[Lipid, adipokine and ghrelin concentrations in myocardial infarction patients with insulin resistance].

AIM: The estimate insulin resistance in myocardial infarction. PATIENTS AND METHODS: The study involved 200 patients with myocardial infarction, in which on the 1st and 12th day of hospitalization measured glucose, insulin, insulin resistance index (IR), lipid profile, the concentration of adipokines and ghrelin. RESULTS: IR was detected in 77% of patients and was associated with a history of factors of cardiovascular risk, adverse clinical course of the disease, lipid disorders. The most important marker was the level of free fatty acids. High risk associated with increased in 9 times the concentration of free fatty acids in blood plasma. Patients with IR observed increased concentrations of leptin, resistin, and reduced the protective effect of adiponectin. The high specificity and sensitivity characteristic of the concentration of ghrelin: its reduction by 4 times in the acute phase of myocardial infarction increases the risk of MI by 78%. CONCLUSIONS: Significant risk factors for MI myocardial infarction, along with insulinemia and glycemia, is to increase the concentration of free fatty acids and the disbalance in the system adipokines against deficiency of ghrelin in acute and early recovery periods of the disease. Free fatty acids and ghrelin are promising markers to stratify the risk of insulin myocardial infarction. resistance in patients with myocardial infarction.

[Spousal concordance of blood pressure levels (results of 17-year follow-up)].

Study aim was investigation of blood pressure levels (BP) in spouses and assessment of the role of arterial hypertension (AH) in a spouse as risk factor (RF) of AH in a 17-years prospective study. Primary study based on a random sample of citizens of Tomsk (1546 men and women aged 20-59 years) was carried out in 1988-1991. At repeat study which was carried out in 2002-2005 we obtained data on AH and end points from 81.2% of initial population. Cohort family study comprised 427 family couples. Relative risk (RR) of AH development in men in case of AH of a female spouse was 1.63 (95% confidence interval [CI] 1.14 to 2.33). RR of AH development in a women in this situation was 1.5 (95%CI 1.13 to 1.99). Husbands AH was associated with 5.2% elevation of systolic BP (SBP) (<0.001), 4.8% elevation of diastolic BP (DBP) (=0.001) in his wife. AH of a wife was associated with 5.5% elevation of SBP (<0.001) and 5% elevation of DBP (=0.003) in a husband. Coefficient of correlation (r) of SBP levels between spouses was 0.09 in age group 20-39 years (=0.041) and 0.16 in age group 40-59 years (=0.002). For DBP in age group 20-39 years r=0.14 (=0.002), in age group 40-59 years r=0.10 (=0.042). In a prospective study in men and women we found higher SBP when AH was detected in a spouse during follow-up compared with individuals whose BP had been and remained normal (by 5.4%, =0.015) or those whose BP during this period decreased to normal level (by 17.5%; =0.006). Detection of new cases of AH in men - spouses of women with AH was higher than in man - cohabitants of wives without AH (53.8 and 37.3%, respectively, =0.028). Thus we found concordance of BP levels in spouses, which was conditioned by marital assortment as well as common environment and way of life.