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Determining the leptin level in patients with abdominal obesity without signs of insulin resistance is necessary for stratifying patients into groups with normal (metabolically neutral obesity) and increased adipokine activity. Objective — To compare the prevalence of metabolic disorders and signs of cardiovascular remodeling in young and middle-aged men with "metabolically healthy" and "metabolically neutral" obesity. Material and methods — observational sample survey of 590 men aged 38.5±5.6 years was conducted. Average body weight was assessed on301 men (the control group). Obesity was determined in 289 patients: among them, the criteria for metabolic syndrome were diagnosed for 134 study participants, metabolically healthy obesity (MHO) was diagnosed in 155 men, and 86 patients from MHO with leptin levels 30 kg/m2 in the presence of no more than two criteria for metabolic syndrome and leptin level

The last decades of the late 20th and early 21st centuries have seen a rapid growth of non-infectious diseases such as abdominal obesity, prehypertension, hypertension, diabetes mellitus type 2. According to official data, preobesity is diagnosed in 40.1% of the adult population of Russia; 21.6% of Russians are obese; and only 36.3% of our fellow citizens have normal body weight. The combination of obesity, hypertension, diabetes mellitus type 2 and atherogenic dyslipidemia are the criteria for metabolic syndrome a proven risk factor for progression and complicated course of cardiovascular disease. The scientific community is actively discussing about the appropriateness of singling out a group of patients with metabolically healthy obesity and criteria for its diagnosis, but the hormonal activity of adipose tissue is not evaluated. Leptin is involved in the metabolism of glucose and fatty acids, and leptinresistance is an important prognostic marker of the complicated obesity. On the based of our own scientific data results, the concept of metabolically neutral obesity - obesity with normal adipokines activity (leptin concentration 3.5 ng/ml) without signs of insulinresistance was formulated and proposed. It was shown that in this metabolic type of obesity the prevalence of dyslipidemia was 1.7 times, prediabetes 2 times, atherosclerosis of common carotid arteries 1.5 times lower than in metabolically healthy obesity. Determining the level of leptin in uncomplicated obesity allows stratifying patients into groups with normal and increased adipokines activity. The highlighting of the metabolically neutral type of obesity is considered by us to be practically justified, as it allows to determine the stage of the disease at which the frequency of metabolic and cardiovascular disorders is still minimal and non-drug prevention is necessary. Exceeding the threshold of leptin level 3.5 ng/ml in obesity may require a more aggressive lifestyle correction, and possibly an early start to drug therapy.

The article presents up-to-date information about diagnostic methods for one of the most common and socially significant hepatological diseases-alcoholic liver disease. The most frequent clinical manifestations of this pathology are asthenic, dyspeptic, right hypochondrium, cholestatic, neurological, edematous-ascitic and hemorrhagic syndromes. Validated questionnaires are intended for standardized alcohol use screening, the «gold standard» among which is the «AUDIT» questionnaire aimed at identifying alcohol use disorders. Most of the physical signs of chronic alcohol abuse are presented in the modified LeGo grid. Direct indicators (markers) of laboratory diagnosis of alcohol use include the determination of phosphatidyl ethanol and ethyl glucuronide in blood serum and urine; ethyl glucuronide and fatty acid ethyl esters in hair; ethanol, aminotransferase, peroxidase, ethylglucuronide, ethyl sulfate, haptoglobin, etc., in saliva. Indirect markers include macrocytic anemia, neutrophilic leukocytosis, increased activity of gamma-glutamyl transpeptidase, transaminases, de Ritis coefficient, bilirubin, alkaline phosphatase, serum immunoglobulin A and gamma globulins. Determination of carbohydrate-deficient transferrin is recommended as a preferred marker of alcohol intoxication. In order to determine the degree of fibrosis, predictive diagnostic serum tests are used, both non-proprietary («APRI», «Forns») and commercial («Fibrometer», «Hepascore», «Fibrospect» etc.). The methods of visual diagnostics of liver diseases include ultrasound, magnetic resonance and computed tomography, which can determine steatosis, exclude other causes of liver damage, reveal signs of severe fibrosis or cirrhosis, as well as their complications, but none of them allows to establish the etiology of the lesion. A promising direction is to determine the degree of steatosis when measuring the controlled parameter of ultrasound attenuation, implemented in the «Fibroscan» apparatus. The most accurate methods for diagnosing steatosis today are magnetic resonance imaging of the liver in the mode of determining the proportion of fat, weighted by proton density, and proton magnetic resonance spectroscopy. To determine the degree of fibrosis, a transient, two-dimensional shear wave and magnetic resonance elastography are used. Biopsy followed by morphological examination is the «gold standard» for the diagnosis of alcoholic liver disease, which confirms the presence of liver damage, establishes its stage and often allows confirming alcoholic genesis. However, this procedure has a number of significant drawbacks, so it is advisable to use non-invasive diagnostic techniques for screening, primary examination and further monitoring of the patient’s condition in dynamics.