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Aim. To evaluate the associations of abdominal obesity (AO), adipokines and premature coronary artery disease (CAD) in young people for a deeper understanding of the pathogenesis of atherosclerotic diseases.Material and methods. A total of 1457 people were examined, including 653 (44,8%) men. Mean age was 36,7±6,0 years. Premature CAD was detected in 46 people, while 4 following subgroups were formed (138 people in total): with CAD and AO; with CAD, without AO; control groups by age and sex: without CAD, with AO; without CAD, without AO.Results. Premature CAD in young people is associated with an increase in non-high-density lipoprotein cholesterol (non-HDL-C). Univariate analysis found that the probability of CAD increased by 1% with an increase in adiponectin level, and by 0,2% with an increase of 1 ng/ml in resistin level. Multivariate regression analysis, including sex, age, waist circumference, non-HD-C, adiponectin, and resistin, significant associations were obtained for non-HDL-C and adiponectin. With AO, the CAD probability increased by 0,6% with an increase in plasminogen activator inhibitor-1 level (PAI-1). However, when non-HDL-C was included in the model, significance for this biomarker was not achieved.Conclusion. In young people, CAD is associated with increased levels of non-HDL cholesterol, adiponectin, resistin and PAI-1. Independent associations with premature CAD were obtained only for adiponectin, which makes this marker promising for study in young people.

Interleukin (IL) 6 is one of the key cytokines whose role in the inflammation development in rheumatoid arthritis (RA), is well proven. The pleiotropic effects of the cytokine and biologic agents that inhibit its action have been studied much worse. The review provides information on the effects of IL-6 and blocking its signaling pathway on adipose tissue, glucose metabolism and adipocytokine levels in RA. It has been shown that prolonged blockade of IL-6 receptors does not lead to the adipose tissue accumulation and improves glycemic control, although it is not clear whether such effect is associated only with the anti-inflammatory properties of tocilizumab and sarilumab. Moreover, the mechanism of this beneficial effect is not fully understood, since the data on increased sensitivity of peripheral tissues to insulin during tocilizumab treatment are ambiguous. Perhaps changes in the relationship of adipocytokines or hormones play a certain role.

According to the recent World Health Organization statistics, cardiovascular disease (CVD) is one of the leading causes of high mortality worldwide. While obesity is a major and persistent risk factor for CVD, the cause of this condition, the pathological molecular connection between peripheral fat depots and the heart, remains poorly understood. The aim of this review is to introduce the reader to the metabolic activity of epicardial adipose tissue (EAT), the consequences of excessive epicardial fat accumulation and the development of heart failure (HF).EAT is visceral adipose tissue that is in direct contact with the myocardium and coronary vessels and can influence cardiac function through both mechanical effects and more subtle paracrine molecular mechanisms. HF with preserved ejection fraction (HFpEF) is closely associated with obesity and patterns in fat distribution. Excessive amounts of EAT are associated with abnormal hemodynamics in HFpEF, with the potential for direct mechanical effects on the heart causing a constriction-like effect and local myocardial remodeling effects resulting from the secretion of inflammatory mediators. However, patients with excess EAT tend to have more subcutaneous adipose tissue, making it difficult to determine a cause-and-effect relationship between epicardial fat and HFpEF. This review provides evidence that excess EAT is an important part of HFpEF pathogenesis.

Cardiovascular disease (CVD) in type 1 diabetes mellitus (T1DM) is preceded by asymptomatic changes in the geometry of the heart. The only symptoms of the beginning of cardiac remodeling and concomitant predictors of an unfavorable cardiovascular prognosis are: thickening of epicardial fat (EAT), secreting a number of adipokines, and cardiospecific miRNAs. To improve the effectiveness of prevention of CVD in young patients with DM1, a search was made for structural-functional and epigenetic markers. Aim. To assess the state of the cardiovascular system according to MRI-heart with T1 mapping in T1DM without CVD. To reveal the relationship of epigenetic markers (circulating miR-126-5p, miR-21-5p) and adipokines with cardiovascular system in T1DM. Suggested personalized approach to patients with T1DM with initial manifestations of joint remodeling and/or exclusion of cardiospecific microRNA. Materials and methods. The study included 40 patients: 30 with T1DM (age 26.2±7.4 years), 10 without T1DM (26.4±8.2). The patients underwent a general clinical examination, bioimpedancemetry, electrocardiography, MRI of the heart with T1 mapping, determination of adiponectin, resistin, visfatin, NT-proBNP, miR-126-5p, miR-21-5p. Results. Patients with T1DM had lower levels of cardioprotective miR-126-5p (p=0.046). According to MRI of the heart in T1DM, signs of vascular remodeling were revealed – thickening of the interventricular septum (p=0.001), posterior wall (p=0.012) and relative size of the walls (p=0.048) of the left ventricle, an increase in EAT density (p=0.001). Diffuse vascular fibrosis was found in 16% of patients from the T1DM group. Also, in T1DM, the expression of visfatin is increased (p=0.036) and adiponectin is reduced (p=0.043). Conclusion. Structural and functional changes in the cardiovascular system (including thickening of the EAT), shifts in miR-126-5p expression and adipokines profile are observed already at a young age in patients with T1DM. In T1DM, diffuse vascular fibrosis is detected in 16% of patients. The data obtained were used to identify the group increased risk of developing CVD in T1DM and served as the basis for determining the timing of the start of preventive therapy.

