetuses. [ABSTRACT FROM AUTHOR]

The review presents the latest data from the world scientific literature of clinical studies of inhibitors protoprotein convertasesubtilisin/kexin 9 type (PCSK9). The results of the most important completed clinical trials and announcements of prospective clinical trials are presented, the completion of which is expected in the near future. The place of PCSK9 inhibitors in modern recommendations of the European and Russian Cardiological Society is highlighted.The results of studies on the efficacy and safety of PCSK9 inhibitors in selected patient groups (familial hypercholesterolemia, hypertriglyceridemia) are presented. A review of the research aimed at finding new inhibition mechanisms for PCSK9, opening new horizons in the treatment of patients with dyslipidemia.

In the review, modern views on the significant role of hypercholesterolemia (HCH), especially familial HCH, hypertriglyceridemia and hyperglycemia in the onset and development of coronary heart disease (CHD) and its complications (myocardial infarction) in young people 25-45 years are systematized. According to prospective studies of CHD, about 8-10 % of young men are ill. For the purpose of effective prevention of the disease, it is necessary to conduct screening examinations of the young population, which necessarily include the determination of blood levels of total cholesterol, low-density lipoprotein cholesterol and glucose.

ABSTRACT. Early initiation of artificial nutrition is one of the important components of intensive care for those affected with SMCT. The priority is given to enteral nutrition (EN). Parenteral nutrition (PN) is indicated in order to cover estimated needs in various substrates when EN cannot be performed or is inadequate. However, it must be taken into account that in addition to positive effects, PN may be followed by a number of complications: hyperglycemia, hypertriglyceridemia, impaired pulmonary function, increased thrombogenesis..PURPOSE OF THE STUDY. To assess the safety of PN, used as a component of mixed artificial nutrition in victims with SMCT.MATERIAL AND METHODS. Twenty patients with SMCT, conscious state up to GCS 6-13 and severity of the condition ISS 30-55 upon admission were examined. The age of victims was 40.2±13.1 years, the ratio of men/women was 17/3. All the victims had the diagnosis of brain contusion. In 9 patients, acute subdural hematomas were revealed. They underwent decompressive craniotomy and hematoma removal. The energy consumption was calculated using the Harris-Benedict equation with correction coefficients and indirect calorimetry (IC) method. IC was performed 24 hours a day also calculating respiratory coefficient. Nitrogen balance was studied to assess the severity of hypercatabolism. Enteral nutrition was initiated in all victims starting from day 2 after the injury. In connection with the impossibility of complete compensation of protein-energy requirements by EN, on day 8.8±1.3, PN was added. A three-component mixture of Nutriflex Lipid 70/180 (B. Braun, Germany), 625 ml was used. The concentration of triglycerides (TG) and glucose in venous blood plasma was assessed daily, as well as the ratio of oxygen tension in the arterial blood to the oxygen fraction in the inhaled mixture (PaO2 /FiO2 ).RESULTS. All patients had hypercatabolism prior to initiation of mixed artificial nutrition, and its severity lowered when mixed artificial nutrition was initiated (on day 3 of artificial nutrition in 11 patients, on day 5 in 3 patients and by day 7 in 6 patients). The introduction of PN “three in one” mixture was accompanied by a slight increase in the concentration of TG 2 hours after the start of the infusion and did not affect the dynamics of pulmonary gas exchange. The introduction of PN was accompanied by the development of hyperglycemia. The increase of glucose in venous blood serum was noted 2 and 12 hours after the onset of PN.CONCLUSION. Mixed artificial nutrition in patients with severe multisystem craniocerebral trauma does not lead to the development of hypertriglyceridemia and violation of pulmonary gas exchange and allows to achieve nutritional therapy goals.

This article presents innovative techniques for diagnostics, risk stratification and treatment of patients with hypertriglyceridemia. Hypertriglyceridemia is not only known as an independent risk factor of cardiovascular diseases, but also its high level can become a cause of acute pancreatitis.

