NESFATIN-1 ACTIVITY IN THE BLOOD SERUM IN PATIENTS WITH CHRONIC HEART FAILURE OF ISCHEMIC ORIGIN AGAINST THE BACKGROUND OF TYPE 2 DIABETES MELLITUS AND OBESITY.

OBJECTIVE: The aim: To study the nesfatin-1 activity in the blood serum of patients with chronic heart failure (CHF) of ischemic origin against the background of such metabolic disorders as type 2 diabetes mellitus (T2DM) and obesity. PATIENTS AND METHODS: Materials and methods: 154 patients with CHF were examined, and divided into 4 groups, according to the presence of metabolic disorders. Group 1 included patients with CHF on the background of coronary heart disease (CHD) and T2DM and obesity (n=42). The second group consisted of patients with heart failure on the background of CHD with concomitant T2DM (n=46), the third group - with concomitant obesity (n=36), the fourth group was formed from patients with signs of heart failure of ischemic origin without metabolic disorders (n=30). The control group (CG) included 30 practically healthy persons of comparable age. RESULTS: Results: The mean level of serum nesfatin-1 was 1.64±0.27 ng/mL in the СHF group, 0.342±0.19 ng/mL in the CHF + T2DM + obesity group, 1.06±0.36 ng/ mL in the obese + CHF group, 0.96±0.27 ng/mL in the CHF + T2DM group and 2.98±0.38 ng/mL in the CG. Significant correlation was found between the serum nesfatin-1 level and BMI (r=-0.34, p<0.05), HOMA (r=-0.54, p<0.05), insulin (r=-0.41, p<0.05). No significant correlation was found between the serum nesfatin-1 level and blood glucose level (r=0.13, p=0.65). CONCLUSION: Conclusions: Thus, nesfatin-1 may play a significant role in the pathogenesis of both weight-related abnormalities and type 2 diabetes mellitus in patients with chronic heart failure of ischemic origin.

ESTIMATION OF PREDICTORS AND DEVELOPMENT OF PROGNOSTIC MODEL FOR COMORBID COURSE OF DIABETES MELLITUS AND ISCHEMIC HEART DISEASE.

OBJECTIVE: The aim: To determine predictors and develop the model of prognosis of comorbidity of ischemic heart disease and type 2 diabetes mellitus. PATIENTS AND METHODS: Materials and methods: 126 patients were involved in the study and divided into three groups. Main group involved 70 patients with comorbid T2DM and IHD; comparison group included 36 IHD-only patients; 20 patients were included into control group. RESULTS: Results: Predictors of comorbid T2DM and IHD included titin (OR = 0.001 [95.0 % CI 0.001-0.105], р = 0.021); I and II grade hypertension (respectively OR = 28.993 [95.0 % CІ 1.595-526.940], р = 0.023 and OR = 19.050 [95.0 % CІ 1.078-336.620], р = 0.044); left ventricle hypertrophy (OR = 3.169 [95.0 % CІ 1.103-3.108], р = 0.032); very low density cholesterol level (OR = 49.032 [95.0 % CІ 4.155-578.644], р = 0.022); and stenocardia symptoms in significant physical load (OR = 6.199 [95.0 % CІ 1.129-34.039], р = 0.036). CONCLUSION: Conclusions: developed model can be used in prediction of comorbid course of T2DM in patients with IHD for early diagnosis of cardiovascular complications in such patients.