Early screening of complications of diabetes mellitus (DM) is one of the priorities for public health. Most patients with type 1 diabetes mellitus (T1DM) are patients of working age. New strategies for the primary prevention of cardiovascular disease (CVD) are needed to prevent their early disability. Aim. To assess the predictive value of adipokines in relation to a personalized approach to the need for an in-depth examination of young patients with T1DM. Materials and methods. The study included 98 patients without CVD: 70 patients with T1DM (mean age 26.48.1 years) and 28 patients without DM (mean age 279 years). All patients underwent a general clinical examination, the levels of adipokines were determined, ergospirometry, echocardiography, and bioimpedancemetry were performed. Results. Changes in the cardiorespiratory system in patients with T1DM were revealed, in comparison with persons without T1DM: anaerobic threshold was reached faster (p=0.001), maximum oxygen consumption was lower (p=0.048), metabolic equivalent was reduced (p=0.0001). Signs of myocardial remodeling were found in the T1DM group: there was an increase in the relative wall thickness (p=0.001), the posterior wall of the left ventricle (p=0.001), myocardial mass index (p=0.049), in comparison with persons without T1DM. Changes in the adipokines system were revealed: higher levels of resistin (p=0.002) and visfatin (p=0.001), lower level of adiponectin (p=0.040) in T1DM. A positive correlation was found between posterior wall of the left ventricle and visfatin (p=0.014) and a negative relationship between adiponectin and relative wall thickness (p=0.018) in T1DM. Conclusion. In T1DM, even at a young age, there are multifactorial changes in the heart, which can be detected even at the preclinical stage. The data obtained can be used to identify groups of patients at high risk of developing dangerous CVD in T1DM, which can form the basis for determining the timing of the start of preventive therapy.

Objectives: to evaluate the effectiveness of multidose supplementation of vitamin D on the dynamics of serum levels of markers of lipid metabolism in pregnant women with obesity. Materials and methods. The study included 75 pregnant women with the І degree of obesity and low vitamin D status, who were divided into subgroups depending on the vitamin D dose of and the baseline 25(OH)D level in blood serum: I subgroup – 24 women with 25(OH)D less than 22.0 ng/ml who received Decristol 4000 IU/day; II subgroup – 26 pregnant women with 25(OH)D = 22.1–28.0 ng/ml who received Decristol 2000 IU/day; III subgroup – 25 patients with 25(OH)D over 28.1 ng/ml, who received 1000 IU of vitamin D per day. Pregnant women of all these subgroups also took acetylsalicylic acid at a dose of 100 mg/day. The control group included 26 practically healthy women who received 600 IU of vitamin D per day. Serum adipokinins levels were studied at 11–13, 22–24 and 31–33 weeks of gestation. Results. Significant differences were found in the increase of leptin (p < 0.0001) and resistin (p < 0.0001) and the decrease of adiponectin (p = 0.006) in pregnant women with impaired vitamin D metabolism against the background of moderate obesity in the І trimester compared to the control group. A more positive effect was found for Decristol 4000 IU (patients with vitamin D deficiency), against the treatment of Decristol 2000 IU (patients with vitamin D deficiency). At 31–33 weeks of gestation, there was a statistically significant decrease in serum level of resistin (p = 0.006) and a similar increase in adiponectin (p = 0.025) in patients receiving vitamin D 4000 IU, compared with the same indicators in clinical subgroups. Resistin and adiponectin may be markers of perinatal pathology in obese pregnant women in the first trimester of gestation, in terms of specificity (91.5 and 78.7%, respectively), sensitivity (100.0 and 91.3%, respectively); positive probability (11.75 and 4.29%, respectively), negative prognostic value (100.0 and 94.9%, respectively) and test accuracy (94.3 and 82.9%, respectively). Conclusions. The use of markers of lipid metabolism as diagnostic criteria during pregnancy in women with the І degree of obesity and low vitamin D status has predictor and prognostic value for the risk of perinatal pathology and helps to assess the effectiveness of comprehensive prophylactic therapy.

Metabolic syndrome is a symptom complex that is based on visceral obesity and insulin resistance. Its prevalence is quite high, which is a big problem, since this condition increases the risk of developing cardiovascular diseases and mortality from them. Metabolic syndrome includes, in addition to abdominal obesity, arterial hypertension, disorders of carbohydrate, lipid and purine metabolism. Visceral adipose tissue plays a key role in the formation of insulin resistance and other components of the metabolic syndrome. This is due to the fact that abdominal fat, in contrast to subcutaneous fat, synthesizes pro-inflammatory cytokines, as well as adipokines — adipose tissue hormones that are involved in the formation of insulin resistance, affect carbohydrate and fat metabolism and the cardiovascular system. These include leptin, adiponectin, resistin, apelin and others. Some adipokines have an adverse effect on metabolism and increase cardiovascular risks, while others, on the contrary, have a positive effect. Taking into account their role in the development of the components of the metabolic syndrome, the possibilities of a therapeutic effect on the hormones of adipose tissue to improve metabolic processes and prevent complications associated with it are discussed.

Aim. To evaluate the cardiovascular risk (CVR) based on arterial stiffness and content of adipokines in young-aged persons of different ethnicity (European and South Asian). Materials and methods. 290 persons of European (Slavic) and South Asian (Korean) ethnicity aged from 19 to 49 years with and without arterial hypertension (AH) were examined. Clinical, anthropometric, laboratory examinations were performed, levels of resistin and adiponectin of blood were assessed. Total CVR was assessed by SCORE scale, patients under the age of 40 years were assessed by relative risk scale. Aortic stiffness was examined by non-invasive arteriography. Results. Patients of European ethnicity had higher blood pressure (BP), body mass index (BMI), waist circumference (WC), levels of resistin and adiponectin. Pulse wave velocity in the aorta (PWVA) did not differ significantly in ethnic groups. According to the SCORE scale in individuals of the European and South Asian races in general groups and groups with arterial hypertension a moderate absolute risk was determined, in individuals under 40 years of age a moderate relative risk was determined without a significant difference between the groups. However increased levels of PWVA (more than 10 m/s) were registered more often in Korean ethnicity (46.9% compared to Slavic ethnicity, 22.2%). Closer reliable correlations between the level of BP and BMI, WC, PWVA were revealed in Korean ethnicity. Ethnic differences in correlation of adipokines in blood and their dependence on anthropometric and hemodynamic characteristics were described. Conclusion. The assessment of CVR according to traditional scales does not always accurately represent its real level. New information was obtained on the features of adipokine metabolism and its connections with early manifestations of vascular remodeling in young-aged depending on the race. Taking into account ethnic differences, we recommend in-depth diagnostics of CVR in South Asians. The data can be useful for the design of personalized programs for the diagnostics and assessment of CVR.