The purpose of the review. Analyze basic data on the hypertrigliceridemia (HTG) role in the pathogenesis of HTG-associated acute pancreatitis (AP), and the current treatment of the disease. Recent literature data. HTG-associated AP met in 5-15 % of the AP cases. In the HTG-associated AP pathogenesis leading role belongs to obstruction of capillaries by TG and chylomicrons, local ischemia of the pancreas, as well as the accumulation of toxic free fatty acids by TG hydrolysis, resulting in damage to the acinary cells and capillary epithelium, which exacerbates acidosis and stimulates premature trypsinogen activation with the initiation of acute edematous or necrotizing pancreatitis. Modern treatment of HTG-associated AP include plasmapheresis to the TG levels of 300-500 mg/dL, then - diet, refuse from alcohol, drugs: omega-3 fatty acids, fibrates, nicotinic acid. Planned for lipoprotein lipase deficiency gene therapy by injecting a viral vector alipogen tiparvovek, resulting in significantly increasing of lipoprotein lipase activity, decreased plasma triglycerides and chylomicrons levels and decreases the incidence of AP.

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.

The metabolism, classification, biomedical implication and clinical application of polyunsaturated fatty acids (PUFAs) were analyzed. It was proved that PUFAs class omega-3 have positive effects on cardiovascular system. First of all, this is an antiarrhythmogenic action, which is accompanied by the increase in variability of heart rhythm. Omega-3 PUFAs cause the reduction in platelet activity and vasoactive mediator release (serotonin, thromboxane A2), vasodilatation, the reduction in inflammatory mediators release and endothelium permeability, the rising of endothelium dependent dilatation of vessels, the depression of vascular response on angiotensine П and noradrenalin. Omega-3 PUFAs are responsible for the reduction in blood pressure, the increase in erythrocytes elasticity, the fall of fibrinogen concentration and normalization of plasma lipid profile. Omega-3 PUFAs in large dozes show antiatherosclerotic effect. Clinical data showing that Omega-3 PUFAs increase in life time due to reduction in sudden death incidence were provided. It is suggested to use Omega-3 PUFAs (OMAKOR) for secondary prevention of ischemic heart disease and treatment of hypertriglyceridemia.

Goal. Central aortic pressure (CAP) is regarded as a perspective indicator of the cardiovascular risk. It is interesting to study the association between the CAP and the components of the metabolic syndrome. Research methods. We studied 69 individuals (46 women and 23 men) aged 56–78 years: 34 – research participants of the population sampling of Novosibirsk and 35 – outpatients. The components of the metabolic syndrome was determined according to the criteria of RSC 2009. Central aortic pressure was determined on a Sphygmo Cor (At Cor Medical, Australia). Omron HEM9000AI device (Omron, Japan) was used to calibrate the instrument. Data was analyzed in the GLM. Results are presented as mean value with a measure of the variation as an average error. Results. Multivariate analysis with the simultaneous inclusion in the model age, sex, abdominal obesity, hypertriglyceridemia, hypo-alpha-cholesterolemia, hyper-beta-cholesterolemia, fasting hyperglycemia have revealed that only hypertriglyceridemia was a significant independent determinant of systolic and diastolic CAP (p = 0,014 and p = 0,008, respectively) from all of analyzed components. Findings. The results of the study indicate that the central aortic pressure, regardless of age and sex was associated with only one component of the metabolic syndrome – hypertriglyceridemia.

Nonalcoholic fatty liver disease (NAFLD) is associated with major cardiovascular risk factors, such as type 2 diabetes mellitus, obesity, dyslipidemia, hypertension, and insulin resistance, and has been recently considered to be a new component of metabolic syndrome and it serves as a criterion for the hepatic manifestation of the latter. The review considers the present-day views and approaches to diagnosing and treating NAFLD and its dangerous manifestation - fibrosis (sclerosis), which may lead to cirrhosis and hepatocellular carcinoma. Fibrogenesis is a widespread and universal process that is a final path of chronic inflammation of and damage to different tissues (including those of the liver and cardiovascular system). Although the mechanisms for developing NAFLD remain unclear, insulin resistance, an obesity-related slowly progressive inflammatory response, and elevated levels of free fatty acids with their lipotoxicity along with possible genetic, dietary, and environmental (lifestyle) factors play a key role in the pathogenesis of this disease. So it is important for patients at high risk for NAFLD or with existing liver disease to pay attention to their life style, proper balanced diet, and slow and gradual weight loss. At present there are drugs that can improve liver function. Success in NAFLD therapy will be determined by the identification of the most significant pathogenetic factors in a specific patient and by the purposeful action on them.

