[Ghrelin Physiology and Pathophysiology: Focus on the Cardiovascular System].

Ghrelin is a multifunctional peptide hormone, mainly synthesized by P / D1 cells of the stomach fundus mucosa. Its basic effect, which is realized via GHS-R1 α receptor in the arcuate and the ventromedial nucleuses of hypothalamus, is stimulation of the synthesis of pituitary hormones. Ghrelin is involved in control of appetite and energy balance, regulation of carbohydrate and lipid metabolism, cell proliferation and apoptosis, as well as modulation of functioning of gastrointestinal, cardiovascular, pulmonary and immune systems. It was found that cardiomyocytes are able to synthesize ghrelin. High concentrations of GHS-R1α in the heart and major blood vessels evidence for its possible participation in functioning of cardiovascular system. Ghrelin inhibits apoptosis of cardiomyocytes and endothelial cells, and improves the functioning of the left ventricle (LV) after injury of ischemia-reperfusion mechanism. In rats with heart failure (HF) ghrelin improves LV function and attenuates development of cardiac cachexia. In addition, ghrelin exerts vasodilatory effects in humans, improves cardiac function and reduces peripheral vascular resistance in patients with chronic HF. The review contains of the predictive value of ghrelin in the development and prevention of cardiovascular disease.

[The perspectives of application of retinol-binding protein as a biomarker of risk of cardiovascular pathology.]

The fatty tissue is an endocrine organ secreting biologically active factors called adipokines that have systemic and local features. The adipokines play an important role in development of complications caused by obesity. nowadays, retinol-binding protein 4 (RBP4), one of adipokines identified recently, is considered as a connecting link between obesity and its complications. Adipokine participates in development of resistance to insulin and correlated with cardio-metabolic markers at chronic inflammatory diseases, including diabetes mellitus type II, metabolic syndrome and cardio-vascular diseases. It is considered that inflammation, produced by RBP4, induces resistance to insulin and cardio-vascular diseases. It seems that RBP4 is an adipokine that both induces resistance to insulin and participates in pathogenesis of other metabolic complications of obesity. This is confirmed by a tight relationship between RBP4 and atherogenic lipoproteins, atherosclerotic affection of vessels and cardio-vascular diseases. However, an important restriction in certain studies related to RBP4 is that they included patients who received medicinal therapy (sugar lowering and hypo-lipidemic pharmaceuticals) or had renal and hepatic insufficiency. The mentioned factors impact concentration of RBP4 in blood and hence can distort the results. In spite of that, the established potential metabolic role of RBP4 requires a further investigation. Besides further carefully planned studies are required focusing on establishing is RBP4 a molecular participator of molecular alterations or it is only a dynamically volatile "witness". The present review summarizes actual knowledge concerning the role of RBP4 under obesity, in development of dyslipidemia, insulin resistance and cardio-vascular diseases. The purpose of the study is to summarize data of studying of inflammatory and immune effects of RBP4 especially in case of cardio-vascular diseases and also establishment of perspective of applying retinol-binding protein as a potential biomarker of cardiovascular risk.

[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.

[The detection of leptin and metabolic markers of insulin resistance in patients with myocardial infarction].

The shortage of data concerning the character of changes of leptin concentration and its role information of insulin resistance under development of acute coronary events determined the appropriateness of the present study. The cardiac infarction patients with and without diabetes type II were examined. The identified hyperleptinemia, its relationship with basal and post-prandial hyperglycemia and with increase of C-peptide concentration and free fatty acids made possible to consider leptin both as one of the important components in the series of carbohydrate and lipid metabolism disorders and the additional marker of development of insulin resistance under cardiac infarction. These study results can be applied to patients with diabetes anamnesis and to patients without this concomitant pathology. The study results can be used as a foundation for new diagnostic and therapy tactics of metabolic disorders correction in patients with acute coronary vascular pathology.

[The detection of oxidation-modified lipoproteins and their antibodies in case of complicated course of myocardial infarction with segment ST boost].

According contemporary conceptions, the key role in the development of atherosclerosis play the low density oxidative modified lipoproteins and its antibodies. The purpose of the study was to discover the characteristics of changes in lipid metabolism indicators, including the low density oxidative modified lipoproteins and their antibodies. The factors of oxidative status in patients with cardiac infarction with complicated and non-complicated course were considered. It is established that the development of cardiac infarction is followed the increase of concentration of low density oxidative modified lipoproteins and their antibodies both during the first day after acute pain syndrome and stabilization period. The evaluation of content of low density oxidative modified lipoproteins and their antibodies broaden the possibilities of diagnostics, prognosis and decrease of risk of development both acute and recurrent coronary events.

[Lipid peroxidation in terminal and extreme conditions]. / Lipoperoksidatsionnyi status pri terminal'nykh i ékstremal'nykh sostoianiiakh.

It was demonstrated in experiments with cats, who survived a 5-minute clinical death caused by a prolongated blood loss, that the determination of lipid-peroxidation dynamic indices, made in incubated homogenates, reveals the altering ratios between the pro- and anti-oxidant activities as well as those ratios leveled by rapid shifts in hemodynamic parameters; it also displays the quantitative, qualitative and temporal differences of such ratios in the brain, liver and kidneys at dying and immediately after reanimation, which can not be detected by determining the content of lipid-peroxidation products in tissues in vivo.