Aim. To determine the prevalence of refractory hypertension (RfH) in patients with and without type 2 diabetes mellitus (DM), as well as to evaluate whether diabetic patients with RfH significant differ from those with uncontrolled resistant hypertension (RH) in clinical phenotype, metabolic profile and endothelial function. Materials and methods. The study included 193 patients with RH: RH 74 patients with diabetes and 119 patients without DM. Uncontrolled RH and RfH were defined by the presence of uncontrolled blood pressure BP (140 and/or 90 mm Hg) despite the use of 3 but 5 antihypertensive drugs (for RH) and 5 antihypertensive drugs, including a mineralocorticoid receptor antagonist (for RfH). Clinical examination, lab tests were performed. Flow-mediated dilation (FMD) and vasoreactivity of middle cerebral artery (MCA) using both breath-holding and hyperventilation test were measured by high-resolution ultrasound. Results. The prevalence of refractory hypertension in patients with and without DM was similar (30% vs 28%, respectively). No differences in BP levels, data of echocardiography and clinical phenotype were found between the diabetic groups, but value of HOMA index, plasma resistin level and postprandial glycaemia were higher in patients with RfH. FMD and MCA reactivity to the breath-holding test were worse in patients with RfH, and they had a more pronounced vasoconstrictor response of MCA to the hyperventilation test compared to patients with RH. Conclusion. The prevalence of RfH is the same in patients with and without diabetes. Diabetic patients with refractory hypertension have a more unfavorable metabolic profile and greater impairment of endothelial function than patients with uncontrolled resistant hypertension.

Introduction. The use of bariatric surgery as a treatment for obesity has increased dramatically over the past few years. Because the results in obese patients with type 2 diabetes were so impressive, the International Diabetes Federation recommended considering bariatric surgery as an acceptable treatment option in patients with a BMI of 30-35 kg / m2 when diabetes cannot be adequately controlled with traditional therapies. The aim of the study is to compare the results of bariatric surgery in patients with metabolic syndrome according to the dynamics of body mass index and major orexigenic and anorexigenic hormones. Material and Methods. The results of surgical treatment of 19 patients with morbid obesity (5 men and 14 women) aged 44 ± 3.26 years with a body mass index ˃40 kg / m2 were evaluated. The control group consisted of 12 patients with normal body mass index and no manifestations of metabolic syndrome. Results. Our study also demonstrated the positive effect of LGAE on hormonal parameters with a decrease in ghrelin and leptin. This helped reduce BMI by 10.12% after 6 months. At the same time there is an increase in adiponectin and resistin. Conclusions. LGAE in patients with ghrelin-associated obesity is possible as an alternative intervention, given its good tolerability. Or, as the first preparatory stage of comprehensive surgical treatment in obese patients who are not good candidates for standard bariatric surgery.

Objective: to investigate the adipokine profile’s changes, depending on the presence or absence the signs of psychoemotional disorders in the form of associated affective symptoms in patients with stable coronary heart disease (CHD) without diagnosed carbohydrate metabolism’s disorders undergoing routine percutaneous coronary intervention (PCI) with stenting, and also to assess their relationship with clinical outcomes within 1 year after hospitalization.Materials and methods: the study included 20 male patients with stable angina pectoris of functional classes II – III, hospitalized for coronary stenting. The severity of affective symptoms were being assessed. The levels markers of adiponectin, leptin, resistin in the blood plasma were determined before PCI and on the 3rd day after the operation.Results: patients with stable coronary artery disease had increase in resistin concentrations and a decrease in adiponectin levels compared with reference. The change of psychoemotional status was accompanied by an initially more expressed increase in the concentrations of plasma resistin. The resistin’s level has been signifi cantly increased on the third day after PCI in patients without depressive symptoms. The dynamics of depressive symptoms hasn’t observed during the year. Clinically unfavorable outcomes, including stent’s restenosis, re-hospitalization, and the increase in angina attacks, were recorded more oft en in patients with subclinical symptoms of depression that persisted throughout the observation period.Conclusions: the factors that negatively aff ected the cardiac prognosis were the disorders of the psychoemotional status and adipokine’s changes, including аn increasе of resistin’s and a decrease of adiponectin’s levels.

One of the factors negatively affecting the cardiac prognosis of coronary heart disease (CHD) is affective disorders of the depressive spectrum. Symptoms of depression may increase the level of systemic inflammation and promote disorders of carbohydrate metabolism by altering the synthesis and secretion of adipokines: leptin, resistin, adiponectin. The aim of this study was to assess the adipokin status in patients with stable coronary artery disease in the conditions of conservative therapy and during percutaneous coronary interventions (PCI) with stenting, including patients with depressive symptoms. The presence of depressive symptoms was accompanied by an increase in the level of resistin in the blood plasma in patients with stable ischemic heart disease. PCI with coronary artery stenting resulted in an increase in the concentration of all the adipokines: adiponectin, leptin, resistin. Stenting of coronary arteries in people with depressive symptoms led to an increase in the level of resistin, adiponectin with a decrease in the concentration of leptin in the blood plasma on the third day after the operative intervention.