The review concerns he etiology of polygenic hyperlipidemias. The most prominent and prevalent in more than 1% of inhabitants genetic markers are discussed. The mechanisms of minor alleles influence on the hypercholesterolemia are shown: APOAI 75G>A (rs670), CETP (rs5882), LIPC (rs1800588), APOE (E2/E3/E4), hypertrigliceridemia: APOA5 (rs3135506), FABP2 rs1799883, LPL rs328. Also the genetic markers discussed that influence food-seeking behavior and by various ways do increase daily fat intake: CD36 (rs1761667), FTO (rs8050136), MC4R (rs17782313). Carrying of several pathologic alleles in a patients does significantly increase the risk of primary hyperlipidemias. More studies needed to evaluate the effect of different genetic markers combination to invent these tests as an instrument of personified predictive medicine in clinical practice.

Now to the independent predictors of cardiovascular events include indicators of arterial stiffness. It is shown that the arterial stiffness and, in particular, pulse wave velocity is increased in patients with the metabolic syndrome. It is of interest to what exactly the components of the metabolic syndrome, regardless of age is associated pulse wave velocity. We studied 63 individuals (45 women and 18 men) aged 56–78 years. The components of the metabolic syndrome was determined according to the criteria of ВНОК 2009. Pulse wave velocity in the carotid-femoral segment determined the device SphygmoCor. When analyzing the data in univariate model was registered significant association of pulse wave velocity with the age of participants (p = 0.001), hypertension (p = 0.009) and hypertriglyceridemia (p = 0.004). Multivariate analysis with the simultaneous inclusion in the model variables such as age, sex, abdominal obesity, hypertension, hypertriglyceridemia, hypo-alpha-cholesterolemia, hyper-beta-cholesterolemia, fasting hyperglycemia, has revealed that out of all of these components of the metabolic syndrome, a significant independent determinant of pulse wave velocity, along with age (p = 0.008) are only hypertriglyceridemia (p = 0.024).

The aim of the current study was to evaluate the therapeutic effects of omega–3 plant sterol esters (n–3–PSE) on lipid profile and other coronary heart disease risk factors in subjects with mixed hyperlipidemia. N–3–PSE treatment did not result in a significant change in LDL–C levels. Triglyceride levels were reduced significantly in the n–3–PSE group in comparison with the placebo group (p = 0.025). Diastolic blood pressure and level of high-sensitivity C–reactive protein (hsCRP) were reduced significantly, too. So, in patients with mixed hyperlipidemia, n–3–PSE treatment may offer a safe and effective therapy for triglyceride level reduction while avoiding the typical increase in LDL–C levels associated with n–3 fatty acid treatment. The observed reduction in blood pressure and inflammation markers warrants further evaluation. The positive effect of n–3–PSE treatment was preserved at the end of the follow up phase.

Aim: to study the role and relationship of lipid metabolism and levels of proinflammatory cytokines in patients with type 2 diabetes mellitus (DM2) with diabetic nephropathy (DN), depending on the stage of chronic kidney disease (CKD). Materials and Methods: a total of 240 patients with type 2 diabetes in the early stages of DN and CKD were studied. Results: in patients with type 2 diabetes development of DN was associated with an increased level of proinflammatory cytokines and lipid abnormalities (hypertriglyceridemia). We found a negative correlation between the level of triglycerides (TG) and glomerular filtration rate (GFR) (r = -0,43) and a direct correlation between the level of IL-6 and TG (r = 0,48). Conclusions: increased levels of proinflammatory cytokines and triglycerides increase the risk of development and progression of DN and CKD.

Aim. To assess lipid-lowering effectiveness of generic atorvastatin in patients with various hyperlipidaemia (HLP) phenotypes in an open, short-term (four weeks) study.Material and methods. All participants were divided into two groups — with isolated hypercholesterolemia (HCH) and normal fasting triglycerides, (n=25), and with combined HLP and TG levels >1,7 mmol/l (n=26). Atorvastain dose was 20 mg/d. Serum levels of total cholesterol (TCH), TG and high-density lipoprotein cholesterol (HDL- CH) were measured by standard enzyme methods. Medication effectiveness was assessed by the reduction in low- density lipoprotein CH (LDL-CH) and TG levels.Results. In both groups, the medication significantly decreased serum levels of LDL-CH by 34-36,4%, without any substantial inter-group difference. However, lipid-lowering effect in patients with lower baseline TG levels was stronger than in individuals with normal TG concentrations — 27,1% and 12,9%, respectively (p=0,027).Conclusion. Cholesterol-lowering effect of generic atorvastatin (20 mg/d) was similar in patients with IIa and IIb HL. The effect on TG levels depended on HLP phenotype and was greater in individuals with higher baseline TG levels.

