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The aim of the study was to examine of endothelial dysfunction markers in patients with dyscirculatory encephalopathy I–II stages. Material and methods. The study included 30 patients with dyscirculatory encephalopathy I–II stages. All the examinees underwent detection of endothelin-1, desquamated circulating endothelial cells and endothelial NO synthase levels in the blood, reflected endothelial damage. Results of investigation of 21 practically healthy people served as control. Results. Reliable increasing of endothelial dysfunction markers were detected at initial stage of dyscirculatory encephalopathy, aggravated with the progress of disease.

В многочисленных эпидемиологических исследованиях выявлена связь между ожирением и смертностью от сердечно-сосудистых, цереброваскулярных болезней и диабета. В последнее время к факторам риска относят абдоминальное распределение подкожного жира, которое четко коррелирует с интолерантностью к глюкозе при оральной пробе с глюкозой, выявляя инсулинорезистентность, а также с дислипопротеинемиями. Обнаруженная зависимость между высокими степенями суммарного коронарного риска и уровнем сагиттального диаметра позволяет предположить, что этот антропометрический параметр может выступать значимым индикатором предрасположенности к метаболическим изменениям, ассоциированными с риском болезней системы кровообращения. Выявленная выраженная взаимосвязь между сагиттальным диаметром и вероятностью возникновения инфаркта миокарда на ближайшие 10 лет, свидетельствует о необходимости проведения скрининг-обследований населения по выявлению лиц с абдоминальным распределением жира по этому показателю с целью осуществления направленной первичной профилактики. Определение аналогичной выраженной взаимосвязи у лиц с верифицированным диагнозом болезней системы кровообращения представляется полезным для назначения эффективных мероприятий вторичной профилактики. Ключевые слова: факторы риска, абдоминальное ожирение, сагиттальный диаметр, сердечно-сосудистые заболевания, коронарный риск

According to modern views, the key component in atherosclerosis pathogenesis is endothelial dysfunction (ED), manifesting in dysbalance between main endothelial functions: vasodilatation and vasoconstriction, proliferation inhibition and promotion, antithrombotic and prothrombotic, antioxidant and prooxidant functions. Endothelial effects are mediated through vasoactive agents’ release – vasodilatators (NO, prostacyclin, bradykinin) and vasoconstrictors (endothelin, free oxygen radicals, thromboxan A2 , angiotensin II). It has been demonstrated that virtually all atherosclerosis risk factors (RF) realize their negative effects via ED. Therefore, endothelial function parameters could be used as early atherosclerosis markers in individuals with atherosclerosis RF, at pre-clinical stage. Pathogenetic therapy, administered early or in already verified atherosclerosis, could improve patients’ prognosis substantially.

The review is devoted to biological role of reactive oxygen forms, generated in various cells of all healthy organisms, and performing, due to their high chemical reactivity and short lifetime, vital function of signal intracellular transduction and intercellular mediation, realizing immediate and delayed adaptation of tissue metabolism, circulatory system included. In excessive amount of these molecules, their moderating function transforms into damaging oxidation and destruction of tissue lipids, proteins and nucleic acids. This concept is supported by numerous clinical data on substantial increase in tissue and plasma levels of active oxygen forms and oxidative cellular biopolymer damage products among patients with essential arterial hypertension, atheroscleroisis, coronary heart disease and myocardial infarction. The leading pathogenetic role is played by local and/or systemic hyperproduction of superoxide and hydroxide radicals, hydroperoxide, NO, peroxinitrite and other active oxygen forms.

According to the WHO, there are 2 bilUon of obese people worldwide. Obesity prevalence is increasing in developed countries, and also tends to increase in developing regions. Some researchers have demonstrated that abdominal obesity (АО), and not general obesity with increased body mass index (MBI), is associated with raised cardiovascular risk. АО is diagnosed by computed tomography and anthropometry: measurement of waist circumference, waist/hips circumference ratio, sagittal abdominal diameter (SAD). SAD is linked to coronary risk and insulin resistance; therefore, is can be used for identifying obese patients with high risk of type 2 diabetes mellitus and coronary heart disease.