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Adipose tissue is an active endocrine organ secreting a number of hormones – adipokines. One of them is resistin, which is produced not only by adipocytes, but also by monocytes, macrophages, cardiomyocytes. Since the beginning of its discovery in 2001 the effect of this adipokine on insulin resistance has been studied. However, later his role in the initiation of inflammatory reactions, activation of the endothelium, proliferation of smooth muscle cells of the blood vessels have been researched, and therefore resistin began to be considered as a possible marker of cardiovascular pathology. This review article presents data on resistin in terms of its effect on the development and progress of cardiovascular diseases.

Recently more and more attention of researchers is paid to determining of adiponectin and resistin role in the development, progression and outcomes of chronic heart failure (CHF) with overweight and obesity, given the continuing increase in the incidence of both pathologies. Purpose – to examine the contents of adiponectin and resistin in serum and their ratio in patients with CHF in overweight and obesity depending on severity of disease, body mass index, age, gender and contractile myocardial ability. Materials and Methods. We examined 100 patients of the main group who had CHF of II–III functional class (FC) on the background of normal, overweight and obesity I–III degree. The comparison group included 12 patients with cardiac pathology and normal weight without clinical and instrumental signs of CHF, matched by age and gender. The control group consisted of 12 healthy subjects with normal weight. The presence of normal, overweight and degree of obesity was calculated based on the body mass index (BMI). The level of adiponectin and resistin in the blood serum was determined with ELISA method. Results. In patients with CHF, overweight and obesity the content of adiponectin and resistin in serum is increased and depends on FC of disease and age. Increasing degree of overweight and reducing the myocardium contractile ability are characterized by higher levels of resistin. The resistin/adiponectin ratio in patients with CHF, overweight and obesity increases with increasing BMI, in relation to the adiponectin/resistin ratio opposite changes occur. Conclusions. In CHF patients with concomitant overweight and obesity is an excessive activation of adipocytokines system, which is manifested by increase in the content of adiponectin, resistin, resistin/adiponectin ratio and a reduction of adiponectin/resistin index.

Adipose tissue as an endocrine organ synthesizes a large number of biologically active substances, adipocytokines, which have both local and systemic effects influencing the vascular wall, tissue sensitivity to insulin, glucose metabolism, and systemic inflammation. The data obtained from clinical and experimental studies demonstrate the close relationship between the imbalance of adipocytokines and pregnancy complications such as insulin resistance, gestational diabetes, and preeclampsia. In this connection, close attention of obstetrician-gynecologists and endocrinologists is focused on etiopathogenic aspects of the formation of gestational complications with metabolic disorders caused by an imbalance of adipocytokines with maternal obesity and to the search for markers of these disorders. The review presents the current literature data on adipose tissue hormones and their influence on the course of a gestational process.

Objective: to investigate the interrelationships between adiponectin and resistin levels with the components of metabolic syndrome in patients with coronary heart disease and concomitant nonalcoholic fatty liver disease. Methods. Cross-cohort analytical study involved 46 patients, the primarily selected group consisted of 24 patients, mean age 58 y (44.64) with documented coronary artery disease, stable exertional angina of II–III functional class combined with NAFLD; comparison selected group: 20 patients, mean age was 60.5 y (50.5; 65) with coronary artery disease without NAFLD. The control selected group consisted of 12 healthy individuals. Results: a significant increase in the value of BMI by 13 % (p

Aim. To investigate the relationship of the ovarian reserve to the levels of adipokines and sex hormones in reproductive-aged women with abdominal obesity. Subjects and methods. A total of 157 women aged 18 to 45 years with a body mass index (BMI) of more than 30 kg/m2 were examined (a study group). A control group consisted of 93 women aged 18—45 years with a BMI of less than 25 kg/m2. Anthropometric and carbohydrate and lipid metabolic parameters and the levels of sex hormones, anti-Müllerian hormone, resistin, and adiponectin were investigated. Results. The mean age of the participants with a BMI of more than 30 kg/m2 was 33.1±6.1 years and that of those with a BMI of less than 25—30 kg/m2 was 32.8±6.2 years. No statistically significant differences were found in age, ethnicity, and marital status between the participants of both groups; however, there was a statistically significant difference in education levels — 76.3% of the women with a BMI of less than 25 kg/m2 (p

Aim. To study the impact of type 2 diabetes and its combination with gout on the level of adipokines, hormonal and metabolic parameters.Materials and methods. The study included 18 men with type 2 diabetes with a mean age 57,83 ± 1,67 years, and 21 subjects with a combination of type 2 diabetes and gout, whose average age was 57,57 ± 1,44 years. The controls were 40 healthy men: 20 subjects with an average age of 21,03 ± 0,15 years and 20 men with average age 51,31 ± 1,34 years. All patients had anthropometric measurements, evaluation of parameters of lipid and carbohydrate metabolism, uric acid, levels of adiponectin, leptin and resistin.Results. Patients of both groups had elevated concentrations of leptin, resistin and reduced level of adiponectin. Men with type 2 diabetes, and its combination with gout had increased levels of total cholesterol, triglycerides, glucose and insulin.Conclusion. In patients with type 2 diabetes, and its combination with gout are characterized by hyperleptinemia, hypererresistinemia, hypooadiponectinemia. Insulin resistance with compensatory hyperinsulinemia and atherogenic dyslipidemia was found in all patient groups.