Aim. To analyse atypical variants of dyslipidemia (DLP) in coronary heart disease (CHD).Material and methods. The study included rehabilitation unit patients with myocardial infarction (MI). Over 5 years, 78 patients with severe hypertriglyceridemia (HTG) or selective decrease in anti-atherogenic lipoproteins were selected. The patients with the DLP phenotypes most typical for CHD (IIa, IIb) were not included in the study. Mean age of the participants was 46± 1 years. All participants were divided into three groups: with combined hyperlipidaemia (HLP) due to increased cholesterol (CH) and triglycerides (TG), but with prevalent HTG — Group I (n=24); with isolated HTG — Group II (n=23); with selective reduction in high- density lipoproteins (HDL) — Group III (n=31).Results. Group I was characterised by substantial increase in the levels of CH and TG (6,8±0,5 mmol/l); Group II — by isolated increase in TG level (4,1±0,4 mmol/l); and Group III — by selective reduction in HDL-CL concentration (0,82±0,02 mmol/l).Conclusion. Atherosclerosis and its complications might develop not only in HLP IIa and IIb, but also due to HTG or decreased anti-atherogenic lipoprotein levels. All primary DLP are hereditary, but typically they are linked to polygenic defects — i.e., are dependent on functionally important nucleotide polymorphisms in genes regulating lipid metabolism.

Aim. To assess a hypolipidemic effect and tolerance of phenofibrate (lipantil 200M) in different variants of treatment in patients with combined hyperlipidemia having moderate and high levels of triglycerides (TG). Material and methods. A total of 26 patients (16 males, 10 females; age 32-67, mean age 55.1 years) received lipantil 200M (phenofibrate) in a dose 200 mg for 12 weeks either as monotherapy or in combination with statins (or fibrate) or plasmapheresis. Clinical, biochemical and blood lipid parameters were studied at baseline and after 12-week treatment. Baseline mean value and standard deviation of a blood cholesterol level was 8.3 (15.4) mmol/l, TG - 7.2 (70.5) mmol/l). Results. A mean cholesterol level decreased by 26.1%, TG - by 64.4%. Correlation with initial values was found. Systolic and diastolic blood pressure diminished significantly. No significant changes were found in the levels of AST, ALT, GGT, CPK, alkaline phosphotase, total bilirubin, creatinine. Before the treatment blood glucose was elevated in 14 patients, after 12-week therapy it remained elevated in 10 patients. Conclusion. Lipantil 200 M (phenofibrate) had a good hypolipidemic effect in patients with combined hyperlipidemia in different baseline levels of cholesterol and TG elevation and in different variants of treatment. Significant side effects were not registered.

Aim. To study clinical course and severe complication development in patients with severe hypertriglyceridemia (HTG), >10 mmol/l. Material and methods. The study included 75 patients aged 21-68 years (mean age 49±11,05 years), examined at the Cardiology Complex in 1982-2006, with verified fasting HTG >10 mmol/l. Results. Coronary heart disease (CHD) was observed in 45,2% of the participants (50% males, 37% females), arterial hypertension (AH) – in 68% (60,4% and 81,4%), Type 2 diabetes mellitus – in 42,6% (44,4% and 41,7%), pancreatitis – in 34,9% (33,3% and 37,5%, respectively). Conclusion. In patients with severe HTG, high rates of CHD, AH, metabolic syndrome and pancreatitis were observed. Therefore, to prevent severe complications in such patients, detailed examination and adequate TH and cholesterol level control are necessary.

The review is devoted to modern views on hypertriglyceridemia (HTG) etiology and pathogenesis, and its casual role in some disease development. Data on normal TG metabolism, main causes of HTG, its clinical role and diagnostics are discussed. Even though HTG plays an important role in atherosclerosis, pancreatitis, Alzheimer disease, pre-eclampsia development, it is still inadequately described, from clinicians’ point of view.