Aim. To investigate the relationship between resistin, adiponectin, leptin, and hormonal and metabolic parameters in patients with type 2 diabetes mellitus (T2DM) and in those with its concurrence with asthma. Subjects and methods. Twenty-seven patients with T2DM and 26 patients with T2DM concurrent with asthma were examined. The examination data of 23 apparently healthy women served as a control. Anthropometric measurements, carbohydrate and lipid metabolic parameters, and leptin, resistin, adiponectin, interleukin (IL)-6 and IL-10 levels were studied. Results. Hyperleptinemia, hyperresistinemia, and lower adiponectin concentrations were found in the patients with T2DM and in those with its concurrence with asthma. These changes in the patients from these groups occurred in the presence of subclinical inflammation. Obvious insulin resistance (IR) accompanied by compensatory hyperinsulinemia was identified in the examined women. The detected atherogenic dyslipidemia appeared as increases in the levels of total cholesterol (C), triglycerides, low-density lipoprotein C, and atherogenic index and as a decrease in those of high-density lipoprotein C. The women with the concurrence of the diseases showed a positive correlation of the level of resistin with insulin and the HOMA index. Conclusion. The patients with T2DM and those with its concurrence with asthma exhibited obvious IR accompanied by compensatory hyperinsulinemia. Hyperresistinemia plays a role in the development of IR in the concurrence of these diseases. The patients with T2DM and those with its concurrence with asthma were found to have hyperleptinemia, hyperresistinemia, and a trend for decreasing adiponectin values in the presence of subclinical inflammation.

Aim. To evaluate the association of serum resistin with morphological and functional indices of hypertrophic myocardium in patients with type 2 diabetes and chronic heart failure (CHF) with preserved left ventricular ejection fraction.Material and methods. Patients (n=60; 12 men and 48 women) with type 2 diabetes and ischemic heart disease and CHF class II-III (NYHA) were included into the study. Clinical, laboratory and instrumental examinations, as well as determination of serum resistin were performed in all patients.Results. Positive correlation was found between serum resistin level and left ventricle end-diastolic pressure (LV EDP; r=0.43; p=0.02) in patients with concentric left ventricular hypertrophy (LVH). Negative correlation was found between serum resistin level and LV EDP (r=-0.61; p=0.000) in patients with eccentric LVH. A number of supraventricular extrasystoles positively correlated with the serum resistin level (r=0.34; p=0.033) in patients with concentric LVH.Conclusion. The role of "physiological" levels of resistin in the formation of cardiovascular indicators of the hypertrophic myocardium as well as possible prognostic significance of different levels of resistin for optimization of therapy are shown in patients with type 2 diabetes with CHF.

The purpose of this research is to examine resistin levels in blood serum and frequency of the main components of metabolic syndrome among oilmen working in shifts in Western Siberia. The research design is cross-sectional study. The research object is 125 men working in the oil industry in Western Siberia at the age of 30–45 (mean age is 35.3±3.5). Examination methods are anthropometry, measurement of blood pressure, electrocardiogram and determination of total cholesterol, glucose and resistin in blood plasma. Statistical data processing was performed using the Statistica 8.0 software package. 73.6 % of the examined men had certain components of metabolic syndrome: abdominal obesity (32.8 %), hypertension (23.2 %), hypercholesterolemia (59.2 %). The combination of these features was observed in 52.17 % of cases. 43.2 % of oilmen had overweight, 36.0 % – high normal blood pressure. Resistin concentrations in plasma fluctuated within 2.75–25.52 ng/ml (mean value is 4.85 ± 2.06 ng/ml). Evaluating an extent of interrelation on the Cheddock scale, statistically significant p < 0.05 dependence of resistin concentration in plasma and blood pressure level was revealed: in case of systolic blood pressure the dependence was reverse and noticeable; it is direct and high in the event of diastolic blood pressure. Association with BMI was direct and noticeable.

Study objective: to study the adipokines content and echocardiography indicators of women with hypothyroidism.Materials and methods. 30 women with hypothyroidism were included into the study with the average age of 55.2 ± 2.2 years old and the duration of disease of 8.53 ± 0.84 years. Anthropometric parameters of all patients were measured. Levels of leptin, resistin, adiponectin were investigated with enzyme multiplied immunoassay. Morphometric parameters of the left ventricle (LV) were assessed with echocardiography.Results. The examined patients with hypothyroidism displayed increased concentration of leptin and resistin, as well as decreased concentration of adiponectin. Concentric and eccentric hypertrophy of the left ventricle is revealed in more than half of cases with patients with the hypofunction of the thyroid gland.Conclusion. Evident decreasing of the level of adiponektin and increasing of the level of leptin and resistin was revealed with examined patients on the background of the excessive body weight. Hypertrophy of the left ventricle and diastolic dysfunction of the myocard with its relatively preserved contractile ability was revealed with women that suffer from hypothyroidism. Age, excessive body weight, increasing of arterial blood pressure, and hypoadiponectinemia play a significant role in the left ventricle myocardial remodeling.

Cardiovascular disease (CVD) in type 1 diabetes mellitus (T1DM) is preceded by asymptomatic changes in the geometry of the heart. The only symptoms of the beginning of cardiac remodeling and concomitant predictors of an unfavorable cardiovascular prognosis are: thickening of epicardial fat (EAT), secreting a number of adipokines, and cardiospecific miRNAs. To improve the effectiveness of prevention of CVD in young patients with DM1, a search was made for structural-functional and epigenetic markers., Aim: To assess the state of the cardiovascular system according to MRI-heart with T1 mapping in T1DM without CVD. To reveal the relationship of epigenetic markers (circulating miR-126-5p, miR-21-5p) and adipokines with cardiovascular system in T1DM. Suggested personalized approach to patients with T1DM with initial manifestations of joint remodeling and/or exclusion of cardiospecific microRNA., Materials and Methods: The study included 40 patients: 30 with T1DM (age 26.2±7.4 years), 10 without T1DM (26.4±8.2). The patients underwent a general clinical examination, bioimpedancemetry, electrocardiography, MRI of the heart with T1 mapping, determination of adiponectin, resistin, visfatin, NT-proBNP, miR-126-5p, miR-21-5p., Results: Patients with T1DM had lower levels of cardioprotective miR-126-5p ( p= 0.046). According to MRI of the heart in T1DM, signs of vascular remodeling were revealed - thickening of the interventricular septum ( p= 0.001), posterior wall ( p= 0.012) and relative size of the walls ( p= 0.048) of the left ventricle, an increase in EAT density ( p= 0.001). Diffuse vascular fibrosis was found in 16% of patients from the T1DM group. Also, in T1DM, the expression of visfatin is increased ( p= 0.036) and adiponectin is reduced ( p= 0.043)., Conclusion: Structural and functional changes in the cardiovascular system (including thickening of the EAT), shifts in miR-126-5p expression and adipokines profile are observed already at a young age in patients with T1DM. In T1DM, diffuse vascular fibrosis is detected in 16% of patients. The data obtained were used to identify the group increased risk of developing CVD in T1DM and served as the basis for determining the timing of the start of preventive therapy.

Forty-four patients with allergic (ABA) and non-allergic (NABA) variants of bronchial asthma (BA) were examined to evaluate levels of key adipokines (leptin, resistin, adiponectin) in sputum in different variants of BA. Adipokines in sputum and blood plasma were measured by Enzyme-Linked Immunosorbent Assay (ELISA). The indices that reflect the percentage of adipokines in sputum regarding adipokines in plasma of the same patients were worked out to evaluate the ratio of levels of corresponding adipokines in plasma and sputum in patients with BA. Two regularities are clearly seen in the study: the first - levels of proinflammatory adipokines (leptin, resistin) in sputum in ABA correlate directly with indicators of respiratory function but levels of anti-inflammatory adipokines (adiponectin) in sputum correlate inversely with indicators of respiratory function; the second -correlation of levels of the studied adipokines with indicators of respiratory function are almost not revealed in NABA. The first regularity reflects the important fact that the content of adipokines in bronchial secretion is to a certain extent one of regulating local mechanisms in target organ controlled system levels of corresponding adipokines in exacerbation of BA.

This article presents the results of a survey of 40 women with physiological pregnancy cesarean delivery at the age of 21-40 years and 12 non-pregnant women. The level of content of adiponectin, resistin, insulin and glucose levels in the blood plasma by ELISA. Calculated BMI and HOMA-IR. The study found that multiparous women develop more severe insulin resistance, characterized by increasing levels of insulin, glucose, HOMA-IR compared with nulliparous. However, pregnancy is characterized by physiological changes in endocrine activity of adipose tissue, expressed in decreased level of adiponectin and resistin concentration is increased.

Obesity in pregnancy is a risk factor for complications for both the mother and of the fetus. Adipose tissue hormones (leptin, adiponectin, resistin) are secreted by the human placenta and regulate the function of trophoblast.The review presents data from the literature on the role of adipocytokines in the development of gestational diabetes and preeclampsia in obesity women. The article considers the criteria and algorithms for the diagnosis of gestational diabetes recommended by the World Health Organization and the International Association of research groups for diabetes and pregnancy.

Purpose: To investigate levels of adipokines and indicators of carbohydrate metabolism in the blood of women with a true threat of pregnancy termination (isthmico-cervical insufficiency). Materials and Methods: The study involved women in the period of 16 – 26 weeks of gestation – 18 women with a true threat of termination of pregnancy and 52 women with physiological pregnancy. Both groups were compared with levels of leptin, resistin, adiponectin, fasting glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). Results: In the blood of women with a real threat of pregnancy termination are revealed significant changes in carbohydrate metabolism – the increase in levels of fasting insulin and glucose, and also increase the value of the index of insulin resistance HOMA-IR (p

69 young men with obesity manifesting at puberty have been examined. The average age was 19,22±0,26. 17 healthy young men, whose average age was 22 ± 0,72 years old, constituted a control group. The examined were divided according to their blood pressure (BP): the first subgroup included 36 young men with normal blood pressure, the other subgroup included 33 young men with arterial hypertension. Levels of blood lipid spectrum, levels of leptin, resistin, adiponectin, insulin in serum, urinary metanephrine excretion were measured. We obtained the following results: young men with obesity identified atherogenic changes in lipid metabolism, insulin resistance and compensatory hyperinsulinemia. Regardless of the level of blood pressure they showed a significant increase in leptin levels. In the subgroup of patients with hypertension we found increased urinary excretion of metanephrine, indicating increased activity of the sympathoadrenal system and its involvement in the formation of hypertension. The level of adiponectin in the surveyed tended to decrease, more pronounced in the combination of obesity and hypertension.

The aim of the present research was to study the influence of lipid tissue hormones on the mechanisms of insulin resistance development and rates of lipid metabolism in patients with subclinical hypothyroidism (SH) aged over 50 years, depending on the body mass index (BMI), as well as the presence or absence of the levothyroxin (L-T4) replacement therapy. In patients with SH there were revealed disturbances of lipid metabolism which were manifested by low concentration of HDL-C, as well as the reduction in insulin sensitivity (an increase in the insulin level in normoglycemia and elevation of HOMA-IR rates). The analyses of lipid tissue hormones levels in studied groups showed an increase in adiponectin level within the reference values range, but they significantly differed from those of the controls. The values of leptin and resistin in the studied groups did not show significant difference from those of the healthy persons of the corresponding age, sex, and BMI. A correlation analysis of the values of lipid tissue hormones, TSH, lipid spectrum, insulin, glucose, and HOMA-IR was carried out. The results obtained were analyzed by two main points: the replacement therapy and BMI. The analyses of the results in accordance with BMI revealed that in patients with the normal body mass (BMI24.9 kg/m2) the adiponectin rate was higher against the background of the lipid metabolism disturbance. In patients with the excessive body mass (BMI25–29.9 kg/m2) the values of insulin and HOMA-IR increased, the disturbance of lipid metabolism aggravated, and adiponectin concentration decreased. The L-T4 replacement therapy was effective and resulted in the normalization of the rates of lipid and carbohydrate metabolism, adiponectin, and leptin. However the comparison of the results obtained in the groups with compensated and noncompensated SH shows that after 6 months significant differences were revealed only in the levels of adiponectin, resistin, and insulin.