Aim. To compare efficacy of simvastatin, a II generation statin, and ciprofibrate, a III generation fibrate, in various types of hyperlipidemia (HLP) and fibrate pharmacokinetic variants. Material and methods. The authors examined 156 males with primary HLP, aged 41-59. Inclusion criteria were: initial cholesterol (CH) >190 mg/dl; triglycerides (TG) >150 mg/dl; high-density lipoprotein CH >35 mg/dl. Clinical, biochemical, pharmacokinetic, and statistical methods were used. Results. Analysis of lipid-transport system in patients with isolated hypertriglyceridemia (HTG) during 8-week ciprofibrate therapy demonstrated decreases in TG (by 39.2%; pIII-V

Aim      To evaluate economic results of using omega-3 acid ethyl esters 90 for primary prevention of cardiovascular catastrophes in patients with residual hypertriglyceridemia (HTG).Material and methods  The economic evaluation of using the medicine omega-3 acid ethyl esters 90 in the system of drug provision of the population of the Russian Federation was performed by analyzing the effect on the budget using a pharmacoeconomic model developed with the Microsoft Office Excel 2016 software. The effect of omega-3 acid ethyl esters 90 was evaluated in 555 643 patients with residual HGT (Moscow). The study lasted for one year. Results of the meta-analysis by A.A. Bernasconi et al. (2020) were used as a source of efficacy data. The following direct and indirect medical expenses for treatment of cardiovascular complications of residual HTG were taken into account in this study: expenses for drug therapy; expenses for therapy and rehabilitation for nonfatal complications; expenses for fatal outcomes; state support for disability; foregone per capita gross domestic product resulting from losses of earnings due to temporary incapacity to labor by people of work-able age; and salary payments for temporary incapacity to work.Results Using omega-3 acid ethyl esters 90 in 555 643 patients with residual HTG will allow preventing 1 437 fatal ischemic cardiovascular complications (including 564 deaths from ischemic heart disease and 1 128 cases of myocardial infarction (MI), including 558 fatal cases of MI). Furthermore, the difference in expenses compared to the high-dose statin treatment alone will be 359 252 253 rubles or 0.32 %.Conclusion      The results of this comprehensive pharmacoeconomical study showed that the use of omega-3 acid ethyl esters 90 in patients with residual HGT is an economically preferrable strategy compared to high-dose statin treatment alone and does not influence significantly the budgetary expenses as a part of the State Guarantee of Free Medical Care to the Citizens of the Russian Federation (increase in expenses by 0.32 % compared to the current practice). At the same time, the use of omega-3 acid ethyl esters 90 results in a 10% decrease in the number of fatal ischemic cardiovascular complications.

Aim:  To study influence of hypertension, overweight, hypertriglyceridemia and their combinations for all-cause and cardiovascular mortality risk formation. Methods. The prevalence of hypertension, overweight and hypertriglyceridemia was studied (1988-1991) by 27-year prospective cohort study of unorganized population of Tomsk (1546 persons - 916 female and 630 male). The predictive value of these risk factors for all-cause and cardiovascular mortality risk formation were researched in 2015. Hypertension was diagnosed in persons with blood pressure greater or equal to 140/90 mm Hg, overweight was diagnosed in people with body mass index 25 kg/m2, hypertriglyceridemia was diagnosed in individuals having high blood level of triglycerides (greater or equal to 1.7).  Results.  Influence of hypertension for all-cause (relative risk (RR) 2.2) and cardiovascular mortality (RR 3.38) risk formation was detected. A hypertension related elevation of mortality risk was observed both among women and men and in all age groups with the exception of men 40-59 years (the results for cardiovascular mortality in these persons was statistically insignificant). We established that hypertension had the independent significant contribution for mortality risk formation. It is shown that RR of all-cause mortality 1.25 times (cardiovascular mortality 1.8 times) more in overweight persons. Increase of relative mortality risk was detected in overweight women, especially in women 20-39 years old. Hypertriglyceridemia increases relative risk of all-cause mortality 1.46 times, relative risk of cardiovascular mortality 2.15 times, especially in individuals 40-59 years old. It was revealed that hypertriglyceridemia is significant risk factor for all-cause mortality formation only in women. Combination of hypertension and overweight increases the risk of all-cause mortality 2.23 times and the risk of cardiovascular mortality  4.0 times, combination of hypertension and hypertriglyceridemia - 2.83 and 5.06 times,  combination of overweight and hypertriglyceridemia - 1.73 and 2.99 times, respectively. We detected the additional risk of hypertriglyceridemia in individuals with overweight for all-cause (RR 1.53) and cardiovascular (RR 2.18) mortality risk formation compared with overweight persons with normal level of triglycerides and also the additional risk of hypertriglyceridemia (RR 1.51 and 2.04, respectively) in individuals with hypertension compared with normotensive persons (p<0,05). The additional risk of overweight in individuals with hypertension for all-cause mortality was found only in women (RR 3.23). Conclusion. The independent significant impact of hypertension for all-cause and cardiovascular mortality risk formation was revealed by the results of 27-year prospective study. Combination of hypertension and hypertriglyceridemia increases the risk of all-cause mortality 2.8 times and the risk of cardiovascular mortality 5.1 times, combination of hypertension and overweight - 2.2 and 4 times, combination of overweight and hypertriglyceridemia - 1.7 and 3 times, respectively. We detected the additional risk of hypertriglyceridemia for all-cause mortality in overweight people (RR 1.5) and in individuals with hypertension (RR 1.5). Also, the additional risk of hypertriglyceridemia for cardiovascular mortality risk formation in overweight people (RR 2.2) and in persons with hypertension (RR 2.0) was found.