The basis of type 2 diabetes is obesity and insulin resistance. Fat tissue is hormonaly active system which produces adiponectin, resistin and other adipokines. These substances participate in development of insulin resistance. The article presents the results of a study conducted to examine the role of adiponectin, resistin in development of insulin resistance in patients with IGT and type 2 diabetes. The reduction of adiponectin level and insulin resistance was found in women suffering from IGF or type 2 diabetes and in men with only type 2 diabetes. Resistin levels were increased in the examined patients with IGT and with type 2 diabetes.

In recent decades, overweight and obesity have become a major problem for most countries. According to the World Health Organization (WHO), more than a billion people worldwide are overweight and more than 300 million are obese. These clinical and experimental studies highlight a clear relationship between obesity and several chronic diseases such as type 2 diabetes mellitus (T2DM), atherosclerosis, coronary heart disease, high risk of oncological diseases, disorders of the reproductive sphere, pathology of the musculoskeletal system, as well as deviations in mental status and processes of social adaptation. Therefore, considerable efforts of modern endocrinology focused on the study of etiopathogenetic aspects that underlie these diseases and identification of possible markers.

AIM. To investigate the relationship of resistin, adiponectin, leptin, and hormone metabolic parameters in patients with hypothyroidism. MATERIALS AND METHODS. Ninety-three women aged 58.0 (53.0-63.0) years with hypothyroidism were examined. A control group consisted of 10 women aged 48 (47-50) years. Anthropometric characteristics, glucose and lipid metabolic parameters, and leptin, resistin, adiponectin levels were studied. RESULTS. The patients with hypothyroidism were found to have statistically significantly enhanced insulin resistance (IR) and compensatory hyperinsulinemia in the presence of android fat distribution. The found atherogenic dyslipidemia manifested itself as an increase in the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and atherogenic index and as a reduction in high-density lipoprotein cholesterol. The concentration of leptin and resistin was increased and that of adiponectin was reduced in the patients with hypothyroidism. There was a correlation of leptin and adiponectin with fat metabolic parameters. CONCLUSION. The women with hypothyroidism had enhanced IR, as well as compensatory hyperinsulinemia in the presence of android fat distribution. Hypothyroidism is accompanied by the development of atherogenic dyslipidemia. The concentration of leptin and resistin was elevated and that of adiponectin was reduced in the examinees.

The review presents a recent data from the literature on the physiologic and pathophysiologic role of adipose tissue hormones (adiponectin, resistin, leptin). The article details the role of adipocytokines in atherogenesis. It also presents the results of studies depicting the relationship between subclinical hypothyroidism, lipid metabolism and insulin resistance as well as the impact of thyroid dysfunction upon the secretion of adipocytokines.

Aim. To examine continuous positive airway pressure (CPAP) therapy effects on carbohydrate and lipid metabolism in patients with metabolic syndrome (MS) and obstructive sleep apnea syndrome (OSAS). Material and methods. The study involved 62 MS patients: 20 females and 42 males, aged 39-66 years (mean age 52.4±7.6 years). Control group included 15 patients without OSAS, another 47 had OSAS of varying severity (main group). CPAP therapy was administered to 11 OSAS patients for 12 weeks. At baseline and 12 weeks later, height, body weight (BW), waist and hips circumference (WC, HC) were measured, with body mass index calculation (BMI); levels of total cholesterol (TCH), high-density lipoprotein (HDL) CH, triglycerides (TG), glucose, leptin, resistin, adiponectin were assessed; glucose tolerance test and 24-hour blood pressure (BP) monitoring were performed. Results. BW, BMI, WC, WC/HC, TCH decrease wasn’t statistically significant. HDL CH level increased from 0.99±0.2 to 1.12±0.1 mmol/l (р

Early screening of complications of diabetes mellitus (DM) is one of the priorities for public health. Most patients with type 1 diabetes mellitus (T1DM) are patients of working age. New strategies for the primary prevention of cardiovascular disease (CVD) are needed to prevent their early disability., Aim: To assess the predictive value of adipokines in relation to a personalized approach to the need for an in-depth examination of young patients with T1DM., Materials and Methods: The study included 98 patients without CVD: 70 patients with T1DM (mean age 26.4±8.1 years) and 28 patients without DM (mean age 27±9 years). All patients underwent a general clinical examination, the levels of adipokines were determined, ergospirometry, echocardiography, and bioimpedancemetry were performed., Results: Changes in the cardiorespiratory system in patients with T1DM were revealed, in comparison with persons without T1DM: anaerobic threshold was reached faster ( p =0.001), maximum oxygen consumption was lower ( p =0.048), metabolic equivalent was reduced ( p =0.0001). Signs of myocardial remodeling were found in the T1DM group: there was an increase in the relative wall thickness ( p =0.001), the posterior wall of the left ventricle ( p =0.001), myocardial mass index ( p =0.049), in comparison with persons without T1DM. Changes in the adipokines system were revealed: higher levels of resistin ( p =0.002) and visfatin ( p =0.001), lower level of adiponectin ( p =0.040) in T1DM. A positive correlation was found between posterior wall of the left ventricle and visfatin ( p =0.014) and a negative relationship between adiponectin and relative wall thickness ( p =0.018) in T1DM., Conclusion: In T1DM, even at a young age, there are multifactorial changes in the heart, which can be detected even at the preclinical stage. The data obtained can be used to identify groups of patients at high risk of developing dangerous CVD in T1DM, which can form the basis for determining the timing of the start of preventive therapy.

Aim: To study interconnections between epicardial adipose tissue thickness (EATt), parameters of glucose metabolism/insulin, C-reactive protein (hsCRP), serum adipokines and severity of coronary artery disease (CAD) depending on the presence of diabetes mellitus type 2 (DM 2); to determine significant markers of CAD severity in patients with DM 2., Materials and Methods: The study involved 106 patients with CAD (m/f 64/42, 60.96.8 years), including patients with DM 2 (group 1, n=35) and non-diabetic patients (group 2, n=71). Severity of CAD was evaluated according to angiography data with calculation of Gensini Score (GS). EATt was assessed via echocardiography. Serum levels of glucose/insulin metabolism parameters, lipid fractions, hsCRP and adipokines were evaluated. Clinical parameters, including GS, did not differ between groups., Results: EAT thickness median was elevated in gr.1 (5.1 mm vs. 4.4 mm in group 2), while adiponectin levels were decreased (6.55 g/ml vs. 7.71 g/ml). Linear regression of body mass index and resistin levels on EATt was revealed in gr.1; in gr.2 EATt linearly increased with waist circumference increment when EATt6 mm. Linear regression of EATt on GS was revealed in gr.1 when EATt8 mm, while linear regression in the whole GS range was obtained for HDL-C and hsCRP levels., Conclusion: Study results demonstrate differences in mechanisms of deposition and functioning of epicardial and abdominal adipose tissue depending on the presence or absence of diabetic status. Patients with DM2 are characterized by the excessive EAT deposition and decrease of serum adiponectin levels compared to non-diabetic patients in the equal conditions. Independent markers of CAD severity in DM 2 are decreased HDL-C and increased hsCRP levels, but not EATt.

Aim: To evaluate the cardiovascular risk (CVR) based on arterial stiffness and content of adipokines in young-aged persons of different ethnicity (European and South Asian)., Materials and Methods: 290 persons of European (Slavic) and South Asian (Korean) ethnicity aged from 19 to 49 years with and without arterial hypertension (AH) were examined. Clinical, anthropometric, laboratory examinations were performed, levels of resistin and adiponectin of blood were assessed. Total CVR was assessed by SCORE scale, patients under the age of 40 years were assessed by relative risk scale. Aortic stiffness was examined by non-invasive arteriography., Results: Patients of European ethnicity had higher blood pressure (BP), body mass index (BMI), waist circumference (WC), levels of resistin and adiponectin. Pulse wave velocity in the aorta (PWVA) did not differ significantly in ethnic groups. According to the SCORE scale in individuals of the European and South Asian races in general groups and groups with arterial hypertension a moderate absolute risk was determined, in individuals under 40 years of age a moderate relative risk was determined without a significant difference between the groups. However increased levels of PWVA (more than 10 m/s) were registered more often in Korean ethnicity (46.9% compared to Slavic ethnicity, 22.2%). Closer reliable correlations between the level of BP and BMI, WC, PWVA were revealed in Korean ethnicity. Ethnic differences in correlation of adipokines in blood and their dependence on anthropometric and hemodynamic characteristics were described., Conclusion: The assessment of CVR according to traditional scales does not always accurately represent its real level. New information was obtained on the features of adipokine metabolism and its connections with early manifestations of vascular remodeling in young-aged depending on the race. Taking into account ethnic differences, we recommend in-depth diagnostics of CVR in South Asians. The data can be useful for the design of personalized programs for the diagnostics and assessment of CVR.

Aim: To determine the prevalence of refractory hypertension (RfH) in patients with and without type 2 diabetes mellitus (DM), as well as to evaluate whether diabetic patients with RfH significant differ from those with uncontrolled resistant hypertension (RH) in clinical phenotype, metabolic profile and endothelial function., Materials and Methods: The study included 193 patients with RH: RH 74 patients with diabetes and 119 patients without DM. Uncontrolled RH and RfH were defined by the presence of uncontrolled blood pressure BP (140 and/or 90 mm Hg) despite the use of 3 but 5 antihypertensive drugs (for RH) and 5 antihypertensive drugs, including a mineralocorticoid receptor antagonist (for RfH). Clinical examination, lab tests were performed. Flow-mediated dilation (FMD) and vasoreactivity of middle cerebral artery (MCA) using both breath-holding and hyperventilation test were measured by high-resolution ultrasound., Results: The prevalence of refractory hypertension in patients with and without DM was similar (30% vs 28%, respectively). No differences in BP levels, data of echocardiography and clinical phenotype were found between the diabetic groups, but value of HOMA index, plasma resistin level and postprandial glycaemia were higher in patients with RfH. FMD and MCA reactivity to the breath-holding test were worse in patients with RfH, and they had a more pronounced vasoconstrictor response of MCA to the hyperventilation test compared to patients with RH., Conclusion: The prevalence of RfH is the same in patients with and without diabetes. Diabetic patients with refractory hypertension have a more unfavorable metabolic profile and greater impairment of endothelial function than patients with uncontrolled resistant hypertension.

In recent years, the independent role of adipose tissue in the pathogenesis of obesity and related complications has been actively discussed. Adipose tissue is also a key factor in the development and progression of insulin resistance. Among adipokines secreted by adipose tissue and influencing the development of insulin resistance and metabolic disorders, the most studied are leptin, adiponectin, resistin, visfatin. These adipokines are dedicated to this review.

Recent information concerning the white fat tissue allows considering it as endocrine system involved in the neuro-immune-endocrine interactions in regulating various aspects of homeostasis. The contribution presented sums up the latest evidence of adipocyte secreting hormones (leptine and resistine), cytokine (TNF alpha), as well as shedlight on mechanisms, involved in control of energy metabolism, immune reactions and food intake monitoring.