Aim: to elucidate predictors of high level of basal triglycerides (TG) in blood of children of persons with early (onset: men ≤55, women ≤60 years) ischemic heart disease (EIHD)., Materials and Methods: We examined 316 families: patients (probands) (n=295; 77.9 % after MI) with EIHD, their spouses (n=219; 83.1 % women) and native children of probands (n=413; 55.7 % men) aged 5-38 years. In children aged 5-17 and 18-38 years proband's spouse was mother in 88 and 77 % of cases, respectively. Hypertriglyceridemia in children (HTG) was defined in persons aged 5-17 years as ≥90 percentile (Lipid Research Clinics), ≥18 years - ≥1.7 mmol / l or HTG drug treatment. Predictors of HTG were selected by binary logistical regression with adjustment for age, sex and drugs., Results: HTG was found in 31 / 158 children aged 5-17 years. Its independent predictors were systolic arterial pressure (odds ratio [OR] of top [>108] vs. two bottom [≤108 mm Hg] tertiles 3.85, 95 % confidence interval [CI] 1.38-10.7, р=0.010), heart rate (HR, OR of top [>78] vs. two bottom [≤78 bpm] tertiles 2.94, 95 % CI 1.20-7.23, р=0.019), and high density lipoprotein cholesterol (HDL-C, OR 0.35, 95 % CI 0.13-0.94; р=0.038) of their children; HR (OR of top [>72] vs. two bottom [≤72 bpm] tertiles 3.56, 95 % CI 1.38-9.11, р=0.008), low density lipoprotein cholesterol (OR 2.49, 95 % CI 1.12-5.52, p=0.025]), and type 2 diabetes (OR 25.9, 95 % CI 1.01-665.3; p=0.049) of the parent - proband's consort. HTG was found in 35 / 255 children aged 18-38 years and was associated with own age (OR 1.10, 95 % CI 1.02-1.19, р=0.012) and male sex (OR 6.21, 95 % CI 2.45-15.8; р=0.000). HTG was independently associated with body mass index (OR top [>25.4] vs. two bottom [≤25.4 kg / m2] tertiles 4.94, 95 % CI 2.13-11.4, р=0.000); basal glycemia (OR top [5.1] vs. two bottom [≤5.1 mmol / l] tertiles 2.52, 95 % CI 1.17-5.43, р=0.019); HDL-C (OR 0.17, CI 0.04-0.81, 0.027); alcohol consumption (OR consuming more than once vs. once a week and less 2.27, 95 % CI 1.02-5.02, p=0.044) of these children; HDL-C (OR 0.19, 95 CI 0.04-0.94; p=0.041) of the proband-parent., Conclusions: HTG in children aged 5-38 years with parental early IHD was independently associated mainly with own characteristics, forming components of metabolic syndrome. Attention should be paid to the dominance of maternal transmission in children and adolescents (age group 5-17 years).

Aim: To assess the relationship between hypertriglyceridemia (THG) and left ventricular remodeling types in patients with chronic kidney disease(CKD)., Materials and Methods: A total of 152 patients with CKD from stages 1 to 3 were examined, 98 of them with CKD without THG (subgroup 1) and 54 with CKD and THG. All patients were assessed for the parameters of anthropometry, hemodynamics, lipid spectrum, uric acid, calcium, C-reactive protein (CRP), and serum cystatin C measurement with calculation of glomerular filtration rate. The parameters of vascular stiffness (augmentation index and stiffness) and echocardiography are analyzed., Results and Discussion: In the 2nd subgroup (CKD + THG), the number of patients suffering from type 2 diabetes, a stable form of coronary heart disease, gout, and their combination with hypertension, as well as cerebrovacular disorders and hyperuricemia was significantly higher compared with patients with CKD without GTG (p.

Inhibition of hydrolysis of palmitic and oleic triglycedires (TG) in very low density lipoproteins (VLDL), slow formation of active apoВ-100 conformation, blockade of апоЕ/В-100 ligand formation in VLDL and their reduced uptake by insulin-dependent cells cause hypertriglyceridemia (HTG). Palmitic and oleic VLDL (>80% total VLDL) are not converted in low density lipoproteins (LDL). Atherosclerosis is not an alimentary deficiency of polyenic fatty acids (PFA), but results from low in vivo bioavailability of PFA in LDL against the background of high dietary palmitic FA and palmitic LDL. Plasma PFA content and cellular PFA deficiency are as high as LDL cholesterol (CL). Primary prevention of atherosclerosis should be based on a decrease in dietary content of palmitic saturated FA, trans FA and a moderate increase in PFA. It seems highly unlikely that the xeobiotics statins, fibrates and probucol produce pleiotropic biological effects in vivo. These effects are brought about by phylogenetically early humoral mediators eicosanoids: prostacyclins, prostaglandins, thromboxanes, leukotrienes, and resolvins. It is reasonable to suggest that all preparations which act according to the same algorithm activate TG hydrolysis in VLDL and normalize cellular uptake of PFA in linoleic and linolenic LDL via apoВ-100 endocytosis. Atherosclerosis is a syndrome of cellular deficiency of essential polyenic FA., Competing Interests: The authors declare no conflict of interest.

Study Aim: The main purpose of the study was to estimate prevalence of subjects with hypertriglyceridemia (HTG) in Russia. Secondary objectives were to explore HTG prevalence by levels, age and sex, and to assess correlation between glycated hemoglobin (HbA1C) and triglyceride (TG) level. Additionally, we analyzed geographical differences in HTG prevalence in regions of Russia., Methods: This was a cross-sectional, retrospective, observational study using database of results of lipid profile determination in 357,072 subjects from 254 Russian cities during the 3-year period from 2011 to 2013., Results: Altogether, 29.2% (95% confidence interval [CI] 29.1-29.4%) of Russian individuals had HTG (serum TG more or equal 1.7 mmol/L). The percentage of patients with very high (TG more or equal 5.6 mmol/L) and severe HTG (TG more or equal 10.0mmol/L) was low (0.01% and 0.011%, respectively). At the same time, the portion of subjects with mixed hyperlipidemia (total cholesterol [TC] more or equal 5.2mmol/L, low-density lipoprotein cholesterol [LDL-C] more or equal 3.4 mmol/L, TG more or equal 1.7 mmol/L) was 19% of the study population. Men had 1.25 (95% CI, 1.24-1.26) times higher risk of HTG than women. Prevalence of HTG increased with age: in women TG level was maximal in the age group 60-69 years (34%), whereas in men TG level was maximal in the age group 40-49 years (43%). Prevalence of HTG increased from 2011 to 2013 from 28 to 30% (p<0.0001). Risk of HTG was 1.69 times greater when high HbA1C more or equal 6.5% was present, and vice versa, risk of HbA1C more or equal 6.5% was 2.04 times higher in individuals with HTG. Distribution of HTG and dyslipidemia by regions of Russia had large variability being higher in the south and lower in the northern regions of European part of Russia., Conclusion: Almost a third of Russian population has HTG. Men have higher risk of HTG than women. Prevalence of HTG increases with age and reaches its peak in age groups 60-69 years in (women) and 40-49 years (men). There is a linear association between high HbA- and high level of TG. Prevalence of HTG and dyslipidemia is heterogeneous in Russian regions.